ETDRS表原理和使用方法及其与Snellen视力表的比较

早期糖尿病视网膜病变治疗研究（early treatment diabetic retinopathy study,ETDRS）视力表是在Bailey-Lovie视力表基础上发展出来专门用于临床试验的视力表,其原理较Snellen视力表科学和合理,精确度和可重复性都高于后者,检查所耗时间较后者长,其logMAR视力结果可直接用于视力统计。ETDRS视力表能通过不同测试距离（4、2、1 m）对极低视力进行量化和评分,并且不同测试距离视力值可相互转化。但1 m以下测量时理论值和实际测量值存在较大误差,为了避免夸大视力改进或丢失的情况,应谨慎对待不同测试距离的转化值。     

低视力对数视力表在严重弱视儿童视力评价中的应用价值

目的 :应用低视力对数视力表评价严重弱视患儿的疗效。方法 :研究对象是初诊时矫正视力≤ 0 .1的 12例患儿 ,年龄 3～ 5岁 ,其中远视性屈光参差性弱视 11例 ,斜视性弱视 1例。采用由刘晓玲等设计的低视力对数视力表 ,进行矫正远视力评价。治疗采用以遮盖和矫正为主的综合治疗。结果 :12例患儿治疗前矫正视力为 0 .0 4～ 0 .0 8,视功能训练后视力提高 2行或 2行以上的有 10例 ,只有 3例 3眼视力超过 0 .1。但是 ,医师、患儿及家长由此得到了较大的鼓舞 ,积极参加进一步的训练。结论 :虽然严重弱视儿童的视力预后比较差 ,但是使用低视力对数视力表评价以后 ,低于 0 .1的视力也能够被精细测量 ,短时间的治疗已经证明多数儿童视力有 2行以上的提高 ,且得到家长的理解和儿童的配合     

低视力对数视力表的研制

目的 :研制一种适合我国眼科临床使用的低视力对数视力表。方法 :根据Baily Lovie的LogMAR视力表和我国标准对数视力表的设计标准和原理设计 ,1分视角为 1.0视力 ,视标的增率为 10 10 ,视标的间距和行距与我国标准视力表相同 ,E字母设备 ,每行视标个数与Baily Lovie的视力表一致。为了与低视力分级标准一致 ,采用小数记录。结果和结论 :低视力对数视力表 ,设计合理 ,检查低视力的范围大 ,将应用于我国眼科临床     

液晶视力表显示精度与显示屏点距的相关性分析

目的探讨液晶视力表测量精度与显示屏点距的关系。方法 采用标准对照研究方法,调查常用显示屏相关参数,与新标准对数视力表国家标准（GB11533-2011）的视标大小及允许误差进行推算、对比研究。结果 液晶视力表在亮度、幅宽、白度、照明方面完全符合（GB11533-2011）要求;在液晶显示精度方面,0.27 mm点距的显示屏可准确测试远视力≤5.0视力;0.1245 mm点距显示屏可准确测试远视力≤5.2视力;点距0.077 mm的显示屏准确测试远视力≤5.3视力。结论 选择合适点距和测试距离可使液晶视力表测试结果更精确。     

Lea Symbols与Tumbling E视力表在学龄前儿童视力检查中的应用

目的比较LeaSymbols视力表与TumblingE视力表在学龄前儿童中视力的检测率、视力值和双眼间视力差异。方法对温州市某幼儿园一小班24名36～50(平均43.2±3.71)个月的儿童以随机顺序先后用LeaSymbols与TumblingE视力表检查单眼视力,视力值用logMAR记录方法来表示,用logMAR单位记录双眼视力差异。结果Leasymbols视力表的检测率为96%,Tum-blingE视力表的检测率为71%,其中33只眼能配合查Leasymbols与TumblingE,TumblingE的视力为0.26±0.10,Leasymbols的视力为0.19±0.10,两者呈线形相关(相关系数r=0.76),两者作配对t检验有显著性差异(t=6.068,p<0.0001),16名儿童用LeaSymbols测得的双眼视力差别为-0.004±0.065,用TumblingE测得的双眼视力差别为-0.019±0.067,两者呈线形相关(相关系数r=0.65),统计学分析两者无显著性差异(p=0.296)。结论Leasymbols视力表检查学龄前儿童视力特别是3～4周岁的儿童检测率高,LeaSymbols与TumblingE视力表一样能够很好地反映双眼间视力的差别,但与TumblingE视力表相比,LeaSymbols视力表存在过高估计视力的可能。视力的测定是个心理物理学过程,对于学龄前儿童,我们不能简单地根据视力小于0.8判断其弱视,而是要从儿童的认知水平来考虑。     

儿童图形视力表与Teller视敏锐度卡在婴幼儿视力检测中应用分析

目的 探讨儿童图形视力表、Teller视敏锐度卡在婴幼儿视力检测中的可行性和可靠性.方法 对2010年1～12月在北京同仁医院眼科斜弱视门诊就诊的185例患儿,分别使用儿童图形视力表检测2～3岁患儿59例118只眼,用Teller视敏锐度卡检测5个月至2岁患儿126例252只眼.每2个月龄为一组,共分为10组进行视力检测,并对其检测结果进行分析评估.结果 应用儿童图形视力表检测视力结果:0.1～0.2者为14.41％ (17/118),0.3～0.5者为64.41％ (76/118),0.6者为21.19％ (25/118);应用Teller视敏锐度卡检测视力结果:13 cy/cm为21.43％ (54/252),4.8～9.8 cy/cm为20.63％(52/252),1.3～3.2 cy/cm为42.86％ (108/252),0.86 cy/cm为10.71％ (27/252),0.43 cy/cm为4.37％(11/252).结论 儿童图形视力表、Teller视敏锐度卡是一种安全、快速、经济、有效地婴幼儿视力评估检测系统,较常规检查能更早地发现低于该年龄段视力发育水平的低常视力,同时可以对眼部先天性疾患的婴幼儿低视力进行早期干预并制定跟踪治疗方案.     

Reading performance in children with low vision

Purpose: While educators and optometrists are concerned with reading efficiency in children with low vision, in most low vision assessments, children's reading performance is assessed only by a brief evaluation of reading fluency. We examined the relationships between clinical vision measures and reading performance in children with low vision. Methods: Subjects were 71 students with low vision, aged seven to 18 years. The vision and reading performance measures were: high contrast distance visual acuity, contrast sensitivity using both the Pelli‐Robson and LH symbol charts, near text visual acuity and reading rates on a range of print sizes. Results: Most children achieved maximum reading rate at print sizes between 2.5 and seven times larger than threshold print size. Maximum reading rate increased significantly with age and near visual acuity. There was no significant relationship between reading rate and contrast sensitivity. Conclusions: The majority of children with low vision can achieve near normal reading rates with magnification. Age is the strongest predictor of reading rate in children with low vision. They need print sizes well above threshold to achieve maximum reading rate. Routine contrast sensitivity testing of visually impaired students is not indicated for reading assessment.     

Psychometric视力表对弱视儿童视力的评估作用

目的评价Psychometric视力表在弱视儿童诊治中的应用价值．拥挤现象对正常视力儿童和弱视儿童的影响是否相同。方法我院门诊5～15岁儿童113人，男65人，女48人，平均年龄（7.42±2．03）岁，用标准对数视力表和包含拥挤现象的Psychometric视力表分别检查左右眼的两种视力，比较正常眼和弱视眼两种视力的差别。结果正常视力儿童和弱视儿童的两种视力差异都有显著性（P〈0．05）。对数视力比P视力高。弱视儿童的两种视力差别比正常儿童大。不同弱视类型之间视力差别不大．不同弱视程度之间两种视力有差别。结论儿童都受拥挤现象的影响，但是弱视儿童的拥挤现象更明显。拥挤现象影响程度与弱视程度有关。与弱视类型关系不大。Psychometric视力表适合弱视患者的视力检查。     

红色视力表远距离视功能训练在近视性弱视治疗中的疗效分析

目的：对比观察分析红色视力表远距离视功能训练在近视性弱视治疗中的疗效。方法近视性弱视患儿甲、乙两组共112例212眼,甲组62例117眼,年龄4-12岁（5.71±1.78岁）,乙组50例95眼,年龄3-12岁（5.96±1.83岁）;其中甲组轻度、中度、高度近视眼分别为21眼（17.95%）、67眼（57.26%）、29眼（24.79%）,乙组为18眼（18.95%）、55眼（57.89%）、22眼（23.16%）（χ2＝0.09,P〉0.05）;甲组轻度、中度、重度弱视眼分别为30眼（23.15%）、64眼（54.70%）、23眼（19.66%）;乙组为24眼（25.26%）、54眼（56.84%）、17眼（17.89%）（χ2＝0.133,P〉0.05）;甲组病例采用短小遮盖＋近距离视功能训练;乙组病例采用短小遮盖＋红色视力表远距离视功能训练,所有病例治疗随访时间17个月,对比分析两种治疗方法在近视性弱视治疗中的疗效。结果甲组基本治愈率为39.32%,有效率为43.59%,无效率为17.09%;乙组基本治愈率为47.37%,有效率为36.84%,无效率为15.79%,统计学检验差异无显著性（χ2＝1.434,P〉0.05）;甲乙两组治疗后轻、中、高度近视眼数分别为：4眼（3.42%）、65眼（55.56%）、48眼（41.03%）和5眼（5.26%）、67眼（70.53%）、23眼（24.21%）统计学检验差异有显著性（χ2＝6.734,P〈0.05）。结论红色视力表远距离视功能训练治疗近视性弱视疗效好,同时能更好的减少治疗后弱视眼近视度数的发展。     

A new specialized visual acuity chart for amblyopic children aged 3-5 years old:development and its clinical applications

AIM: To introduce a new specialized visual acuity chart for amblyopic children aged 3-5 years old and its clinical applications.METHODS:The new visual acuity chart and notations were designed based on Weber-Fechner law. The optotypes were red against a white background and were specially shaped four basic geometric symbols:circle, square, triangle,and cross. A regular geometric progression of the optotype sizes and distribution was employed to arrange in 14 lines. The progression rate of the optotype size between two lines was 1.2589 and the testing distance was 3m. Visual acuity score could be recorded as logMAR notation or decimal notation. Age-stratified diagnostic criteria for amblyopia established by consensus statement on diagnosis of amblyopia (2011) among members of the Strabismus and Pediatric Ophthalmology Group, Ophthalmology Society, Chinese Medical Association (SPOGOSCMA) were illustrated in the new visual acuity chart.RESULTS: When assessing visual acuity in children aged 3-5 years old, this new visual acuity chart that consists of four symmetrical shapes (triangle, square, cross, and circle) overcame an inability to recognize the letters of the alphabet and difficulties in designating the direction of black abstract symbols such as the tumbling ‘E’ or Landolt ‘C’, which the subjects were prone to lose interest in. The visual acuity score may be recorded in different notations:decimal acuity and logMAR. These two notations can be easily converted each other in the new eye chart. The measurements of this new chart not only showed a significant correlation and a good consistency with the international standard logarithmic visual acuity chart (r=0.932, P<0.01), but also indicated a high test-retest reliability (89% of retest scores were within 0.1logMAR units of the initial test score).CONCLUSION: The results of this study support the validity and reliability of distance visual acuity measurements using the new eye chart in children aged 3 to 5 years over a wide range of visual acuities, and the new eye chart is great for early detection of amblyopia. It can be applied in various clinical settings.     

A new specialized visual acuity chart for amblyopic children aged 3-5 years old:development and its clinical applications

AIM: To introduce a new specialized visual acuity chart for amblyopic children aged 3-5 years old and its clinical applications.METHODS:The new visual acuity chart and notations were designed based on Weber-Fechner law. The optotypes were red against a white background and were specially shaped four basic geometric symbols:circle, square, triangle,and cross. A regular geometric progression of the optotype sizes and distribution was employed to arrange in 14 lines. The progression rate of the optotype size between two lines was 1.2589 and the testing distance was 3m. Visual acuity score could be recorded as logMAR notation or decimal notation. Age-stratified diagnostic criteria for amblyopia established by consensus statement on diagnosis of amblyopia (2011) among members of the Strabismus and Pediatric Ophthalmology Group, Ophthalmology Society, Chinese Medical Association (SPOGOSCMA) were illustrated in the new visual acuity chart.RESULTS: When assessing visual acuity in children aged 3-5 years old, this new visual acuity chart that consists of four symmetrical shapes (triangle, square, cross, and circle) overcame an inability to recognize the letters of the alphabet and difficulties in designating the direction of black abstract symbols such as the tumbling ‘E’ or Landolt ‘C’, which the subjects were prone to lose interest in. The visual acuity score may be recorded in different notations:decimal acuity and logMAR. These two notations can be easily converted each other in the new eye chart. The measurements of this new chart not only showed a significant correlation and a good consistency with the international standard logarithmic visual acuity chart (r=0.932, P<0.01), but also indicated a high test-retest reliability (89% of retest scores were within 0.1logMAR units of the initial test score).CONCLUSION: The results of this study support the validity and reliability of distance visual acuity measurements using the new eye chart in children aged 3 to 5 years over a wide range of visual acuities, and the new eye chart is great for early detection of amblyopia. It can be applied in various clinical settings.     

Effects of chronic smoking on color vision in young subjects

AIM: To evaluate the effects of chronic smoking on color vision in young subjects. METHODS: This study included 91 smokers and 88 non-smokers (a total of 179 volunteers) without any ophthalmologic and systemical disorders. The subjects were between 18-40 years of age with a best corrected visual acuity (BCVA) of 20/20, normal anterior and posterior segment examinations and normal intraocular pressure. The color vision of the subjects were evaluated with Farnsworth-Munsell 100 Hue test (FMHT). The total error scores and axis calculation were performed for each subject and the results correlated. RESULTS: Mean age and the standard deviation was 28±5y in the smokers group, and 26.7±5.5y in the control group (P=0.101). Sex distribution was similar in the two groups (P=0.365). There was no significant correlation between age and FMHT total error scores (P=0.069). Median of FMHT total error scores of smokers and non-smokers were 65 and 50.50, respectively. FMHT total error scores was found significantly higher in smokers than non-smokers (P=0.004). There was no statisticaly significant difference between smoker and non-smoker groups with respect to axis ratio calculation (P=0.611). There was no significant correlation with FMHT total error scores with neither smoking duration nor number of cigarettes smoked per day (P=0.405, P=0.454, respectively). CONCLUSION: This study suggested that chronic smoking affects the color vision of young smokers but this may not be sector selective.     

两对比度中文阅读视力表的设计

选择可视性相似的句子作为视标,以完成两对比度中文阅读视力表的设计。方法实验研究。本研究通过视标的选择和视力表版面的制作完成两对比度中文阅读视力表的设计。通过以下方法选取可视性相近的句子作为视标。①句子的初步标准化：对日常阅读材料的各种文体进行句子长度的统计,得出常用书面文体的句子长度。以人教版初中语文课本的现代文为句子来源,根据所统计句子长度从2500个常用汉字中选取构建并适当修改句子。得到句长相同、字词难度相近、语意语法相近等要求95个汉语句子。②心理物理学测试：选择受过大学教育、远近矫正视力达1.0及以上、调节幅度正常、近期眼部无明显不适的受检者阅读这些句子,根据阅读速度和总笔画数这2个因素的最小范围最大交集的原则,选取视标。阅读视力表的版面设计采用国际通用的原则。在对比度上配置100%和10% 2种对比度。数据采用独立样本t检验和配对t检验进行分析。结果 经过初步筛选和心理物理学测试,最后选取可视性相近的52个句子作为视标,结合通用设计原则完成两对比度中文阅读视力表的设计。结论 两对比度汉字阅读视力表其视标之间的可视性相近,视力表设计特点标准科学,具有测量阅读视力、评价阅读行为等用途。     

Using the real-life vision test to assess the functional vision of age-related cataract patients

Purpose

(1) To describe and validate a newly developed, timed performance-based measures of functional vision—the real-life vision test (RLVT). (2) To determine how RLVT relates to clinical measures and self-report assessment of visual function and the complex interactions among visual impairment, psychosocial status, and demographic factors.

Methods

A total of 64 patients with age-related cataract and 45 age-matched controls were evaluated by four types of measurements: (1) demographic, medical, cognitive, and depressive evaluation and the reaction time (RT) testing; (2) clinical measures (visual acuity, contrast sensitivity, stereopsis, and the color perception); (3) the 25-item National Eye Institute''s Visual Functioning Questionnaire; and (4) the RLVT. Spearman''s coefficients, partial correlation, and multiple regression analysis were conducted to determine the relationship among RLVT, clinical measures, and self-report assessment of visual function while controlling for confounders.

Results

Control subjects performed RLVT significantly better than the cataract patients. RLVT correlated well with both clinical and self-report assessments of visual function. All subscales of RLVT remained highly associated with most of the clinical measures, even after adjusting for age, years of education, depression, cognitive status, and the RT. Distance, intermediate and near visual acuity, and binocular contrast sensitivity were significant predictors of the RLVT performances.

Conclusions

Given the strong relationship among RLVT, clinical measures, and the self-report assessments, our results highlight the potential usefulness of RLVT for assessing the functional vision of cataract patients. RLVT may provide information not obtainable from clinical measures or surveys and therefore it is essential to be incorporated into future ophthalmological practice.     

一种新的计算机适应色觉试验

目的:提出一种新的计算机适应色觉试验(NCACVT)并且解释它在实际应用中的可靠性和重要性.方法:法一孟二式100色度试验(FM100HT)和Holmgren试验已经被改良并且适应计算机应用.经典的Ishihara假同色法试验方法(IPPT)已被假定是色盲的一个简便的筛选检查工具;因此依照Ishihara试验结果,受试者被分为色觉有缺陷组(第1组)和对照组(第2组).第1组为色觉有缺陷者13例(男12例,女1例),年龄在19～29(平均21)岁,而第2组为对照组,13个受试者色觉无缺陷(男8例,女5例),年龄在19～28(平均22)岁.为了研究两组人的色觉敏感性,所有的受试者都要进行FM100HT和NCACVT试验.将经典的IPPT,FM100HT和NCACVT的试验结果用统计学方法进行比较.在这两组中NCACVT和FM100HT的误差计分用秩和检验来分析.结果:在误差计分中的差别分别在统计学上是有显著意义的(U=169,P＜0.05;U=153 P＜0.05).根据NCACVT来诊断色觉缺陷的临界点是通过使用接受机器作特征曲线(ROC)而被发现是23.根据23这个临界点的误差计分,在筛选检查色觉缺陷方面,发现NCACVT具有100%的敏感性和100%的特异性.结论:根据Harper和Reeves,这些特点使得这个试验成为一个可靠的、有创意的眼科实践筛选试验.     

视觉评估领域的SLCT和锥细胞对比敏感度测试的临床应用分析

目的：描述新的对比敏感度及色觉检查的原理及其临床应用。方法：对比敏感度用SLCR来评估。SLCT是由几行大小不变(20／25)，但对比度逐渐降低的字母组成的对比敏感度表。色觉以锥细胞的对比敏感度来评估，这是一种视屏测试方法，每一个字母都代表三种视锥细胞中的一种类型(红、绿或蓝)，对比度逐渐降低，分别确定分辨的阈值。测试对象分别为正常受试者以及有眼部疾病的患者。结果：SLCT在检查微小的离焦量以及早期眼部疾病方面比传统的检查具有更大的优势。锥细胞对比敏感度测试比传统的色觉检查敏感性高，不仅可以揭示遗传性色觉异常的类型及其严重程度，而且可以发现不同疾病造成的敏感度的下降。结论：这些新的方法拓展了视觉评估领域，揭示了人眼分辨力的微小变化，提示了遗传性、获得色觉异常眼病的类型和严重程度。     

Use of the mollon-reffin minimalist color vision test with young children

PURPOSE: We evaluated the Mollon-Reffin Minimalist (M-R M) color vision test to determine how successfully young children can perform the task and to compare success rates with the American Optical Hardy Rand Rittler (HRR) test and a preferential-looking type test based on the F2 plates (the Pease-Allen color test [PACT]). METHODS: Participants included 146 children (aged 3-10 years) and 32 older subjects (aged 11-39 years). The M-R M test uses 3 series of colored caps coinciding with protan, deutan, and tritan confusion axes, with 6 saturations along each axis. The observer must identify a single colored cap from gray caps of varying lightness. The PACT test consists of 2 cards with targets for detecting red-green and blue-yellow color deficiencies. The tester judges the location of the target on the basis of the child's looking and/or pointing responses. The HRR was performed according to standard instructions, although a more flexible scoring protocol was also used. RESULTS: A significant difference in the children's performance between the "test" item of the 3 tasks emerged (Cochran Q test, P<.001): all children successfully completed the M-R M, 90% successfully completed the PACT, and 88% successfully completed the HRR. Few errors were made on the M-R M red-green series, even among children aged 3 to 4 years, although errors were made with the least saturated blue-yellow cap at all ages. Recommendations are made for the use of the M-R M with children. CONCLUSIONS: The M-R M test can be performed by young children and may prove to be especially useful for detecting and monitoring acquired color vision defects.     

Habitual visual acuity in a large urban cohort of Western India and factors influencing poor habitual vision

Purpose:The aim of this study was to determine habitual visual acuity (HVA) in a large urban cohort in western India and identify factors associated with poor HVA.Methods:This was a prospective study conducted over 10 days in September 2018 to assess the HVA in individuals attending a 10-day festival in Western India. Participants who volunteered to undergo vision screening and also filled the questionnaire form pertaining to demographic information including their age, gender, address, income, and educational status were included in this study. HVA was recorded with the distance correction that the participants were wearing when they attended the screening. The study evaluated the prevalence of visual acuity 6/6 or <6/6, 6/12, and 6/18 and the factors associated with lower visual acuity.Results:Of the 6300 participants, 1660 (26.3%) were females. Majority of the participants were from urban background (6084, 96.6%) and were of younger age group (18–40 years––3786, 60.1%; 41–60 years––2187, 34.7%; >60 years––327, 5.2%). HVA was recorded as 6/6 both eyes in 4136 (65.6%), at least 6/12 both eyes in 5691 (90.3%), and at least 6/18 both eyes in 5974 (94.8%) individuals. Only 11 patients (0.17%) had VA worse than 6/60 with only 3 patients (0.003%) having bilateral VA <6/60. Older age, female sex, lower education status, and low annual income were significant risk factors for poor HVA.Conclusion:Poor education, lower income, female gender, and old age are significantly associated with poor HVA even in urban Western India despite relatively easy access to affordable eye care facilities.