3种远视力检查方法在儿童中的应用比较

Comparative application of three methods for testing distance visual acuity among children

目的了解3种远视力检查方法在儿童中的应用差异,为制定统一的儿童远视力检查提供参考。方法选取2022年8月15—25日在安徽省某儿童医院眼科就诊的98名4~16岁儿童,分别应用2014年中国学生体质与健康研究(V1)、2019年中国学生体质与健康调研(V2)以及《中小学生屈光不正筛查规范(WS/T 663—2020)》(V3)规定的远视力检查方法进行视力测定,采用配对样本McNemar检验和Wilcoxon检验配对比较3种方法的视力不良检出率和检查结果组间差异。结果98名受检儿童分别按照V1、V2和V3方法检查的结果显示,右眼视力M(P25,P75)分别为4.8(4.6,5.0)、4.8(4.7,5.0)和4.8(4.7,5.0),左眼视力分别为4.8(4.6,5.0)、4.9(4.7,5.0)和4.9(4.7,5.0)。右眼视力不良检出率分别为63.3%,58.2%,58.2%,左眼视力不良检出率分别为58.2%,54.1%,53.1%。McNemar检验结果显示,V1与V2、V1与V3和V2与V3左、右眼视力不良检出率差异均无统计学意义(左眼:χ^(2)值分别为2.25,2.29,0.00,右眼:χ^(2)值分别为3.20,3.20,0.00,P值均>0.05)。Wilcoxon检验结果显示,左眼和右眼V1与V2、V1与V3的视力检查结果组间差异有统计学意义(左眼:Z值分别为-4.15,-4.60;右眼:Z值分别为-4.70,-4.99,P值均<0.01)。结论无论起始视标从4.0还是5.0行开始,视标通过标准不同对视力结果都有影响。现行远视力检查方法建议统一标准。

Objective To understand the dfferences in the application of three distant vision examination methods in children,so as to provide a reference for developing a unified distant vision examination for this population.Methods The study involved 98 children aged 4 to 16 years who visited the ophthalmology department of a children's hospital in Anhui Province between August 15 and 25,2022.Vision was measured using the distant vision test method specified in the 2014 National Student Physical Fitness and Health Survey(V1),the 2019 National Student Physical Fitness and Health Survey(V2),and Specification for Screening of Re-fractive Error in Primary and Secondary School Students(WS/T 663-2020)(V3).The paired-samples McNemar's test and Wilcox-on test were performed to compare the detection rate of poor vision and the difference between the visual acuity test results of the three methods.Results The results of the 98 children examined according to V1,V2,and V3 showed that the M(P2s,Prs)of the right eye were 4.8(4.6,5.0),4.8(4.7,5.0),and 4.8(4.7,5.0)while the left eye visual acuity M(P25,Prs)were 4.8(4.6,5.0),4.9(4.7,5.0),and 4.9(4.7,5.0),respectively.The rates of poor visual acuity detection for the right eye were 63.3%,58.2%and 58.2%for V1,V2,and V3,respectively,while for the left eye,they were 58.2%,54.1%and 53.1%,respectively.McNemar test results showed that there were no statistically significant differences in the rates of poor visual acuity detection between the right and left eyes for V1 vs.V2,V1 vs.V3,and V2 vs.V3(left eyes:χ^(2)=2.25,2.29,0.00,right eyes:χ^(2)=3.20,3.20,0.00,P>0.05).Wilc-oxon test results indicated that there were statistically significant differences between the right and left eye visual acuity groups for V1 vs.V2 and V1 vs.V3(left eyes:Z=-4.15,-4.60,right eyes:Z=-4.70,-4.99,P<0.01).Conclusion Irrespective of whether the starting visual standard starts at row 4.0 or 5.0,different standards of visual standard passage have an impact on the vis-ual acuity results.It is recommended that existing methods of screening for distance vision are standardized.