Prager T C, Zou Y L, Jensen C L, Fraley J K, Anderson R E, Heird W C
Department of Ophthalmology and Visual Science, University of Texas Health Science Center, Houston, USA.
J AAPOS. 1999 Oct;3(5):275-82. doi: 10.1016/s1091-8531(99)70023-6.
Commonly used behavioral and electrical testing methods for estimation of visual acuity and visual function in infants yield different estimates and may not accurately predict visual acuity and visual function in later life. Moreover, neither test-retest variability nor side-by-side comparisons of the various methods have been thoroughly evaluated in the same infant population. The purpose of this study was to provide such an evaluation.
The test-retest variability of visual acuity and visual function was evaluated for the Teller Acuity Card (TAC) procedure, sweep visual evoked potential (VEP), as well as latency and amplitude measured by transient pattern VEP. Groups of approximately 20 infants contributed test-retest data. Visual function estimated by the various methods in a larger group of infants (n = 118) was compared. Correlations between methods and the validity of the various methods to detect maturational changes between 4 and 8 months of age were also assessed. Administration of these tests was according to standard and usual procedures.
The average percent difference between test and retest estimates of acuity as well as the SD was lowest for transient VEP latency (3%, 7% SD). The other methods were markedly more variable: sweep VEP (2%, 22% SD), TAC procedure (8%, 20% SD), and transient VEP amplitude (7.5%, 39% SD). Average coefficients of variation showed a similar trend: transient VEP latency, 8%; sweep VEP, 15%; TACs, 30%; and transient amplitude, 53%. Correlations among estimates by the methods were poor, but expected changes in visual maturation from 4 to 8 months of age were detected with all methods.
All methods evaluated provide valid and reliable test-retest data for a group, but are less valid for estimating visual acuity and visual function of an individual subject. The poor correlations between any 2 of the testing methods suggest that each test assesses a different aspect of vision. Nonetheless, expected maturational changes between 4 and 8 months of age were readily detectable by all methods evaluated.
用于评估婴儿视力和视觉功能的常用行为和电测试方法会得出不同的评估结果,且可能无法准确预测其日后的视力和视觉功能。此外,在同一婴儿群体中,尚未对各种方法的重测变异性以及并排比较进行全面评估。本研究的目的是提供这样一种评估。
对泰勒视力卡(TAC)程序、扫描视觉诱发电位(VEP)以及通过瞬态图形VEP测量的潜伏期和振幅进行视力和视觉功能的重测变异性评估。约20名婴儿组成的小组提供了重测数据。比较了在更大一组婴儿(n = 118)中通过各种方法估计的视觉功能。还评估了各种方法之间的相关性以及各种方法检测4至8个月龄成熟变化的有效性。这些测试的实施遵循标准和常规程序。
瞬态VEP潜伏期的视力重测估计值之间的平均百分比差异以及标准差最低(3%,标准差7%)。其他方法的变异性明显更大:扫描VEP(2%,标准差22%)、TAC程序(8%,标准差20%)和瞬态VEP振幅(7.5%,标准差39%)。平均变异系数显示出类似趋势:瞬态VEP潜伏期为8%;扫描VEP为15%;TAC为30%;瞬态振幅为53%。这些方法的估计值之间的相关性较差,但所有方法都检测到了4至8个月龄时视觉成熟的预期变化。
所有评估方法都为一组受试者提供了有效且可靠的重测数据,但对于估计个体受试者的视力和视觉功能则不太有效。任何两种测试方法之间较差的相关性表明,每种测试评估的是视力的不同方面。尽管如此,所有评估方法都能轻易检测到4至8个月龄时预期的成熟变化。