Chen Weiwei, Fu Jing, Sun Ali, Li Lei, Sun Yunyun, Meng Zhaojun
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, No.1 Dong Jiao Min Xiang, Beijing, 100730, China.
BMC Ophthalmol. 2021 Dec 2;21(1):416. doi: 10.1186/s12886-021-02150-8.
Decreased best corrected visual acuity among children should be treated early in life, and vision screening in schoolchildren is an efficient and feasible selection for developing countries. Thus, the screening accuracy of different visual acuity tests is the key point for making vision screening strategies. The present study aims to explore the screening accuracy of uncorrected visual acuity (UCVA) and pin-hole corrected visual acuity (PCVA) using different vision chart in the detection of decreased best-corrected visual acuity (BCVA) among schoolchildren.
Grade one primary schoolchildren in urban Lhasa with data of UCVA using tumbling E chart (UCVAE), PCVA using tumbling E chart (PCVAE), UCVA using Lea Symbols chart (UCVAL), PCVA using Lea Symbols chart (PCVAL) and BCVA using Lea Symbols chart were reviewed. Decreased BCVA was defined as BCVA≤20/32(≥0.2 logMAR). Difference, reliability, and diagnostic parameters in the detection of decreased BCVA of different visual acuity results were analyzed.
Overall, 1672 children aged 6.58 ± 0.44 years fulfilling the criteria. The prevalence of decreased BCVA was 6.8%. Although no significant differences were found between UCVAE vs UCVAL (p = .84, paired t-test) as well as PCVAE vs PCVAL (p = .24), the ICC between them was low (0.68 and 0.57, respectively). The average difference between BCVA and UCVAE, UCVAL, PCVAE, PCVAL was logMAR -0.08 (- 0.37, 0.21), - 0.08 (- 0.29, 0.17), - 0.05 (- 0.30, 0.19), - 0.06 (- 0.23, 0.12) using Bland-Altman method. The area under the receiver operating characteristic curve of UCVAE, PCVAE, UCVAL, PCVAL for the detection of decreased BCVA was 0.78 (0.73, 0.84), 0.76 (0.71, 0.82), 0.95 (0.94, 0.96), 0.93 (0.91, 0.95), respectively.
Pinhole does not increase the screening accuracy of detecting decreased BCVA in grade one primary schoolchildren. Visual acuity test using Lea Symbols is more efficient than Tumbling E in the screening of that age.
Data were maily from the Lhasa Childhood Eye Study which has finished the clinical registration on ( ChiCTR1900026693 ).
儿童最佳矫正视力下降应在早期进行治疗，而对学童进行视力筛查对发展中国家来说是一种有效且可行的选择。因此，不同视力测试的筛查准确性是制定视力筛查策略的关键。本研究旨在探讨使用不同视力表的未矫正视力（UCVA）和针孔矫正视力（PCVA）在检测学童最佳矫正视力（BCVA）下降方面的筛查准确性。
回顾了拉萨市城区一年级小学生的相关数据，包括使用翻转E视力表的UCVA（UCVAE）、使用翻转E视力表的PCVA（PCVAE）、使用Lea符号视力表的UCVA（UCVAL）、使用Lea符号视力表的PCVA（PCVAL）以及使用Lea符号视力表的BCVA。BCVA下降定义为BCVA≤20/32（≥0.2 logMAR）。分析了不同视力结果在检测BCVA下降方面的差异、可靠性和诊断参数。
总体而言，1672名年龄为6.58±0.44岁的儿童符合标准。BCVA下降的患病率为6.8%。尽管UCVAE与UCVAL之间（p = 0.84，配对t检验）以及PCVAE与PCVAL之间（p = 0.24）未发现显著差异，但它们之间的组内相关系数较低（分别为0.68和0.57）。使用Bland-Altman方法，BCVA与UCVAE、UCVAL、PCVAE、PCVAL的平均差异分别为logMAR -0.08（-0.37，0.21）、-0.08（-0.29，0.17）、-0.05（- 0.30，0.19）、-0.06（-0.23，0.12）。UCVAE、PCVAE、UCVAL、PCVAL检测BCVA下降的受试者工作特征曲线下面积分别为0.78（0.73，0.84）、0.76（0.71，0.82）、0.95（0.94，0.96）、0.93（0.91，0.95）。
针孔检查并不能提高一年级小学生BCVA下降检测的筛查准确性。在该年龄段的筛查中，使用Lea符号的视力测试比翻转E视力表更有效。
数据主要来自拉萨儿童眼病研究，该研究已在（ChiCTR1900026693）完成临床注册。
