Department of Ophthalmology and Visual Sciences, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, Texas, USA.
J Telemed Telecare. 2023 Feb;29(2):81-90. doi: 10.1177/1357633X20970398. Epub 2020 Nov 22.
Visual acuity (VA) testing is a vital screening tool for the assessment of ocular function. The coronavirus 2019 pandemic has caused an immediate need for synchronous telemedicine in all specialties, including ophthalmology. While a plethora of mobile VA applications exist, there is no consensus as to what technology can accurately and reproducibly measure a patient's vision at home.
A systematic literature search was performed in April 2020 using PubMed, Embase and Medline, identifying English publications from 2010 to 2020 on remote VA tests: 4338 articles were identified and 14 were ultimately included in the review.
Of those 14, the highest quality studies, best reproducibility and correlation with in-clinic acuities measured were found using the Peek Acuity application. The studies included patients throughout the world aged 3-97, with and without correction, with known ocular pathology.The Peek Acuity studies measured distance vision on a Samsung Galaxy S3 with a mean difference of 0.055 Logarithm of the Minimum Angle of Resolution (LogMAR) for home testing compared with the Early Treatment Diabetic Retinopathy Study (ETDRS). Test-retest variability was ±0.029 LogMAR for 95% confidence interval limits.
There can be one or more lines of variability in vision testing in a clinical setting using reference standard ETDRS and clinical standard Snellen charts. Test-retest reliability is not perfect even on standard clinical charts (variation up to 0.48 LogMAR). Of the technologies reviewed, Peek Acuity home testing had the greatest correlation with ETDRS clinical vision and high test-retest reliability. Peek Acuity performed no worse than Snellen and ETDRS charts.
视力（VA）测试是评估眼部功能的重要筛查工具。2019 年冠状病毒病大流行立即需要在所有专业领域（包括眼科）同步开展远程医疗。虽然存在大量的移动视力应用程序，但对于哪种技术可以在家中准确和可重复地测量患者的视力，尚无共识。
2020 年 4 月，使用 PubMed、Embase 和 Medline 进行了系统的文献检索，确定了 2010 年至 2020 年期间关于远程视力测试的英文出版物：共确定了 4338 篇文章，最终有 14 篇文章纳入了综述。
在这 14 篇文章中，Peek Acuity 应用程序的研究质量最高、再现性最佳，与临床视力相关性最强。这些研究包括来自世界各地的年龄在 3-97 岁的患者，有或没有矫正，有或没有已知眼部疾病。Peek Acuity 研究使用三星 Galaxy S3 测量远距离视力，与早期糖尿病视网膜病变研究（ETDRS）相比，家庭测试的平均差异为 0.055 对数最小分辨角分辨率（LogMAR）。95%置信区间的测试-再测试变异性为±0.029 LogMAR。
在使用参考标准 ETDRS 和临床标准 Snellen 图表的临床环境中，视力测试可能会有一条或多条线的变化。即使在标准临床图表上，测试-再测试的可靠性也不是完美的（变化高达 0.48 LogMAR）。在所审查的技术中，Peek Acuity 家庭测试与 ETDRS 临床视力相关性最强，且测试-再测试可靠性最高。Peek Acuity 的表现并不逊于 Snellen 和 ETDRS 图表。
