有视力障碍和无视力障碍的学龄前儿童的立体视锐度
Stereoacuity of preschool children with and without vision disorders.
作者信息
Ciner Elise B, Ying Gui-Shuang, Kulp Marjean Taylor, Maguire Maureen G, Quinn Graham E, Orel-Bixler Deborah, Cyert Lynn A, Moore Bruce, Huang Jiayan
机构信息
*OD, FAAO †PhD ‡OD, MS, FAAO §MD, MSCE ∥PhD, OD, FAAO **MS The Pennsylvania College of Optometry at Salus University, Philadelphia, Pennsylvania (EBC); Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania (GSY, MGM, JH); College of Optometry, The Ohio State University, Columbus, Ohio (MTK); The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania (GEQ); School of Optometry, University of California, Berkeley, Berkeley, California (DOB); Northeastern State University, Tahlequah, Oklahoma (LAC); and the New England College of Optometry, Boston, Massachusetts (BM).
出版信息
Optom Vis Sci. 2014 Mar;91(3):351-8. doi: 10.1097/OPX.0000000000000165.
PURPOSE
To evaluate associations between stereoacuity and presence, type, and severity of vision disorders in Head Start preschool children and determine testability and levels of stereoacuity by age in children without vision disorders.
METHODS
Stereoacuity of children aged 3 to 5 years (n = 2898) participating in the Vision in Preschoolers (VIP) Study was evaluated using the Stereo Smile II test during a comprehensive vision examination. This test uses a two-alternative forced-choice paradigm with four stereoacuity levels (480 to 60 seconds of arc). Children were classified by the presence (n = 871) or absence (n = 2027) of VIP Study-targeted vision disorders (amblyopia, strabismus, significant refractive error, or unexplained reduced visual acuity), including type and severity. Median stereoacuity between groups and among severity levels of vision disorders was compared using Wilcoxon rank sum and Kruskal-Wallis tests. Testability and stereoacuity levels were determined for children without VIP Study-targeted disorders overall and by age.
RESULTS
Children with VIP Study-targeted vision disorders had significantly worse median stereoacuity than that of children without vision disorders (120 vs. 60 seconds of arc, p < 0.001). Children with the most severe vision disorders had worse stereoacuity than that of children with milder disorders (median 480 vs. 120 seconds of arc, p < 0.001). Among children without vision disorders, testability was 99.6% overall, increasing with age to 100% for 5-year-olds (p = 0.002). Most of the children without vision disorders (88%) had stereoacuity at the two best disparities (60 or 120 seconds of arc); the percentage increasing with age (82% for 3-, 89% for 4-, and 92% for 5-year-olds; p < 0.001).
CONCLUSIONS
The presence of any VIP Study-targeted vision disorder was associated with significantly worse stereoacuity in preschool children. Severe vision disorders were more likely associated with poorer stereopsis than milder or no vision disorders. Testability was excellent at all ages. These results support the validity of the Stereo Smile II for assessing random-dot stereoacuity in preschool children.
目的
评估“启智”学前儿童的立体视锐度与视力障碍的存在、类型和严重程度之间的关联，并确定无视力障碍儿童的可测试性及按年龄划分的立体视锐度水平。
方法
在一项全面视力检查中，使用立体微笑II测试对参与学龄前儿童视力（VIP）研究的3至5岁儿童（n = 2898）的立体视锐度进行评估。该测试采用二选一强迫选择范式，有四个立体视锐度水平（480至60秒弧度）。根据是否存在（n = 871）或不存在（n = 2027）VIP研究目标视力障碍（弱视、斜视、显著屈光不正或不明原因的视力下降）对儿童进行分类，包括类型和严重程度。使用Wilcoxon秩和检验和Kruskal-Wallis检验比较组间以及视力障碍严重程度水平间的中位立体视锐度。确定总体上无VIP研究目标障碍的儿童以及按年龄划分的可测试性和立体视锐度水平。
结果
有VIP研究目标视力障碍的儿童的中位立体视锐度显著低于无视力障碍的儿童（120秒弧度对60秒弧度，p < 0.001）。视力障碍最严重的儿童的立体视锐度比轻度障碍儿童更差（中位值480秒弧度对120秒弧度，p < 0.001）。在无视力障碍的儿童中，总体可测试性为99.6%，随年龄增长至5岁儿童时升至100%（p = 0.002）。大多数无视力障碍的儿童（88%）具有两个最佳视差（60或120秒弧度）的立体视锐度；该百分比随年龄增加（3岁儿童为82%，4岁儿童为89%，5岁儿童为92%；p < 0.001）。
结论
任何VIP研究目标视力障碍的存在都与学龄前儿童明显较差的立体视锐度相关。严重视力障碍比轻度或无视力障碍更可能与较差的立体视觉相关。各年龄段的可测试性都很好。这些结果支持立体微笑II在评估学龄前儿童随机点立体视锐度方面的有效性。
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