Eye Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
https://orcid.org/0000-0002-4409-2176.
Transl Vis Sci Technol. 2024 Mar 1;13(3):14. doi: 10.1167/tvst.13.3.14.
To determine the testability, performance, and test-retest variability (TRV) of visual acuity (VA) assessment using the Freiburg Visual Acuity Test (FrACT) compared to the LEA Symbols Test (LEA) in preschool children.
In 134 preschool children aged 3.0 to 6.8 years, monocular VA of each eye was measured twice with a four-orientation Landolt C version of the FrACT and once with the LEA. FrACT runs were preceded by a binocular run for explanatory purposes. Test order alternated between subjects. Optotypes were presented on a computer monitor (FrACT) or on cards (LEA) at a distance of 3 m.
Overall, 68% completed the FrACT (91/134 children) and 88% completed the LEA (118/134 children). Testability depended on age: FrACT, 19% (<4 years) and 87% (≥4 years); LEA, 70% (<4 years) and 95% (≥4 years). Mean ± SD VA difference between tests was 0.11 ± 0.19 logarithm of the minimum angle of resolution [logMAR], with LEA reporting better acuity. The difference depended on age (0.27 ± 0.23 logMAR [<4 years], 0.09 ± 0.18 logMAR [≥4 years], P < 0.001) and on test sequence (higher age dependence of FrACT VAs for LEA first, P < 0.001). The 95% limits of agreement for the FrACT TRV were ±0.298 logMAR.
The examiner-independent FrACT, using international reference Landolt C optotypes, can be used to assess VA in preschool children aged ≥4 years, with reliability comparable to other pediatric VA tests.
Use of the automated FrACT for VA assessment in preschool children may benefit objectivity and validity as it is a computerized test and employs the international reference Landolt C optotype.
确定弗赖堡视力测验（FrACT）与 LEA 符号测验（LEA）在学龄前儿童中的测试性、性能和重测变异性（TRV）。
在 134 名 3.0 至 6.8 岁的学龄前儿童中，每只眼的单眼视力用 FrACT 的四向 Landolt C 版本进行两次测量，用 LEA 进行一次测量。FrACT 测试前进行了一次解释性的双眼测试。测试顺序在受试者之间交替。视标在计算机显示器（FrACT）或卡片上（LEA）呈现，距离 3 米。
总体而言，68%（91/134 名儿童）完成了 FrACT，88%（118/134 名儿童）完成了 LEA。测试性取决于年龄：FrACT，19%（<4 岁）和 87%（≥4 岁）；LEA，70%（<4 岁）和 95%（≥4 岁）。两次测试之间的平均±标准差视力差异为 0.11±0.19 对数最小角分辨率[logMAR]，LEA 报告的视力更好。差异取决于年龄（0.27±0.23 logMAR [<4 岁]，0.09±0.18 logMAR [≥4 岁]，P<0.001）和测试顺序（LEA 第一的 FrACT 视力年龄依赖性更高，P<0.001）。FrACT TRV 的 95%一致性界限为±0.298 logMAR。
使用国际参考 Landolt C 视标，无需检查者的 FrACT 可用于评估≥4 岁学龄前儿童的视力，其可靠性可与其他儿科视力测试相媲美。
曹明慧
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