الفهرس 
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Abstract
Visual vertigo (VV) is one of the common symptoms among vestibular
disorder. The Visual Vertigo Analogue Scale (VVAS) is a measurement that
was used to assess intensity of visual vertigo containing nine conditions of
visual stimuli that aggravate dizziness.
This work was done to develop the Arabic version of VVAS and to assess
its reliability and validity. The present study was conducted at audio-vestibular
unit, otolaryngology department, and faculty of medicine - Menoufia University
in the period from January 2018 to April 2019. We developed an Arabic
language version of the VVAS by translation from English and modification to
meet cultural acceptability.
The study included 170 subjects; the control group included100 normal
subjects (51 male, 49 female with age range 19- 63 years), while the cases (30
male, 40 female with age range 18- 65 years) were diagnosed as visual vertigo
patients according to the modified visual vestibular mismatch questionnaire.
The results of this study showed that the VV common in middle age
patients (45.6±11.9 years), female (57% of the patients). There was statistically
significant difference between the study and control groups regarding mean
score of items of the Arabic VVAS (P value < 0.001) using the Wilcoxon-Mann
Whitney test. The mean (± SD) total score of the Arabic VVAS in controls was
10.9±12.1 versus 35.5±16.8 for VV patients.
The internal consistency was used to evaluate the degree to which different
test items produce similar results. The results showed that the Arabic VVAS has
good internal consistency indicating good reliability (Cronbach’s alpha =0.72
for controls and =0.83 for the VV patients).
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Summary
After one week, subgroup of participants who attended the follow-up visit
was requested to fill the Arabic VVAS again. We found that there was a
positive correlation between total sores of the Arabic VVAS in the first and
second visit in the study and control groups, further demonstrating good
repeatability of the Arabic VVAS ( r = 0.97, p value < 0.001). For controls, in
the first visit the total score mean was 10.9 ± 12.1. In the second visit, the total
score mean was 10.6 ± 11.9, Spearman’s correlation (r) = 0.976* for the total
score. For visual vertigo patients, in the first visit the total score mean was 35.5
± 16.8. In the second visit, the total score mean was 34.5 ± 17.1, Spearman’s
correlation (r) = 0.978* for the total score.
The receiver operating characteristic curve was performed to find the
optimal cut-off point for the Arabic VVAS. Sensitivity, specificity, positive
predictive value, negative predictive values, and accuracy were also calculated.
The Arabic VVAS demonstrated the best psychometric properties for a cut off
score of 17 with a sensitivity of 80%, specificity of 82%, area under the curve
of 0.897, a positive predictive value was 76%, a negative predictive value of
85%, and accuracy was 81%.
The results showed that the Arabic VVAS is a reliable and valid screening
tool in diagnosing visually- induced dizziness among the Arabic community.