Division of Child Neurology (ATW, AML, GWL, BLB), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Neurology (ATW, RAA, GTL, BLB), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pediatrics (ATW, BLB), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Neuro-ophthalmology Service (RAA, GTL), Division of Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Department of Ophthalmology (RAA, GTL, MGM, GY), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
J Neuroophthalmol. 2020 Jun;40(2):148-156. doi: 10.1097/WNO.0000000000000821.
High-contrast visual acuity (HCVA) changes with age, yet little is known about pediatric-specific age- and sex-normative values for low-contrast letter acuity (LCLA). We define maturational changes in monocular and binocular HCVA and LCLA in childhood and adolescence.
Normally sighted youth (ages 5-20 years, without neurologic or ophthalmologic disease and best-corrected HCVA of 20/25 or better in each eye) were recruited. Mean monocular and binocular scores using Early Treatment Diabetic Retinopathy Study (for HCVA) and 2.5% and 1.25% Sloan (for LCLA) charts and the magnitude of binocular summation were calculated using 2-year bins. Relationships between scores and age were explored using scatterplots with Locally Weighted Scatterplot Smoothing (LOWESS) and analysis of variance that accounts for intereye correlation, followed by test of linear trend for age effect.
Among 101 (202 eyes) healthy participants (mean age 13 years, 42% males), monocular and binocular scores varied by age, with highest mean scores achieved in the 13 to 14-year age group for both HCVA and LCLA. Between the ages of 5 and 14.9 years, monocular scores increased linearly with age (0.76 letter/year for HCVA, 1.11 letters/year for 2.5% LCLA, and 0.97 letter/year for 1.25% LCLA; all P < 0.0001). Binocular HCVA scores also increased with age between 5 and 14.9 years (0.71 letters/year, P < 0.0001). The magnitude of binocular summation for HCVA or LCLA did not change with age.
HCVA and LCLA abilities mature into adolescence, peak between 13 and 14.9 years of age, and then plateau into adulthood. Evaluation of patients with visual deficits should consider age-expected normal visual acuity.
高对比度视力（HCVA）随年龄变化，而对于儿童特定的低对比度字母视力（LCLA）的年龄和性别规范值知之甚少。我们定义了儿童和青少年中单眼和双眼 HCVA 和 LCLA 的成熟变化。
招募视力正常的年轻人（年龄 5-20 岁，无神经或眼科疾病，双眼最佳矫正视力均为 20/25 或更好）。使用早期糖尿病视网膜病变研究（用于 HCVA）和 2.5%和 1.25%Sloan 图表（用于 LCLA）图表计算平均单眼和双眼得分，并使用 2 年间隔计算双眼总和的幅度。使用散点图和局部加权散点平滑（LOWESS）以及考虑到眼间相关性的方差分析来探索得分与年龄之间的关系，然后进行年龄效应的线性趋势检验。
在 101 名（202 只眼）健康参与者（平均年龄 13 岁，42%为男性）中，单眼和双眼得分随年龄而变化，HCVA 和 LCLA 的最高平均得分均在 13 至 14 岁年龄组获得。在 5 至 14.9 岁之间，单眼得分随年龄呈线性增加（HCVA 为 0.76 个字母/年，2.5%LCLA 为 1.11 个字母/年，1.25%LCLA 为 0.97 个字母/年；均 P <0.0001）。在 5 至 14.9 岁之间，双眼 HCVA 得分也随年龄增加而增加（0.71 个字母/年，P <0.0001）。HCVA 或 LCLA 的双眼总和幅度随年龄变化而不变。
HCVA 和 LCLA 能力在青春期成熟，在 13 至 14.9 岁之间达到峰值，然后在成年期趋于平稳。评估有视觉缺陷的患者时应考虑年龄预期的正常视力。
