Development and Validation of a Novel Mobility Test for Rod-Cone Dystrophies: From Reality to Virtual Reality.

PURPOSE: To validate a novel mobility test (MOST, MObility Standardized Test) and performance outcomes in real (RL) and virtual (VR) environments to be used for interventional clinical studies in order to characterize vision impairment in rod-cone dystrophies, also known as retinitis pigmentosa (RP). DESIGN: Prospective, interventional, noninvasive, reliability and validity analysis. METHODS: We designed MOST to be used in both VR and RL and conducted 3 experimental studies with 89 participants to (1) validate the difficulty of the mobility courses (15 controls), (2) determine the optimal number of light levels and training trials (14 participants with RP), and (3) validate the reproducibility (test-retest), reliability (VR/RL), sensitivity, and construct/content validity of the test (30 participants with RP and 30 controls). A comprehensive ophthalmologic examination was performed in all subjects. Outcomes of interest included MOST performance score, visual acuity, contrast sensitivity, dark adaptation thresholds, visual field parameters, and correlation between the performance score and visual function. RESULTS: The mobility courses exhibited statistically similar difficulty, and 5 trials are sufficient to control for the learning effect. MOST is highly reproducible (test-retest correlations >0.98) and reliable (correlations VR/RL = 0.98). MOST achieved a discrimination between participants with RP and controls (accuracy >95%) and between early and late stages of the disease (82.3% accuracy). The performance score is correlated with visual function parameter (0.57-0.94). CONCLUSION: MOST is a validated mobility test, with the controlled learning effect, excellent reproducibility, and high agreement between RL and VR conditions, as well as sensitivity and specificity to measure disease progression and therapeutic benefit in rod-cone dystrophies.

Rewarding objects appear larger but not brighter.

Whether reward can accentuate the perception of visual objects, that is, makes them appear larger than they really are, is a long-standing and controversial question. Here, we revisit this issue with a novel two-alternative forced-choice paradigm combining asymmetric reward schedule and task reversal. In a first experiment, participants (n = 27) choose the larger of two unequally rewarded objects in some sessions and the smaller one in other sessions. Response biases toward the most rewarding object differ significantly between the reversed tasks, revealing an influence of reward on perceived sizes. In a second experiment, participants (n = 27) indicate either the brighter or darker object. In contrast with the first experiment, response biases are similar between those reversed tasks, indicating that the perceived luminance is immune to reward manipulation. Together, these results reveal that if two objects are associated with different amounts of reward, participants will perceive the more rewarded object to be slightly larger, but not brighter, than the less rewarded one.