Chang C-H, Tsai R-K, Sheu M-M
Department of Ophthalmology, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
Eye (Lond). 2007 Dec;21(12):1482-8. doi: 10.1038/sj.eye.6702568. Epub 2006 Sep 1.
AIMS OR PURPOSE: Screening for amblyopia at earliest age is important for early treatment and better prognosis. This study aimed at evaluating the validity of uncorrected distant and near visual acuity and random dot stereopsis for screening amblyopia. METHODS; In Eastern Taiwan, population-based screen tests were performed for children at age from 3 to 6 years. The tests included uncorrected distant and near visions and random dot stereopsis (300 s) test. The screen performers were registered nurses of local public health service posts. The golden standards of the tests were the results of examination by the ophthalmologists.
Including Hans and aboriginal Taiwanese, 5232 children were included. Screened by distance visual acuity with different cutoffs and near visual acuity, 10.3, 30.3 and 8.2% children were abnormal. Screened by random dot, only 2% children were abnormal. By a senior ophthalmologist, 115 amblyopic children were diagnosed amblyopic. The sensitivities of distance visual acuity with low/high cutoff and near visual acuity were 74.7/84.8 and 49.4%, whereas that of the NTU random dot stereogram was 20.5%. Simultaneous testing of either two of the three tests improved the sensitivity.
Screening for amblyopia by the local nurses using the visual acuity tests or random dot stereopsis test alone does not display a high sensitivity. Simultaneous testing of distant visual acuity and stereopsis test elevate the sensitivity and preserve the specificity.
目的:尽早筛查弱视对于早期治疗和更好的预后很重要。本研究旨在评估未矫正的远视力、近视力和随机点立体视对弱视筛查的有效性。方法:在台湾东部,对3至6岁的儿童进行基于人群的筛查测试。测试包括未矫正的远视力、近视力和随机点立体视(300秒)测试。筛查人员为当地公共卫生服务岗位的注册护士。测试的金标准是眼科医生的检查结果。
包括汉族和台湾原住民,共纳入5232名儿童。以不同截断值的远视力和近视力进行筛查,分别有10.3%、30.3%和8.2%的儿童异常。以随机点进行筛查,只有2%的儿童异常。一名资深眼科医生诊断出115名弱视儿童。低/高截断值的远视力和近视力的敏感度分别为74.7/84.8和49.4%,而台湾大学随机点立体图的敏感度为20.5%。三项测试中的任意两项同时进行可提高敏感度。
当地护士单独使用视力测试或随机点立体视测试筛查弱视的敏感度不高。同时进行远视力和立体视测试可提高敏感度并保持特异性。