使用远像光屏进行阅读学习的临床价值

The clinical value of using a distant-image screen for reading and learning

目的探讨使用远像光屏进行阅读学习的效果与舒适性。方法前瞻性交叉试验。于2021年7月通过首都医科大学附属北京同仁医院招募成年受试者39人,男性16人,女性23人,年龄(26.4±4.5)岁。按区组随机方法决定先用印刷品阅读(19人)和先用远像光屏阅读(20人),先后阅读打印在纸张上(印刷品)的和显示在远像光屏上的数字校正表,之间休息2 h。记录阅读速度、阅读效率及阅读正确率,记录每次阅读前后的视力(最小分辨角的对数)、屈光度数、闪光融合频率(CFF)、视疲劳评分、立体式锐度等的变化值。定量资料的比较采用配对t检验。结果受试者阅读印刷品的阅读速度、阅读正确率、阅读效率分别为(41.2±11.6)组/min、80.7%±13.3%和(32.4±7.4)组/min,阅读远像光屏的阅读速度、阅读正确率、阅读效率分别为(41.7±11.1)组/min、76.4%±12.6%和(31.1±6.4)组/min,阅读速度(t=-0.462,P=0.648)和阅读效率(t=1.954,P=0.058)的差异无统计学意义,阅读正确率的差异有统计学意义(t=2.226,P=0.032)。受试者在阅读印刷品后右眼和左眼视力分别下降0.014±0.032、0.013±0.050,而阅读远像光屏后分别提高0.007±0.033、0.007±0.036,差异均有统计学意义(右眼t=2.592,P=0.013;左眼t=2.154,P=0.038)。阅读印刷品后右眼、左眼近视度数分别增加(0.07±0.29)和(0.06±0.24)D,阅读远像光后则分别增加(0.01±0.29)和(0.02±0.28)D;阅读印刷品后CFF降低(0.1±1.0)Hz,阅读远像光屏后增加(0.3±1.2)Hz;阅读印刷品和远像光屏后视疲劳主观量表评分均增加;但两者比较差异均无统计学意义(均P>0.05)。结论使用远像光屏进行阅读不影响阅读效率或额外增加视疲劳的程度,能够避免近距离阅读印刷品引起的视力的下降。

Objective To investigate the effect and comfort of using a distant-image screen for reading and learning.Methods It was a prospective cross-over study.Thirty-nine volunteers,including 13 males and 26 females,aged(26.4±4.5)years(20 to 37 years),were recruited from Beijing Tongren Hospital Affiliated to Capital Medical University in July 2021.The volunteers read the digital correction table printed on paper and displayed on a distant-image screen in a random order and rest in an interval of 2 hours.Reading speed,efficiency and accuracy of using the two devices were recorded,and the changes of logMAR vision,diopter,flicker fusion frequency and visual fatigue score after reading were calculated.Comparison of the quantitative data was performed using the paired t-test.Results The speed,accuracy and efficiency were(41.2±11.6)digit groups/min,80.7%±13.3%and(32.4±7.4)digit groups/min in reading on paper,(41.7±11.1)digit groups/min,76.4%±12.6%and(31.1±6.4)digit groups/min in reading from screen,respectively.There was no significant difference in reading speed(t=-0.462,P=0.648)and reading efficiency(t=1.954,P=0.058),but there was significant difference in reading accuracy(t=2.226,P=0.032).The logMAR visual acuity of right eye and left eye decreased by 0.014±0.032 and 0.013±0.050 after reading on paper,but increased by 0.007±0.033 and 0.007±0.036 after reading from screen,respectively.The difference was significant(right eye,t=2.592,P=0.013;left eye,t=2.154,P=0.038).The myopia degree of right eye and left eye increased by(0.07±0.29)D and(0.06±0.24)D after reading on paper,and increased by(0.01±0.29)D and(0.02±0.28)D after reading from screen,respectively.The flicker fusion frequency decreased by(0.1±1.0)Hz after reading on paper,but increased by(0.3±1.2)Hz after reading from screen.There was no significant difference(P>0.05).The subjective scale score of visual fatigue increased in both groups,with no statistically significant difference(t=1.165,P=0.251).Conclusion The use of a distant-image screen for reading and learning does not affect the reading efficiency or increase the visual fatigue,and can avoid the decline of visual acuity caused by near viewing compared with using the printed matter.