Lea Symbols视力表在42～78个月儿童视力检查中的重复测量可信度分析

目的：探讨Lea Symbols视力表在学龄前儿童视力检查中的重复测量可信度。方法：横断面研究。 2017年4-5月对泉州市泉港区实验幼儿园的250名42～78（61.9±10.3）个月的学龄前儿童进行全面 的眼科检查，使用Lea Symbols视力表重复测量右、左眼的单眼远视力，采用LogMAR记录法记录 视力值。采用Bland-Altman分析、加权Kappa检验、组内相关系数3种统计分析方法衡量2次测量之 间的重复测量可信度。结果：3种分析方法均显示Lea Symbols视力表在学龄前儿童视力检查中的重 复测量可信度较好，2次测量间视力的差值94.3%在1行以内，2次测量的视力值之间的相关性较高 （r=0.753，P<0.001）。在139名屈光正常儿童中，2次测量的视力值（LogMAR）平均相差0.014。在 139名屈光正常儿童中，视力与月龄的相关性是显著的，月龄越大视力越好（r第1次=-0.335，P<0.001； r第2次=-0.424，P<0.001）；性别对可重复性没有影响（P=0.197）。结论：Lea Symbols视力表可用于 中国42个月及以上学龄前儿童的视力检查，可以在临床视力检查中推广使用。

Test-Retest Reliability of the Lea Symbols Chart in Preschool Children Aged 42-78 Months

Objective: To evaluate the repeatability of the Lea Symbols chart in vision examinations of preschool children. Methods: In this cross-sectional study, we included 250 children aged 42 through 78 months (61.9±10.3) from April to May 2017. All children completed comprehensive ophthalmological examinations and monocular assessment of visual acuity was performed in both eyes with the Lea Symbols chart. All visual acuity scores are presented in LogMAR units. Bland-Altman analysis, weighted Kappa test and correlation analysis were used to measure the reliability of repeated measurements between the two measurements. Results: The visual acuity (LogMAR) difference between test and retest thresholds was between ±0.10 in 94.3% of eyes. Correlation between test and retest thresholds was 0.753 (P<0.001). The mean difference in visual acuity (LogMAR) between test and retest was 0.014 in 139 preschool children without refractive errors. A significant relationship was found between age and visual acuity in 139 preschool children without refractive errors (rfirst=-0.335, P<0.001; rsecond=-0.424, P<0.001). Repeatability was not associated with gender (P=0.197). Conclusions: The Lea Symbols chart provides a repeatable measure of visual acuity in children 42 months and older. It is recommended for the clinical examination of children