ETDRS对数视力表在儿童视力检查中的可重复性分析

Repeatability of ETDRS Visual Acuity Measurement in Children

目的:探讨ETDRS对数视力表对儿童视力检查的可重复性及其影响的相关因素。方法:在流行病学调查的过程中,随机使用ETDRS对数视力表,为250位裸眼视力低于0.5和98位视力正常儿童进行裸眼视力重复检查。结果:两次视力测量之间差异的均数为0.004log±0.07;Kappa分析结果具有很好的一致性(k=0.71);性别与视力检查一致性无明显相关(P=0.845);年龄与视力检查一致性有显著相关性(P=0.019),年龄越小视力检查一致性越差;屈光不正与视力检查一致性也有显著相关性(P=0.000),近视度数在-1.00D～-5.00D之间的儿童视力检查一致性相对差,而正视眼的视力检查一致性较好。结论:结果提示ETDRS对数视力表适合儿童视力检查,建议推广使用。

Purpose： To evaluate repeatability of the ETDRS log MAR visual acuity measurement in children and the relative influence factors. Methods： The children （n = 348） with visual acuity less than 0.5 （equal to 0.3 log unit） in either eye, or one tenth in children with normal visual acuity were chosen to do repeatable uncorrected VA measurement with Bland-Ahman analysis and Kappa analysis using ETDRS acuity chart. Results. The mean difference of visual acuity was 0.004log±0.07. There was a significant repeatability （k = 0,71 ） between two visual acuity examination. There were significant consistent results both on male and female patients （P = 0.845）. A significant relationship was found between age and VA repeatability（P= 0.019）. The VA repeatability could also be influenced by refractive error （P= 0.000）. The acuity measurement in children with emmetropia （k =0.82） had a higher repeatability than in the children with myopia （k = 0.66）. Conclusions： The ETDRS visual acuity chart can provide a repeatable measure of visual acuity in children. It is recommended for clinic examination of children. Eye Science 2008; 24： 48-52.