激光干涉条纹视力测定对弱视疗效的预测

对弱视患者１１６例（１７１只眼）进行了激光干涉条纹视力（ｌａｓｅｒｉｎｔｅｒｆｅｒｅｎｃｅｆｒｉｎｇｅｓｖｉｓｕａｌａｃｕｉｔｙ，ＩＶＡ）与Ｅ视力的测定，并进行系统的治疗与平均２．５年的随访观察。８６．５％的弱视眼ＩＶＡ优于Ｅ视力，１３．５％的弱视眼ＩＶＡ＝Ｅ视力，治疗后Ｅ视力均能提高到ＩＶＡ的水平（Ｐ＜０．０００１，ｒ＝０．８２１８）。表明ＩＶＡ能准确预测弱视疗效，还能在治疗中起监测作用。并就ＩＶＡ与注视性质、弱视程度、类型及大龄、成人弱视等的关系进行了讨论。     

弱视儿童干涉条纹视力测定分析

目的测定分析弱视儿童干涉条纹视力。方法25例(43眼)弱视儿童通过手持式的Heine视网膜视力计进行干涉条纹视力的检查,其结果与最佳矫正视力进行对比。结果43只弱视眼干涉条纹视力平均为4．57±0．2。干涉条纹视力与最佳矫正视力呈正直线相关(r=0．650,P＜0．001),回归方程(?)=0．736x+1．171。中度弱视组干涉条纹视力检查的准确性低于轻度弱视组(X~2=2．471,P=0．166)。结论弱视儿童干涉条纹视力与其最佳矫正视力呈正直线相关,在轻度弱视儿童中两者比较接近。干涉条纹视力的检查可以帮助诊断弱视。     

弱视眼视力拥挤现象

对四组人的单字视力与并列视力进行了对比研究。发现拥挤现象在１２岁以上的眼病组占２．５％；屈光不正组占２３．２５％，两者均与视力水平无关。正常儿童组４～８岁占４７．６２％，但幅度不大，９～１２岁仅５．５６％，说明正常儿童在视觉发育期存在拥挤现象，弱视组４１．８１％有拥挤现象，且较明显，并列视力与单字视力之差≥５排的占１０．７３％，这对筛选儿童弱视具有一定的临床意义，同时对判断弱视的预后有相当价值。     

弱视儿童非弱视眼的视觉诱发电位分析

双８４例儿童正常视力眼的视觉诱发电位（ｖｉｓｕａｌ ｅｖｏｋｅｄ ｐｏｔｅｎｔｉａｌ，ＶＥＰ）进行了分析，其中正常儿童２０人，屈光参差性弱视儿童２８人，治愈的屈光参差性弱视儿童８人，单卵双生子８对，双卵双生子６对。结果表明：弱视的对侧眼及已治愈的弱视眼，尽管视力完全正常，但ＶＥＰ仍表现异常，以Ｐ１００波潜伏期延长明显；双生子中遗传物质相同的单卵双生子，其视力正常眼与弱视眼间的ＶＥＰ差异无显著性意义     

玻璃体混浊患者的激光干涉视力测定

对34例明显玻璃体混浊拟行玻璃体切割手术的患者进行激光干涉视力测定，以预测术后视力的恢复程度。其中3例术前激光干涉视力为无红光感，术后视力恢复分别为0．05，0．04和FC；25例术前激光视力为红光感，术后视力恢复为FC至0．5不等；6例能够辨别条纹的玻璃体混浊患者，5例术后恢复视力基本与激光干涉视力相符。认为：玻璃体混浊相对较轻患者能够辨别条纹，术前测定激光干涉视力有一定价值；严重玻璃体混浊患者，激光不能在视网膜上形成干涉条纹，对视力的预测会出现假阴性结果，应予正确认识。     

视力与立体视

前言立体视觉(简称体视)是人对三维空间各种物体的远近、凸凹和深浅的感知能力,是双眼视觉的高级形式。近年来,国外许多学者从实验角度对视力与立体视的关系进行了一些研究,但是关于视力与立体视关系的临床资料国内外均不多见。本文对150例弱视病人的视力与立体视功能进行了分析和探讨,试图与国外实验性研     

Measurement of Visual Acuity in Latent Nystagmus

A method is described for rapid and accurate assessment of visual acuity in patients with latent (occlusion) nystagmus. By using the duochrome slide of the American Optical Project-O-Chart® and the green filter of the Worth red-green glasses, monocular visual acuity may be readily measured in patients with nystagmus brought out by monocular cover. The results obtained in seven patients are compared with standard opaque occlusion and occlusion with a +5.00 diopter lens.     

激光干涉条纹视力预测白内障术后视力的观察

对52只白内障眼在手术前作激光干涉条纹视力检查,并与术后矫正视力对照,二者基本符合占51.8%、大致符合占13.4%,共65.2%,提示用激光干涉条纹视力检查法预测白内障的术后矫正视力有一定临床意义,建议将激光干涉条纹视力检查作为白内障术前视网膜功能检查方法之一。     

ETDRS对数视力表在儿童视力检查中的可重复性分析

目的：探讨ETDRS对数视力表对儿童视力检查的可重复性及其影响的相关因素。方法：在流行病学调查的过程中，随机使用ETDRS对数视力表，为250位裸眼视力低于0．5和98位视力正常儿童进行裸眼视力重复检查。结果：两次视力测量之间差异的均数为0．004log±0．07；Kappa分析结果具有很好的一致性（k=0．71）；性别与视力检查一致性无明显相关（P=0．845）；年龄与视力检查一致性有显著相关性（P=0．019），年龄越小视力检查一致性越差；屈光不正与视力检查一致性也有显著相关性（P=0．000），近视度数在-1．00D—-5．00D之间的儿童视力检查一致性相对差．而正视眼的视力检查一致性较好。结论：结果提示ETDRS对数视力表适合儿童视力检查，建议推广使用。眼科学报2008；24：48-52．     

视力表的历史、现状与发展趋势

视觉是人类最重要的感觉之一。视锐度反映了视觉系统辨别空间细节的能力,是临床实践中最常用的视功能评估指标。视力表是使用最广的视锐度测量工具。笔者回顾了国内外视力表的发展历程,简述了早期糖尿病视网膜病变治疗研究视力表和标准对数视力表的设计原理和计分规则。由于传统视力表自身的精度限制,其在视力普查和儿童青少年近视防控工作中的局限性也日益凸显,电子视力表代替传统视力表正逐渐成为趋势。笔者分析了当前不同电子视力表的硬件特性、软件算法逻辑和测量结果,发现显示屏的分辨率和尺寸、程序的测量和计分规则等多种参数设置的不统一可能会造成不同设备测量视力的结果不具有可比性。研发规范化的新型电子视力表势在必行。     

智能视力表投影仪的可重复性及其与传统视力表的比较

目的：分析智能视力表投影仪在视力检查中的可重复性及其与传统视力表测量结果的比较。方法：系列病例研究。收集2022年1月4—22日在首都医科大学附属北京同仁医院就诊的眼部不适患者60例（120眼）。先通过智能视力表投影仪（LSJ-IVAC-6000A）对患者进行3次视力检测,并采用组内相关系数（ICC）评价3次测量结果之间的可重复性;再用传统灯箱的国家标准视力表测量1次,并分别采用ICC和Bland-Altman图表法分析智能视力表投影仪与传统视力表检测结果的一致性。结果：同一受检者右眼、左眼使用智能视力表投影仪测量3次的ICC值分别为0.830和0.868,双眼的ICC值均>0.8（P<0.001）;同一受检者右眼、左眼使用智能视力表投影仪和传统灯箱的国家标准视力表测量的ICC值分别为0.846和0.873,双眼的ICC值均>0.8（P<0.001）。右眼、左眼使用智能视力表投影仪和传统灯箱的国家标准视力表测量差值的95%一致性界限分别为-0.25~0.20和-0.24~0.17。结论：智能视力表投影仪的可重复性较好,与传统灯箱的国家标准视力表的测量结果相比一致性较强,应用于临床工作中可提高视力筛查的效率并节省人力和物力。     

Comparison of Applicability of Different Visual Acuity Charts for Pediatric Outpatient Visual Tests

Purpose： To evaluate the applicability of different visual acuity charts for outpatient pediatric visual tests.
Methods： Fifty-three children （53 eyes） aged 4-8 years undergoing visual acuity tests as outpatients were randomly selected for this study. The best corrected visual acuity （BCVA） of the eye with better visual acuity was measured for each child using the digital LogMAR visual chart, the ETDRS visual chart, and a new standard logarithm visual chart; all measurements were repeated twice and the BCVA was recorded. Paired comparisons were made between the LogMAR visual acuity chart and ETDRS chart measurements or between the ETDRS chart and logarithm visual acuity chart measurements for statistical analysis of the differences in measurement of visual acuity. The results of different measurements by the same chart were compared to evaluate the consistency of the measurement results. Bland-Altman analysis was employed to evaluate the most suitable chart for outpatient measurement of visual acuity in children.
Results： Bland-Altman analysis revealed that the mean visual acuity measured was （0.447±0.017 LogMAR）by the digital LogMAR chart, （0.301±0.024 LogMAR） by the standard logarithm visual acuity chart, and （0.309±0.018 LogMAR） by the ETDRS visual acuity chart. The BCVA was significantly lower when measured by the LogMAR visual acuity chart than by the ETDRS chart （P〈0.01）. The BCVA was slightly higher when measured by the logarithm visual acuity chart than by the ETDRS chart, but the difference was not statistically sig nificant（P〉0.05）. The Bland-Altman plot showed that the highest consistency was obtained with the digital LogMAR chart, with a difference between two repeated measurements of 0.068 LogMAR, compared to 0.090 and 0.072 LogMAR for the logarithm and ETDRS visual acuity charts, respectively.
Conclusion： All three types of visual acuity charts are appli-cable for outpatient measurement of pediatric visual acuity. The ETDRS and logarithm visual acuity ch     

用视诱发电位和富里叶变换作视力客观估计

目的:研究用图形视觉诱发电位(PVEP)和离散富里叶变换(DFT)作视力客观估计的方法。方法:检测对象为33只正常眼。用翻转频率为10次/秒,条纹张角分别为30、20、18、12、10、6、4和2弧分的垂直方波光栅图形刺激,记录相应的稳态图形视诱发电位。用离散富里叶交换提取WEP频谱中10Hz成分的幅值。以光栅条纹张角为横坐标、相应的VEP频谱幅值为纵坐标作关系曲线,取阈值附近的近似线性部分的数据点作直线回归,用外推法求得阈值和视力。结果:比较VEP所测之视力与用国际标准视力表所测之视力,可见在本研究中70％的受检眼VEP视力估计较准确。结论:用本研究中的VEP技术客观地测量视力可靠性较高。眼科学报1997;13:59～61。     

中心性浆液性脉络膜视网膜病变的屈光变化幅度与视力预后

目的：探讨中心性浆液性脉络膜视网膜病变（CSC）患眼的屈光变化幅度及其与视力预后的关系。方法：对23例原为正视眼的单眼活动期CSC患眼作随访前后屈光状态及矫正视力的检测。随访时间3至12个月（平均7．2个月）。结果：随访前15只患眼（65．2％）呈轻度远视状态，而对侧健眼呈远视状态的为5只眼（21．7％），远视率在患眼与健眼的分布上差异有显著性意义（P＜0．01）。随访后仅5只患眼（21．7％）仍呈远视状态，随访前后患眼远视率比较差异有显著性意义（P＜0．01）。随访前经验光矫正视力增进3行或以上的患眼90．9％在随访后矫正视力可达到1．0或以上。结论：大部分CSC患眼由于黄斑区神经上皮脱落、水肿而呈暂时性的轻度远视；通过活动期患眼屈光状态及矫正视力的检测，对患眼视力预后的评价有一定的价值。     

Central Retinal Artery Obstruction and Visual Acuity

The records of 72 patients (73 eyes) with acute central retinal arterial obstruction (CRAO) were reviewed. Three eyes (4%) were initially observed to have no light perception vision. However, two of these three were found to have concomitant posterior ciliary circulation defects on fluorescein angiography, and the third had electroretinographic evidence of both outer and inner retinal damage. Previous studies have indicated that a much higher percentage of patients with CRAO present with NLP vision. From the data presented it is the feeling of the authors that cases with obstruction of the central retinal artery alone and NLP acuity in the involved eye are most unusual. If true NLP vision is present, additional complicating factors should be suspected, particularly abnormalities of the choroidal circulation and the optic nerve.     

A Novel Computerized Visual Acuity Test for Children

Purpose

To investigate the efficacy of a computerized visual acuity test, the SNU visual acuity test for children.

Methods

Fifty-six children, ranging from 1 to 5 years of age, were included. In a dark room, children gazed at and followed a circular dot with 50% contrast moving at a fixed velocity of 10 pixels/sec on a computer monitor. Eye movement was captured using a charge coupled device camera and was expressed as coordinates on a graph. Movements of the eye and dot were superimposed on a graph and analyzed. Minimum visualized dot diameters were compared to the Teller visual acuity.

Results

Ten eyes (8.9%) of six children failed to perform the Teller visual acuity test, and two eyes (1.8%) of one patient failed to perform the SNU visual acuity test. The observed Teller visual acuity and SNU visual acuity were significantly correlated (p < 0.001). Visual angle degrees converted from the Teller visual acuity and SNU visual acuity were also significantly correlated (p < 0.001).

Conclusion

The SNU visual acuity using moving targets correlated well with Teller visual acuity and was more applicable than the Teller acuity test. Therefore, the SNU visual acuity test has potential clinical applications for children.