黄斑疾病患者基于网络的视力与早期糖尿病视网膜病变研究组（ETDRS）视力的远程自我评估：一项方法比较研究
Remote web-based self-assessment of visual acuity versus ETDRS in patients with macular diseases: a method comparison study.
作者信息
van der Zee Casper, Huynh Leon Daniel Huang, Imhof Saskia Marijke, Ossewaarde-van Norel Jeannette, van Leeuwen Redmer, Wisse Robert Pieter Leendert
机构信息
Ophthalmology Department, University Medical Center Utrecht, Utrecht, the Netherlands.
, Heidelberglaan 100, Utrecht, 3584 CX, the Netherlands.
出版信息
Int J Retina Vitreous. 2025 Mar 14;11(1):29. doi: 10.1186/s40942-025-00656-7.
BACKGROUND
Macular diseases (MD) lead to frequent clinic visits, involve time-consuming visual acuity (VA) measurements by professionals. Independent home measurements could improve efficiency. This study evaluates the agreement of a web-based test in MD compared to in-hospital measurements.
METHODS
Adults with MD were included at the University Medical Center Utrecht in March-July 2023. Users need a phone, computer, and 3m distance. The test uses Tumbling-E and triangles as optotypes. Primary outcome is the web-based vs. ETDRS Distance Visual Acuity (DVA). Secondary outcomes were test-retest variability (TRV), near visual acuity (NVA), and the Amsler grid. Outcomes were reported in mean differences and 95% Limits of Agreement (LoA).
RESULTS
89 eyes were included. The DVA mean difference was 0.03LogMAR(1.5 letters), SD0.17, LoA - 0.31;0.36LogMAR(-15.5;18 letters), TRV had a mean difference of 0.03(1.5 letters) SD0.14. The NVA mean difference was 0.13(6.5 letter) SD0.24, positive- and negative predictive values 0.93(95%CI = 0.82;0.98) and 0.71(95%CI = 0.51;0.86) respectively.
CONCLUSIONS
The agreement of the DVA web-based test is on par with Snellen line assessment and subpar to ETDRS. We showed that elderly can perform this test independently at home, providing a time- and cost-saving opportunity. Developments should focus on the NVA since it can be a valuable adjunct to MD follow-up.
TRIAL REGISTRATION
the Dutch Medical Ethical committee (Medisch Ethische Toetsingscommissie; METC NedMec) registration number: 22-879/DB. Approved at 27-09-2022.
背景
黄斑疾病（MD）导致患者频繁就诊，专业人员进行视力（VA）测量耗时较长。独立的家庭测量可以提高效率。本研究评估了与医院测量相比，基于网络的测试在MD中的一致性。
方法
2023年3月至7月，乌得勒支大学医学中心纳入了患有MD的成年人。用户需要一部手机、一台电脑和3米的距离。该测试使用翻转E和三角形作为视标。主要结果是基于网络的测试与ETDRS远距离视力（DVA）的比较。次要结果是重测变异性（TRV）、近视力（NVA）和阿姆斯勒方格表。结果以平均差异和95%一致性界限（LoA）报告。
结果
纳入89只眼。DVA平均差异为0.03LogMAR（1.5个字母），标准差0.17，LoA为-0.31；0.36LogMAR（-15.5；18个字母），TRV平均差异为0.03（1.5个字母），标准差0.14。NVA平均差异为0.13（6.5个字母），标准差0.24，阳性和阴性预测值分别为0.93（95%CI = 0.82；0.98）和0.71（95%CI = 0.51；0.86）。
结论
基于网络的DVA测试的一致性与斯内伦视力表评估相当，但低于ETDRS。我们表明老年人可以在家中独立进行这项测试，这提供了节省时间和成本的机会。应关注NVA的发展，因为它可能是MD随访的有价值辅助手段。
试验注册
荷兰医学伦理委员会（Medisch Ethische Toetsingscommissie；METC NedMec）注册号：22-879/DB。2022年9月27日批准。
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