Boon Joewee, Goh Jue Shao, Rojas-Carabali William, Puah Marilyn, Lee Bernett, Rajagopalan Rajesh, Ang Bryan, Agrawal Rupesh
National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore.
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
Eye (Lond). 2024 Dec;38(18):3554-3561. doi: 10.1038/s41433-024-03362-0. Epub 2024 Oct 17.
Visual acuity (VA) represents a fundamental measure of visual function. The significant prevalence of underdiagnosed ocular disorders underscores the importance of effective VA assessment. This study evaluates the efficacy of a web-based VA assessment tool ("PocDoc") versus conventional VA testing.
Prospective observational study including 353 participants recruited from various eye clinics in a tertiary referral centre. Age, diagnosis, and VA related information (i.e. VA measurements from PocDoc and conventional VA test [Snellen chart], test type, etc) were collected. Spearman's rank correlation, Intraclass Correlation, and Bland-Altman plot compared outcomes of both tests. One-way ANOVA and paired-T test were used to compare means.
Most patients were males (59.2%) with a mean age of 52.2 ± 20.6 years. PocDoc had moderate positive correlation to conventional testing (rho = 0.50, p < 0.001). PocDoc led to higher logMAR scores compared to conventional testing (mean logMAR 0.19 and 0.13 respectively, p < 0.01). Moreover, PocDoc demonstrated a sensitivity of 82.8% and specificity of 79% for detecting visual impairment. The discrepancy between PocDoc and conventional VA testing increased with higher logMAR values, indicating greater inconsistency between the tests for patients with poorer VA. Age, test type, and disease type contributed to this variability.
The concordance between PocDoc and conventional testing for VA measurement across various ages and conditions makes it a suitable screening tool. Future technological inventions should consider age, test type, and disease type as critical factors related to the level of agreement and correlation between digital and conventional VA testing methods.
视力（VA）是视觉功能的一项基本指标。未被诊断出的眼部疾病的高患病率凸显了有效视力评估的重要性。本研究评估了一种基于网络的视力评估工具（“PocDoc”）与传统视力测试的效果。
前瞻性观察性研究，纳入了从一家三级转诊中心的各个眼科诊所招募的353名参与者。收集了年龄、诊断结果以及与视力相关的信息（即来自PocDoc和传统视力测试[斯内伦视力表]的视力测量值、测试类型等）。采用斯皮尔曼等级相关性分析、组内相关性分析和布兰德-奥特曼图来比较两种测试的结果。使用单因素方差分析和配对t检验来比较均值。
大多数患者为男性（59.2%），平均年龄为52.2±20.6岁。PocDoc与传统测试具有中度正相关性（rho = 0.50，p < 0.001）。与传统测试相比，PocDoc得出的对数最小分辨角（logMAR）得分更高（分别为平均logMAR 0.19和0.13，p < 0.01）。此外，PocDoc检测视力损害的敏感性为82.8%，特异性为79%。PocDoc与传统视力测试之间的差异随着logMAR值的升高而增大，这表明视力较差的患者在两种测试之间的一致性更低。年龄、测试类型和疾病类型导致了这种变异性。
PocDoc与传统视力测量测试在不同年龄和情况下的一致性使其成为一种合适的筛查工具。未来的技术发明应将年龄、测试类型和疾病类型视为与数字和传统视力测试方法之间的一致性和相关性水平相关的关键因素。
