Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2026 08 01 1580 1580 Aditya Bisht MSc. Audiology Student, Department of Audiology and Speech Language Pathology, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat Sanket Bhalerao Department of Audiology and Speech Language Pathology, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, 391760 2026 05 28 2026 07 26 Background and Aim: The Subjective Visual Vertical (SVV) is a reliable clinical measure of an individual's ability to determine whether an object is oriented in the vertical plane, regardless of the presence of a true vertical reference. The study aimed to examine the influence of various background conditions on SVV deviation and response time, compare these outcomes between healthy younger and middle-aged adults and to measure the test-retest reliability of the SVV paradigm. Methods: The SVV test was performed in healthy younger and middle-aged adults. A total of 100 participants were recruited for the study, 50 per group. The SVV test was administered using a standardized videonystagmography instrument (Cyclops Balance-eye device) in static and dynamic (clockwise and counterclockwise) visual background Conditions. The outcome variables, SVV deviation (°) and response time (s), were recorded under each condition. Test-retest reliability was also measured. Results: Significant differences in SVV deviation and response time were observed across the testing conditions. Between-group analysis showed significantly greater SVV deviation under the counterclockwise and static background conditions in middle-aged adults compared with younger adults, whereas response time differed significantly between the groups under the clockwise and counterclockwise conditions. The SVV paradigm demonstrated good test–retest reliability. Conclusion: Dynamic SVV conditions were more sensitive than static conditions in detecting differences in SVV deviation and response time between younger and middle-aged adults, indicating subtle age-related changes in visual–vestibular processing. The SVV paradigm also demonstrated good test–retest reliability, supporting its clinical applicability. https://avr.tums.ac.ir/index.php/avr/article/view/1580 https://avr.tums.ac.ir/index.php/avr/article/download/1580/695