Ritchie Ailsa, Atamian Silva, Shah Nilpa, Laidlaw Alistair, Hammond Christopher
Guy's and St Thomas' NHSFT, GB.
King's College London, GB.
Br Ir Orthopt J. 2021 Jun 16;17(1):119-126. doi: 10.22599/bioj.179. eCollection 2021.
The recent pandemic has identified the need for telemedicine assessment of ophthalmology patients. A vital component of such assessment is visual acuity (VA) measurement. The aim of this study was to determine the feasibility and reliability of computerised 'at home' VA measurements using COMPlog software.
A Bland Altman method comparison study of worse eye 'in clinic' and 'at home' orthoptist-supervised COMPlog computerised VA measurements. Subjects underwent gold standard semi-automated computerised test and retest logMAR VA measurements on their habitually corrected worse eye both 'in clinic' and 'at home.' The orthoptist ran the test from the eye clinic with the patient viewing a secondary PC monitor either in the same clinic room or at home. A screen sharing voice and video conferencing application and standard consumer IT hardware were employed to present the test optotypes in the patient's home.
23 paediatric and 13 adult patients with a range of ocular diseases and worse eye visual acuities were included (range -0.14 to 1.06 logMAR). No significant bias was found between 'in clinic' and 'at home' measurements (mean -0.01 logMAR and 95% confidence interval -0.03, 0.00 logMAR). Test-retest variability of 'in clinic,' 'at home' and 'in clinic' versus 'at home' measurements were within normal reported ranges at 0.12 logMAR (6 ETDRS letters) or less.
Remote home VA testing performed by an eye care professional using a semi-automated VA measurement program and video conferencing application provided unbiased measurements with acceptable test-retest reliability. Home testing was both feasible and acceptably reliable in appropriately equipped patients.
近期的疫情凸显了对眼科患者进行远程医疗评估的必要性。这种评估的一个重要组成部分是视力（VA）测量。本研究的目的是确定使用COMPlog软件进行计算机化“在家”VA测量的可行性和可靠性。
采用Bland Altman方法进行比较研究，比较在诊所和在家由视光师监督的COMPlog计算机化VA测量中较差眼的情况。受试者在诊所和在家中对其习惯矫正的较差眼进行金标准半自动计算机化测试和复测logMAR VA测量。视光师从眼科诊所运行测试，患者在同一诊室内或家中观看辅助电脑显示器。使用屏幕共享语音和视频会议应用程序以及标准的消费级信息技术硬件在患者家中呈现测试视标。
纳入了23名儿科患者和13名成年患者，他们患有一系列眼部疾病，较差眼视力范围为-0.14至1.06 logMAR。在诊所测量和在家测量之间未发现显著偏差（平均-0.01 logMAR，95%置信区间为-0.03，0.00 logMAR）。诊所测量、在家测量以及诊所测量与在家测量之间的复测变异性在正常报告范围内，为0.12 logMAR（6个ETDRS字母）或更低。
由眼保健专业人员使用半自动VA测量程序和视频会议应用程序进行的远程家庭VA测试提供了无偏差的测量结果，复测可靠性可接受。在配备适当的患者中，家庭测试既可行且可靠性可接受。
