Cantó-Cerdán Mario, Cacho-Martínez Pilar, García-Muñoz Ángel
Departamento de Óptica, Farmacología y Anatomía, Universidad de Alicante, Spain.
Departamento de Óptica, Farmacología y Anatomía, Universidad de Alicante, Spain.
J Optom. 2018 Jul-Sep;11(3):153-159. doi: 10.1016/j.optom.2017.10.002. Epub 2017 Dec 1.
To establish whether the cover test and von Graefe methods are interchangeable in a non-presbyopic and presbyopic population.
We performed a prospective study on a sample of 127 non-presbyopic subjects between 20 and 45 years old and 56 presbyopic between 40 and 78 years old. Distance and near vision phoria were measured using the von Graefe method (VG) and cover test (CT). We analyzed the significant differences between methods, their correlation and the agreement between them using the Bland and Altman method.
For distance vision, heterophoria values for non-presbyopic subjects were -0.61±1.86Δ with CT and -0.88±2.37Δ with VG, and for presbyopic subjects were -0.56±1.64Δ with CT and -0.85±1.94Δ with VG. For near vision, CT yielded -3.02±3.97Δ, while VG achieved -3.49±4.70Δ in non-presbyopic subjects. For presbyopic subjects these values were -6.05±4.38Δ with CT and -6.29±4.19Δ with VG, respectively. Statistically significant differences between the two methods were observed for all groups analyzed (p<0.05), except for near vision in presbyopic subjects (p>0.05). Coefficient of agreement for non-presbyopic was ±2.97Δ for distance vision and ±6.74Δ at near. For presbyopic patients, this coefficient was ±1.59Δ for distance and ±1.86Δ for near vision.
Cover test and von Graefe methods have a high level of agreement for both distance and near vision when considering presbyopic subjects. For non-presbyopic patients, the level of agreement is very low. Both methods for measuring heterophoria can only be considered interchangeable for presbyopic patients. For clinical purposes, this implies that any method can be used for measuring heterophoria in presbyopic patients.
确定在非老视和老视人群中，遮盖试验和von Graefe法是否可相互替代。
我们对127名年龄在20至45岁之间的非老视受试者和56名年龄在40至78岁之间的老视受试者进行了一项前瞻性研究。使用von Graefe法（VG）和遮盖试验（CT）测量远距离和近距离隐斜。我们使用Bland和Altman方法分析了两种方法之间的显著差异、它们之间的相关性以及一致性。
对于远距离视力，非老视受试者使用CT测量的隐斜值为-0.61±1.86Δ，使用VG测量的为-0.88±2.37Δ；老视受试者使用CT测量的为-0.56±1.64Δ，使用VG测量的为-0.85±1.94Δ。对于近距离视力，非老视受试者使用CT测量得出-3.02±3.97Δ，使用VG测量得出-3.49±4.70Δ。对于老视受试者，这些值使用CT测量分别为-6.05±4.38Δ，使用VG测量为-6.29±4.19Δ。在所有分析的组中，除了老视受试者的近距离视力外（p>0.05）,观察到两种方法之间存在统计学显著差异（p<0.05）。非老视受试者远距离视力的一致性系数为±2.97Δ，近距离为±6.74Δ。对于老视患者，该系数远距离为±1.59Δ，近距离视力为±1.86Δ。
在考虑老视受试者时，遮盖试验和von Graefe法在远距离和近距离视力方面都具有较高水平的一致性。对于非老视患者，一致性水平非常低。两种测量隐斜的方法仅在老视患者中可被视为可相互替代。对于临床目的而言，这意味着在老视患者中测量隐斜时可以使用任何一种方法。
