Purpose: To compare grating acuity of children 1 to 3 years old with albinism with that of age-matched normal children, and to determine whether ocular pigment and macular structure are predictive of grating visual acuity. Methods: In this retrospective cross-sectional review of 64 children with albinism, binocular grating acuity was measured with Teller acuity cards at 1, 2, or 3 years of age. Iris transillumination and macular transparency were graded according to published scales. The presence or absence of macular melanin pigment and a rudimentary foveal reflex were assessed with direct and indirect ophthalmoscopy, respectively. Results: Mean grating acuities of the children with albinism at ages 1 (2.48 cycles (cy)/°), 2 (3.62 cy/°), and 3 (5.87 cy/°) were 2.3, 2.1, and 1.7 octaves lower than published norms (all with P < .001). The studied variables did not correlate with visual acuity except for macular transparency at age 2 (r = 0.40; P = .030). Conclusions: Grating acuity can be used to assess the reduction in visual function in albinism in the first 3 years of life. However, grading of iris transillumination and macular transparency and recognition of an annular reflex or macular melanin do not consistently correlate with the development of vision measured by grating acuity.
Bibliographical noteFunding Information:
Supported by an unrestricted grant from Research to Prevent Blindness, Inc, New York, New York; a grant (AR44649) from the National Institutes of Health; and funding from the Bernard and Mary Ellen Black family.