ETDRS与国际标准视力表在弱视儿童检查中对比研究  

Comparison of international standard and diabetic retinopathy visual acuity chart in amblyopic children

作　　者：李辉[1] 肖满意[2] 

机构地区：[1]昆明市儿童医院眼科,云南650034 [2]中南大学湘雅二医院眼科,长沙410011

出　　处：《中国实用眼科杂志》2014年第1期26-31,共6页Chinese Journal of Practical Ophthalmology

摘　　要：目的比较ETDRS对数视力表与国际标准视力表在弱视儿童检查中的差异及其影响因素。方法两种视力表对照研究。对2008年9月至2009年4月在湘雅二医院眼科就诊的79例（158只眼）弱视儿童按先后顺序随机使用国际标准视力表和ETDRS对数视力表，检查单眼最佳矫正视力，同一个视力表重复2次检查，视力值用logMAR记录方法来表示。使用Bland—Altman方法分析两种视力表的可重复性及一致性。结果ETDRS对数视力表前后两次视力测量具有很高的可重复性，两次测量无差异者为79只眼（50％），视力相差0．1logMAR单位以内者为153只眼（97％），视力相差0．2logMAR以内者为100％。两次检测差异值95％的-致性的界限为（-0．07，0．09）logMAR单位之间。视力检查与年龄有低相关性（，=0．208，P=0．009），与眼别、性别和屈光状态无相关性。ETDRS视力表与国际标准视力表检测视力的-致性不理想，视力相差0．1logMAR单位者为104只眼（66％），视力相差0．2logMAR以内者为142只眼（90％），视力相差超过0．2logMAR单位者为16只眼（10％）。95％-致性界限为（-0．30，0．11）logMAR单位之间。结论ETDRS对数视力表较国际标准视力表的可重复性更高，适合中国弱视儿童的视力检查。ETDRS对数视力表较国际标准视力表检测的视力值要低，原因尚待研究。Objective To compare the two established visual acuity chart of the International Standard （IS） and the Early Treatment of Diabetic Retinopathy Study （ETDRS）. Methods Test-retest reliability study. Visual acuity was measured monocularly on both eyes of 79 amhlyopic patients aged 4 to 10 years from one clinical site. Both IS and ETDRS chart were presented twice in every eye of each patient at random. As the main outcome measure, visual acuity was measured twice. Visual acuity test results were converted to logarithm of minimal angle of resolution （logMAR） units for analysis. Results Test-retest reliability of ETDRS chart was high and for both right and left eyes, 97% of retest scores were within 0.11ogMAR （5 optotypes） and 100% of retest scores were within 0.2 logMAR （10 optotypes）. Reliability was high across on the age range of 4 to 10 years. Based on 95% confidence level estimates, a change in visual acuity of 0.2 logMAR （10 optotypes） from a previous acuity measure was unlikely to result from measurement variability. Test-retest reliability of IS chart was lower, 92% of retest scores were within 0.2 logMAR, 95% confidence level was from-0.21 to 0.19 logMAR. The agreement of IS and ETDRS visual acuity chart was not high. 66% of difference scores were within 0.1 logMAR and 90% within 0.2 logMAR. 95% differ- ence lied between-0.3 and 0.11 logMAR. Conclusions The ETDRS visual acuity chart has high test-retest reliability in Chinese amblyopic children. It suggests that the nonamblyopic, ＂normal＂ eye of amblyopic patients using IS chart behaves abnormally using ETDRS chart.

关 键 词：视力 LogMAR 儿童 可重复性 一致性 

分 类 号：R778.2[医药卫生—眼科]