The effect of response biases on resolution thresholds of Sloan letters in central and paracentral vision

Sloan letters are one of the most commonly used optotypes in clinical practice. Sloan letters have different relative legibility which could be due to three factors: perceivability, response bias, and similarity. Similarities between Sloan letters are known to be the major source of errors in threshold determination. However, little is known about the effect of response biases on the resolution thresholds. The aim of the present study was to investigate the effect of response bias and similarity on resolution thresholds of Sloan letters in central and paracentral vision.
Eight subjects with normal ocular health participated in this study. Using the method of constant stimuli, we measured resolution thresholds for the Sloan letters set at 0° (central) and ± 3° eccentricity along the vertical meridian of the visual field. We calculated thresholds from data pooled across the 10 Sloan letters (pooled threshold). For further analysis we also calculated thresholds for each of the 10 Sloan letters (individual threshold). Response biases and letter similarities were determined using Luce's choice model.
Results showed statistically significant differences between the mean individual thresholds of Sloan letters at the central and the upper visual field, but not at the lower visual field. For equally-sized letters at pooled threshold, unlike letter similarity, response biases showed statistically significant correlations to the differences in individual thresholds at the central, upper and lower visual field locations. For equally legible letters at individual thresholds, response biases and similarities showed no significant correlations to the differences in individual thresholds at the central, the upper and the lower visual field locations.
These results suggest that, for equally-sized letters at pooled threshold, the response biases may lead to an underestimation of the pooled threshold, i.e. an overestimation of visual acuity measurements when using Sloan letters.