Objective: To compare the agreement of the ocular modulation transfer function (MTF) measured by double-pass system and ray tracing wavefront aberrometry, and to analyze the correlations of two MTFs with the visual acuity and contrast sensitivity function results.
Methods: Comparative study. Subjects with no ocular diseases were consecutively enrolled in an epidemic study field located at the Dongyangzhuang Health Center, Yongnian County, Handan City, Hebei Province, China. After comprehensive ophthalmic examinations, the mean values of subtracted lower order aberration MTF at 5, 10, 15, 20, 25, and 30 cycle/degree(c/d) spatial frequencies were obtained with a double-pass system (optical quality analysis system II, OQAS II system) and a ray tracing wavefront aberrometer (iTrace visual function analyzer, iTrace system) in the 4.0 mm and 6.0 mm pupil after dilation, respectively. Paired-sample t test and Bland-Altman analysis were used to compare the difference and agreement of MTFs obtained with two instruments. Correlation analysis was preformed between two MTF measurement results and subjective visual quality including visual acuity and contrast sensitivity function.
Results: Two hundred and fifty-one healthy eyes of 163 subjects were enrolled, aged 30 to 60, mean (44.1 ± 9.7) years, including 139 eyes of 81 males and 112 eyes of 82 females. The mean value of MTF at 5, 10, 15, 20.25, 30 c/d obtained by iTrace in 4.0 mm pupil were 0.730 ± 0.138, 0.431 ± 0.159, 0.262 ± 0.120, 0.169 ± 0.078, 0.118 ± 0.053, 0.094 ± 0.043. The value obtained by OQASII were 0.347 ± 0.123, 0.162 ± 0.086, 0.072 ± 0.049, 0.042 ± 0.033, 0.026 ± 0.022, 0.017 ± 0.022, The result of iTrace were all significant higher than OQAS in both 4mm(t = 38.72, 28.03, 27.32, 27.59, 29.23, 28.96, P < 0.01) and 6.0 mm(t = 4.60, 3.19, 9.34, 13.41, 16.96, 20.24, P < 0.01)pupil diameter. The iTrace-OQAS II MTF difference was smaller in the 6.0 mm pupil. Bland-Altman analysis indicated that the agreement of two instruments was poor, while the limits of agreement improved in the 6.0 mm pupil. The iTrace-derived MTFs were negatively correlated with the subjects' LogMAR best corrected visual acuity (r = -0.139--0.165, P < 0.01) and positively with the log value of contrast sensitivity function at 6 c/d (P < 0.05) . OQAS-derived MTFs were negatively correlated with LogMAR best corrected visual acuity (r = 0.239-0.303, P < 0.01) and positively with contrast sensitivity at all spatial frequencies (r = 0.156-0.398, P < 0.01) .
Conclusions: There exists a significant difference and poor agreement in MTF measurement based on the ray tracing wavefront aberrometer and the double-pass system, while the difference becomes smaller in a large pupil diameter. The double-pass system provides a useful tool in clinical optical quality evaluation.