Mohan Kathleen M, Miller Joseph M, Harvey Erin M, Gerhart Kimberly D, Apple Howard P, Apple Deborah, Smith Jordana M, Davis Amy L, Leonard-Green Tina, Campus Irene, Dennis Leslie K
J Pediatr Ophthalmol Strabismus. 2016 Jan-Feb;53(1):56-9. doi: 10.3928/01913913-20160113-09.
To determine if testing binocular visual acuity in infants and toddlers using the Acuity Card Procedure (ACP) with electronic grating stimuli yields clinically useful data.
Participants were infants and toddlers ages 5 to 36.7 months referred by pediatricians due to failed automated vision screening. The ACP was used to test binocular grating acuity. Stimuli were presented on the Dobson Card. The Dobson Card consists of a handheld matte-black plexiglass frame with two flush-mounted tablet computers and is similar in size and form to commercially available printed grating acuity testing stimuli (Teller Acuity Cards II [TACII]; Stereo Optical, Inc., Chicago, IL). On each trial, one tablet displayed a square-wave grating and the other displayed a luminance-matched uniform gray patch. Stimuli were roughly equivalent to the stimuli available in the printed TACII stimuli. After acuity testing, each child received a cycloplegic eye examination. Based on cycloplegic retinoscopy, patients were categorized as having high or low refractive error per American Association for Pediatric Ophthalmology and Strabismus vision screening referral criteria. Mean acuities for high and low refractive error groups were compared using analysis of covariance, controlling for age.
Mean visual acuity was significantly poorer in children with high refractive error than in those with low refractive error (P = .015).
Electronic stimuli presented using the ACP can yield clinically useful measurements of grating acuity in infants and toddlers. Further research is needed to determine the optimal conditions and procedures for obtaining accurate and clinically useful automated measurements of visual acuity in infants and toddlers.
确定使用带有电子光栅刺激的视力卡程序（ACP）对婴幼儿进行双眼视力测试是否能产生具有临床实用价值的数据。
参与者为年龄在5至36.7个月的婴幼儿，由儿科医生因自动视力筛查未通过而转诊。使用ACP测试双眼光栅视力。刺激物呈现在多布森视力卡上。多布森视力卡由一个手持的哑光黑色有机玻璃框架和两台嵌入式平板电脑组成，其尺寸和形状与市售的印刷光栅视力测试刺激物（泰勒视力卡II [TACII]；立体光学公司，伊利诺伊州芝加哥）相似。在每次试验中，一台平板电脑显示一个方波光栅，另一台显示一个亮度匹配的均匀灰色斑块。刺激物大致相当于印刷版TACII刺激物中的刺激物。视力测试后，每个孩子都接受了睫状肌麻痹验光检查。根据睫状肌麻痹验光结果，按照美国小儿眼科与斜视协会视力筛查转诊标准，将患者分为高屈光不正或低屈光不正。使用协方差分析比较高屈光不正组和低屈光不正组的平均视力，并对年龄进行控制。
高屈光不正儿童的平均视力明显低于低屈光不正儿童（P = .015）。
使用ACP呈现的电子刺激可以产生婴幼儿光栅视力的临床实用测量值。需要进一步研究以确定获得婴幼儿准确且具有临床实用价值的自动视力测量的最佳条件和程序。
