视觉噪声双视力表研制及其在弱视诊断的应用  

Design and application of visual noise dual acuity chart for amblyopia diagnosis

作　　者：肖信[1] 刘伟民[1] 黄建忠[1] 王英[1] 

机构地区：[1]广西壮族自治区人民医院视光科广西视光中心,南宁530021

出　　处：《中国实用眼科杂志》2015年第3期259-262,共4页Chinese Journal of Practical Ophthalmology

基　　金：广西壮族自治区科学研究与技术开发计划项目（桂科回9920018）;广西卫生厅重点课题（桂卫重2012099）

摘　　要：目的研制一种新型视觉噪声双视力表并评估其在弱视诊断中的应用。方法临床诊断试验研究。对2012年2月至2013年2月在广西壮族自治区人民医院视光科应用传统“E”字型对数视力表的基础上，按照Weber．Fechner法则加入白噪声设计出新型噪声双视力表。选取弱视儿童40例（80只眼）和年龄匹配的视力正常儿童40名（80只眼），接受新型视觉噪声双视力表和标准对数视力表检测。采用Pearson相关分析评价新视力表与标准对数视力表的相关性，采用ROC受试者工作曲线分析该视力表行弱视诊断的灵敏度和特异度。结果弱视儿童组与正常儿童组的无噪声视力表与标准对数视力表检测结果相关性强（弱视组：r=-0．885，P〈0．01；正常组：r=0．357，P〈0．01）。两种视力表间存在直线回归关系（Y无噪声视力（弱视组）=9．344～8．210XlogMAR和Y无噪声视力（正常组）=9．237．2．458XlogMAR）。弱视儿童和正常对照儿童有与无噪声视力差值比较差异有统计学意义（t=12．645，P〈0．01）。ROC曲线分析显示，有与无噪声视力差值为0．92行时，约登指数达到最大（76．3％），灵敏度和特异度为95．0％和81．3％。有与无噪声视力差值为0行、1行、2行的弱视诊断灵敏度分别为97．5％，85．0％和45．0％，特异度分别为53．8％，83．8％和100％。结论新视觉噪声双视力表与标准对数视力表相关性好，诊断弱视具有灵敏度高、特异性好、正确率高等优点，为临床弱视诊断提供了一种实用工具。Objective To develop and validate a new visual noise dual acuity chart for amblyo pia diagnosis. Methods This study was a clinical diagnostic tests. According to the WeberFechner rule, a new noise visual acuity chart was developed by adding the white noise into ＂E＂ letter logarithmic visual acuity chart. Forty amblyopic children and 40 agematched normal children were recruited and the visual acuity was assessed using the new visual noise visual acuity chart and standard logarithmic visual acuity chart sequentially. Correlation between new acuity chart and standard logarithmic visual acuity chart was testified using Pearson correlation analysis, and the sensitivity and specificity of new acuity chart for amblyopia diagnosis were analyzed using ROC curve. Re sults The new chart without noise was significantly correlated with standard logarithmic visual acuity chart in both group （amblyopic group： r =-0.885, P 〈0.01; normal group： r =-0.357, P 〈0.01）. The linear regression equation were Ywithout noise （amblyopic group）=9.344-8.210XlogMAR and Ywithout noise （normal group）=9.237-2.458XlogMAR （P 〈0.05）. There was statistical differences in the differences of visual acuity with or without visual noise between amblyopic group and normal group （t =12.645, P 〈0.01）. ROC curve analysis revealed that when the differences of visual acuity with or without visual noise was 0.92 line, the Youden index reach the peak value （76.3%） and thesensitivity and specificity were 95.0% and 81.3% respectively. When the differences of visual acuity with or without visual noise was 0, 1 and 2 lines, the sensitivity were 97.5%, 85.0% and 45.0% and the specificity were 53.8%, 83.8% and 100% respectively. Conclusions A new visual noise dual acu- ity chart with high sensitivity, specificity and accuracy is developed, which is significantly correlated with standard logarithmic visual acuity chart and can be applied for clinical amblyopia diagnosis.

关 键 词：视觉噪声双视力表 弱视 标准对数视力表 诊断 

分 类 号：R778.2[医药卫生—眼科]