数字式Mars对比敏感度检查表在国人低视力患者中的应用

The Mars numeral contrast sensitivity test for use in low-vision Chinese patients

目的评估数字式Mars对比敏感度检查表的精确性和准确性，探索其能否应用于中国低视力患者的对比敏感度检查。方法前瞻性对照研究。正常视力者40例，双眼习惯矫正视力≥1．0，排除明显眼部疾病；低视力患者43例．双眼中好眼最佳矫正视力≤0．3。所有被检者在视力矫正的前提下采取单眼测试，检查程序如下：①由第一名检查者从3张数字式Mars对比敏感度检查表中采取抽签法随机抽取一张表格，对被检者进行测试．并记录结果。②由第一名检查者随机用数字式Mars对比敏感度检查表和字母式Mars对比敏感度检查表分别再次测试被检者，分别记录每次的测试结果。③第二名检查者用步骤l中使用的那张数字式Mars对比敏感度检查表对被检者进行测试并记录结果。重复性和再现性通过统计组内标准差（Sw）、精确度（1．96Sw）、组内变异系数（CVw）和组内相关系数（ICC）进行评估；一致性比较采用Pearson线性相关分析、ICC及Bland—Altman分析法综合分析。结果数字式Mars对比敏感度检查表的重复性参数和再现性参数1．96Sw、CVw较小，而1CC值较高，大于0．75。数字式Mars对比敏感度检查表和字母式Mars对比敏感度检查表之间的一致性示两者之间呈高度正相关（r=0．995，P〈0．01）。ICC为0．997，Bland—Ahman分析结果为95％I』0A的范围非常窄，为（-0．053，0．092）logCS，表明2个表之间具有高度的一致性。结论数字式Mars对比敏感度检查表具有较高的准确性和精确性，能够应用于中国低视力患者的对比敏感度检查。

Objective To evaluate the reliability and validity of the Mars numeral contrast sensitivity test and to explore whether it can be used in the examination of contrast sensitivity in low vision patients. Methods This was a prospective comparative study. Eighty-three subjects （83 eyes） were divided into two groups： a normal vision group, 40 young adults without significant eye diseases whose habitual vision was better than 0.8, and a low-vision group, 43 low-vision patients whose better eye＇s visual acuity ranged from 0.05 to 0.3. Subjects were tested with their corrected visual acuity. （~）The first examiner randomly selected three Mars numeral contrast sensitivity charts and recorded the contrast sensitivity scores after testing. ~）Subjects were tested randomly by the first examiner with one of three forms of the Mars numeral contrast sensitivity charts and the Mars letter contrast sensitivity charts. The contrast sensitivity scores were recorded for each test. （~）The second examiner used the same procedure used by the first examiner to test subjects and record contrast sensitivity scores. Repeatability and reproducibility were assessed based on intersession within-subject standard deviations （Sw）, precision （1.96Sw）, coefficient of variation （CVw）, and intraelass correlation coefficient （ICC）. The agreement between the Mars numeral contrast sensitivity test and the Mars letter contrast sensitivity test was evaluated by Pearson correlation analysis, ICC and Bland-Airman analysis. Results Repeatability and reproducibility： the Mars numeral contrast sensitivity test showed excellent repeatability and reproducibility, with a lower 1.96Sw, CVw, and high ICC values （higher than 0.75）. Agreement between the Mars numeral contrast sensitivity test and the Mars letter contrast sensitivity test： there was excellent agreement between the two tests based on a high correlation （r=0.995, P〈0.01）, high ICC （0.997）, and narrow 95% LoA confidence intervals （-0.053,0.092）1ogCS. Conclusion The Mars Numeral Contrast Sensitivity Test can be used for low-vision testing based on its high reliability and validity.