Simons K, Avery K E, Novak A
Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
J Pediatr Ophthalmol Strabismus. 1996 Mar-Apr;33(2):104-13. doi: 10.3928/0191-3913-19960301-09.
New, small-target (< 1 degree) random dot stereogram (STRDS) and binocular suppression (STBS) tests appropriate for preschool vision screening were developed to correct the shortcomings of previous such tests, particularly missed cases of anisometropic amblyopia such as found with some RDS-based testing.
In Experiment 1, the tests were administered to 14 patients with current or a recent history of moderate (< or = 20/60) anisometropic amblyopia, or with accommodative esotropia or monofixation syndrome. All subjects had good binocularity (< or = 100" contour stereoacuity). In Experiment 2, the new tests were administered in a screening setting to a group of 112 three- to five-year-olds to determine testability. Visual acuity, cover testing, and photoscreening were administered as control measures.
In Experiment 1, eleven of the 14 patients failed both tests. Two anisometropic amblyopes passing one or both tests had an acuity < or = 20/30 in the worse eye and < or = 25" stereoacuity. Three anisometropic amblyopia patients failing the STRDS passed another RDS test with similar disparity but a larger target size, confirming a report34 that anisometropic amblyopes may pass RDS testing with parafoveal stereopsis despite the presence of central suppression. The STRDS and STBS tests indicated 80% and 96% specificity, respectively, with the original methodologies; STRDS specificity increased to 95% with retesting with a different methodology. Administration time was 30 sec to 60 sec per test.
Small-target RDS or suppression testing may be more effective for strabismus and amblyopia screening of preschoolers than previous RDS test formats.
为纠正先前学龄前视力筛查测试的缺点，尤其是矫正性屈光参差性弱视漏诊情况（如一些基于随机点立体图（RDS）测试所发现的情况），开发了新型小目标（<1度）随机点立体图（STRDS）和双眼抑制（STBS）测试。
在实验1中，对14例患有中度（≤20/60）当前或近期矫正性屈光参差性弱视病史、或患有调节性内斜视或单眼注视综合征的患者进行测试。所有受试者双眼视功能良好（≤100"轮廓立体视锐度）。在实验2中，在筛查环境中对一组112名3至5岁儿童进行新测试，以确定其可测试性。进行视力、遮盖试验和照片筛查作为对照措施。
在实验1中，14例患者中有11例两项测试均未通过。两名通过一项或两项测试的矫正性屈光参差性弱视患者较差眼视力≤20/30，立体视锐度≤25"。三名未通过STRDS测试的矫正性屈光参差性弱视患者通过了另一项具有相似视差但目标尺寸更大的RDS测试，证实了一份报告34，即尽管存在中心抑制，矫正性屈光参差性弱视患者可能通过旁中央凹立体视的RDS测试。采用原始方法时，STRDS和STBS测试的特异性分别为80%和96%；采用不同方法重新测试时，STRDS特异性提高到95%。每次测试的给药时间为30秒至60秒。
小目标RDS或抑制测试对于学龄前儿童斜视和弱视筛查可能比以前的RDS测试形式更有效。
