Facchin Alessio, Mazzilli Marilena, Maffioletti Silvio
Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, Italy.
Institute of Research and Studies in Optics and Optometry, 50059 Vinci, Italy.
Pediatr Rep. 2025 Aug 11;17(4):85. doi: 10.3390/pediatric17040085.
Early identification of visual disorders in children is essential to prevent long-term visual impairment and support academic development. Despite the recognized importance of visual screenings, no universal consensus exists on which visual parameters or threshold values should be used, particularly for measuring visual acuity (VA) in pediatric populations. This study aimed to develop age-related percentile norms for VA using LEA symbol charts. : A sample of Italian schoolchildren aged 5 to 15 years ( = 1510) participated in the study. Data were collected retrospectively from school-based vision screenings conducted across 12 schools in the Lombardy and Piedmont regions from 2010 to 2019. Monocular and binocular VA were measured at 3 m using a standardized LEA symbol chart, and values were scored letter-by-letter on a LogMAR scale. Smoothed percentile curves were derived using Box-Cox, Cole, and Green distribution modeling and regression analysis. The results showed a non-linear improvement in VA with age. Compared to prior studies, LEA symbols yielded slightly lower VA scores, reinforcing the need for chart-specific norms. The 50th percentile VA improved from approximately +0.07 LogMAR at age 6 to about -0.09 LogMAR at age 15. : These findings highlight the importance of age-specific, chart-specific, and statistically robust reference data for VA screening in children. The derived percentile tables offer a more sensitive tool than fixed cut-offs for identifying visual anomalies and tailoring clinical interventions. This work contributes to standardizing pediatric VA screening practices and improving early detection of visual deficits.
早期识别儿童视力障碍对于预防长期视力损害和支持学业发展至关重要。尽管视力筛查的重要性已得到认可，但对于应使用哪些视力参数或阈值，特别是在测量儿童群体的视力（VA）方面，尚未达成普遍共识。本研究旨在使用LEA符号图表制定与年龄相关的视力百分位数规范。：1510名5至15岁的意大利学童参与了该研究。数据是从2010年至2019年在伦巴第和皮埃蒙特地区的12所学校进行的基于学校的视力筛查中回顾性收集的。使用标准化的LEA符号图表在3米处测量单眼和双眼视力，并在LogMAR量表上逐字母评分。使用Box-Cox、Cole和Green分布模型及回归分析得出平滑的百分位数曲线。结果显示视力随年龄呈非线性改善。与先前的研究相比，LEA符号得出的视力得分略低，这进一步凸显了针对特定图表制定规范的必要性。第50百分位数的视力从6岁时的约+0.07 LogMAR提高到15岁时的约-0.09 LogMAR。：这些发现强调了针对儿童视力筛查的特定年龄、特定图表且具有统计学稳健性的参考数据的重要性。得出的百分位数表提供了一种比固定临界值更敏感的工具，用于识别视力异常并定制临床干预措施。这项工作有助于规范儿童视力筛查实践并改善视力缺陷的早期检测。
