基于移动终端的视力智能检查和管理系统的研发及临床应用价值评估

Development and clinical evaluation of intelligent vision examination and management system based on mobile terminal

目的研发基于移动终端的视力智能检查和管理系统,并评估其实际临床应用效果。方法采用诊断试验研究方法,纳入2020年3月—5月在中山大学中山眼科中心就诊的儿童和青少年50例100眼,年龄3~14岁,平均(8.16±4.58)岁。使用JAVA及xcode11框架研发适用于Android及IOS平台的基于移动终端的视力智能检查和管理系统,采用实时测距、语音识别、手势识别等智能技术实现视力检查过程中的实时交互。所有受试者均接受双眼裸眼传统E字表视力检查和基于移动终端智能视力检查,2种方法配合眼数差异比较采用χ2检验,2种方法测定的LogMAR视力结果差异比较和一致性分析分别采用Wilcoxon符号秩检验和Kappa检验。结果成功研发适用于Android及IOS平台的基于移动终端的视力智能检查和管理系统,可检测的视力范围为0.1~1.5,视标大小和分辨率均达到视力检查表的国家标准,实现了3 m距离下准确的视力检查、智能交互、结果输出和自动建档功能。传统检查法和智能检查法测量配合眼数比例分别为99.0%(99/100)和98.0%(98/100),二者比较差异无统计学意义(χ2=0.338,P=0.561)。传统检查法和智能检查法测定的LogMAR视力分别为0.3(0.2,0.5)和0.3(0.2,0.5),二者比较差异无统计学意义(Z=-1.602,P=0.109),2种检测方法测定LogMAR视力的一致性较好(Kappa系数=0.885)。结论基于移动终端的视力智能检查和管理系统测定视力具有较好的准确性和可行性,可有效满足用户随时随地自测视力的需求,并可同步建立视觉健康档案,实现对视力情况的长期跟踪,在个性化眼健康管理新模式的发展中具有很好的应用价值。

Objective To develop an intelligent vision examination and management system based on mobile terminal,and evaluate its practical application.Methods A diagnostic test study was adopted.Fifty children and adolescents(100 eyes)aged from 3 to 14 years,with an average age of(8.16±4.58)years,were enrolled in Zhongshan Ophthalmic Center from March to May,2020.An intelligent vision examination and management system for Android and IOS devices,which applied technologies of real-time range measurement,speech recognition,and gesture recognition to achieve the real-time interaction in the vision examination,was developed using JAVA language and xcode11.The uncorrected visual acuity of subjects was tested with the intelligent vision system and the standard eye chart in hospital.The difference in the number of cooperative eyes between the two methods was analyzed byχ2 test.The LogMAR acuity of the two methods were compared by Wilcoxon rank sum test and the consistency between the two methods was analyzed by Kappa test.The study adhered to the Declaration of Helsinki,and the study protocol was approved by an Ethics Committee of Zhongshan Ophthalmic Center(No.2020KYPJ095).Written informed consent was obtained from guardians of each subject prior to any examination.Results The intelligent vision examination and management system was successfully developed for Android and IOS devices,which was loaded with precise vision examination at 3 meters,intelligent interaction,result output and automatic filing functionalities.The inspection range of visual acuity was from 0.1 to 1.5.The size and resolution of eye chart met the national standard.There was no significant difference in the number of cooperative eyes during examination between traditional eye chart(99/100)and intelligent vision examination system(98/100)(χ2=0.338,P=0.561).There was no significant difference in examination results between traditional eye chart 0.3(0.2,0.5)LogMAR and intelligent vision examination system 0.3(0.2,0.5)LogMAR(Z=-1.602,P=0.109),and there was a high consistency between the two methods(Kappa coefficient=0.885).Conclusions The intelligent vision examination and management system based on the mobile terminal is of high accuracy and practicability,which can effectively meet the public demand for at-home vision testing and long-term tracking.The system can be promoted and applied as a new mode for personalized eye health management.