Rubin Gary S
UCL Institute of Ophthalmology, London, UK.
Vision Res. 2013 Sep 20;90:43-51. doi: 10.1016/j.visres.2013.02.015. Epub 2013 Mar 16.
Despite significant changes in the treatment of common eye conditions like cataract and age-related macular degeneration, reading difficulty remains the most common complaint of patients referred for low vision services. Clinical reading tests have been widely used since Jaeger introduced his test types in 1854. A brief review of the major developments in clinical reading tests is provided, followed by a discussion of some of the main controversies in clinical reading assessment. Data for the Salisbury Eye Evaluation (SEE) study demonstrate that standardised clinical reading tests are highly predictive of reading performance under natural, real world conditions, and that discrepancies between self-reported reading ability and measured reading performance may be indicative of people who are at a pre-clinical stage of disability, but are at risk for progression to clinical disability. If measured reading performance is to continue to increase in importance as a clinical outcome measure, there must be agreement on what should be measured (e.g. speed or comprehension) and how it should be measured (e.g. reading silently or aloud). Perhaps most important, the methods for assessing reading performance and the algorithms for scoring reading tests need to be optimised so that the reliability and responsiveness of reading tests can be improved.
尽管在白内障和年龄相关性黄斑变性等常见眼部疾病的治疗方面发生了重大变化，但阅读困难仍然是转诊至低视力服务机构的患者最常见的主诉。自1854年耶格引入他的测试类型以来，临床阅读测试已被广泛使用。本文简要回顾了临床阅读测试的主要发展，随后讨论了临床阅读评估中的一些主要争议。索尔兹伯里眼评估（SEE）研究的数据表明，标准化临床阅读测试能够高度预测自然现实世界条件下的阅读表现，并且自我报告的阅读能力与测量的阅读表现之间的差异可能表明处于残疾临床前期但有进展为临床残疾风险的人群。如果测量的阅读表现作为临床结局指标的重要性要持续增加，则必须就测量内容（例如速度或理解能力）以及测量方式（例如默读或朗读）达成共识。也许最重要的是，需要优化评估阅读表现的方法和阅读测试的评分算法，以便提高阅读测试的可靠性和反应性。
