Vistech和FACT对比敏感度图表在白内障及屈光手术疗效研究中的应用价值。
The usefulness of Vistech and FACT contrast sensitivity charts for cataract and refractive surgery outcomes research.
作者信息
Pesudovs K, Hazel C A, Doran R M L, Elliott D B
机构信息
Department of Optometry, University of Bradford, Richmond Road, Bradford BD7 1DP, UK.
出版信息
Br J Ophthalmol. 2004 Jan;88(1):11-6. doi: 10.1136/bjo.88.1.11.
AIM
To investigate the repeatability and sensitivity of two commonly used sine wave patch charts for contrast sensitivity (CS) measurement in cataract and refractive surgery outcomes.
METHODS
The Vistech CS chart and its descendant, the Functional Acuity Contrast Test (FACT), were administered in three experiments: (1) Post-LASIK and age matched normal subjects; (2) Preoperative cataract surgery and age matched normal subjects; (3) Test-retest repeatability data in normal subjects.
RESULTS
Contrast sensitivity was similar between post-LASIK and control groups and between the Vistech and FACT charts. The percentage of subjects one month post-LASIK achieving the maximum score across spatial frequencies (1.5, 3, 6, 12, 18 cycles per degree) were (50, 33, 13, 13, 0 respectively) for FACT, but only (0, 0, 13, 4, 0 respectively) for Vistech. A small number of cataract patients also registered the maximum score on the FACT, but up to 60% did not achieve the minimum score. Test-retest intraclass correlation coefficients varied from 0.28 to 0.64 for Vistech and 0.18 to 0.45 for FACT. Bland-Altman limits of agreement across spatial frequencies were between +/-0.30 and +/-0.85 logCS for Vistech, and +/-0.30 to +/-0.75 logCS for FACT.
DISCUSSION
The Vistech was confirmed as providing poorly repeatable data. The FACT chart, likely because of a smaller step size, showed slightly better retest agreement. However, the reduced range of scores on the chart due to the smaller step size led to ceiling (post-LASIK) and floor (cataract) effects. These problems could mask subtle differences between groups of patients with near normal visual function as found post-refractive or cataract surgery. The Vistech and FACT CS charts are ill suited for refractive or cataract surgery outcomes research.
目的
研究两种常用于测量白内障和屈光手术效果中对比敏感度（CS）的正弦波视力表的重复性和敏感性。
方法
在三个实验中使用了Vistech CS视力表及其衍生版本功能性视力对比测试（FACT）：（1）准分子激光原位角膜磨镶术（LASIK）术后与年龄匹配的正常受试者；（2）白内障手术术前与年龄匹配的正常受试者；（3）正常受试者的重测重复性数据。
结果
LASIK术后组与对照组之间以及Vistech视力表和FACT视力表之间的对比敏感度相似。LASIK术后1个月在所有空间频率（每度1.5、3、6、12、18周）上获得最高分的受试者百分比，FACT视力表分别为（50%、33%、13%、13%、0%），而Vistech视力表仅分别为（0%、0%、13%、4%、0%）。少数白内障患者在FACT视力表上也获得了最高分，但高达60%的患者未达到最低分。Vistech视力表的重测组内相关系数在0.28至0.64之间，FACT视力表的重测组内相关系数在0.18至0.45之间。Vistech视力表在所有空间频率上的布兰德 - 奥特曼一致性界限在±0.30至±0.85 logCS之间，FACT视力表在±0.30至±0.75 logCS之间。
讨论
Vistech视力表被证实提供的数据重复性较差。FACT视力表可能由于步长较小，显示出稍好的重测一致性。然而，由于步长较小导致视力表上的分数范围缩小，产生了天花板效应（LASIK术后）和地板效应（白内障）。这些问题可能掩盖屈光或白内障手术后视觉功能接近正常的患者组之间的细微差异。Vistech和FACT CS视力表不适用于屈光或白内障手术效果研究。
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