Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
PLoS One. 2023 Apr 4;18(4):e0284112. doi: 10.1371/journal.pone.0284112. eCollection 2023.
In patients with strabismus, the stereopsis and Worth 4-dot (W4d) tests have often been used to evaluate whether sensory fusion is achieved. However, if patients face difficulties undergoing the Titmus or W4d test because of poor visual acuity (VA) due to refractive error abnormalities, the results of these tests cannot be appropriately interpreted. Therefore, we evaluated the correlation between distance uncorrected VA (UCVA) and sensory status in children with reduced VA due to refractive error abnormalities to identify the effects of refractive errors on sensory test results.
We retrospectively reviewed the medical records of 195 children with reduced VA with VA improvement ≥ 20/25, Titmus stereoacuity ≤ 50 arcsec, and fusion in the W4d result after refractive error correction with spectacles. We evaluated the correlation between distance UCVA in logMAR and sensory status measured by the near Titmus stereotest and distance W4d test. Additionally, the minimum required UCVA for interpreting Titmus or W4d results was assessed using a receiver operating characteristic (ROC) curve.
The UCVA showed a marginal but non-significant correlation with Titmus stereoacuity (p = 0.053) and a significant correlation with fusion in W4d (p < 0.001). The ROC curve analysis showed an optimal cut-point value of VA required for interpreting the results of W4d test as 0.3 logMAR (20/40 in Snellen acuity).
Correcting refractive error in advance may help appropriately interpret sensory status in school-aged children with reduced VA due to refractive error abnormalities.
在斜视患者中，立体视锐度和 Worth 4 点（W4d）测试常用于评估是否实现了感觉融合。然而，如果由于屈光不正异常导致视力（VA）较差，患者在进行Titmus 或 W4d 测试时遇到困难，这些测试的结果就无法得到正确解读。因此，我们评估了屈光不正异常导致 VA 降低的儿童的远距未矫正视力（UCVA）与感觉状态之间的相关性，以确定屈光误差对感觉测试结果的影响。
我们回顾性分析了 195 例屈光不正异常导致 VA 降低的儿童的病历，这些儿童的 VA 改善≥20/25，Titmus 立体视锐度≤50 弧秒，且在屈光不正矫正后 W4d 测试的融合结果。我们评估了远距 UCVA 在 logMAR 中的数值与近距 Titmus 立体测试和远距 W4d 测试测量的感觉状态之间的相关性。此外，还使用受试者工作特征（ROC）曲线评估了解读 Titmus 或 W4d 结果所需的最小 UCVA。
UCVA 与 Titmus 立体视锐度呈边缘但无统计学意义的相关性（p=0.053），与 W4d 融合呈显著相关性（p<0.001）。ROC 曲线分析显示，W4d 测试结果解读的最佳视力切点值为 0.3 logMAR（Snellen 视力 20/40）。
提前矫正屈光不正可能有助于正确解读屈光不正异常导致的学龄期儿童 VA 降低的感觉状态。
