儿童视力自动检测系统在婴幼儿视力评价 中的初步应用

目的：采用北京大学第一医院与北京大学信息科学技术学院、心理与认知科学学院共同研制开发的 儿童条栅视力自动检测系统（AACP）对婴幼儿视力进行测量，探讨该系统的应用价值。方法：前瞻 性临床研究。于2018年2月至2021年10月利用北京大学多个院系联合研制开发的AACP，对5个月 ~6岁儿童进行视力自动检测，并同时使用条栅视力检测卡（TAC-II）进行人工检测，将2种检测所得 结果做对比研究。采用Wilcoxon检验进行2种视力间的差异比较，Spearman相关进行相关性分析， Bland-Altman图进行一致性分析。结果：33例（66眼）3~6岁儿童全部完成AACP与TAC-II的双眼视 力检测，其中30例（54眼）儿童完成AACP与TAC-II的单眼视力检测，双眼视力检查完成率100%， 单眼检查完成率90.0%。194例（388眼）5~30个月龄婴幼儿中，141例（282眼）完成2种检测方法的双 眼视力检测并得到有效数据，完成率为72.7%。33例3~6岁儿童的AACP与TAC-II双眼视力及单眼视 力均呈正相关（r=0.40，P=0.021；r=0.55，P<0.001）。141例5~30月龄婴幼儿的AACP与TAC-II双眼 视力有较强的相关性（r=0.88，P<0.001），相关系数高于3~6岁儿童，Bland-Altman图显示90.8%的点 在一致性范围内，不同月龄间AACP与TAC-II视力均存在明显正相关（r=0.82~0.94，均P<0.05），不 同月龄间AACP视力差异有统计学意义（H=32.02，P<0.001），视力随月龄增长而逐渐递增。结论： AACP与TAC-II所得到的婴幼儿视力结果存在正相关，在低年龄婴幼儿中有更好的相关性和一致性。 AACP有望成为适合临床条栅视力评估及婴幼儿视力筛查的检查工具。

Preliminary Application of an Automated Acuity Detection System in Infant Visual Acuity Evaluation

Objective: To explore the application of the automated acuity card procedure (AACP) developed by the Peking University First Hospital, the School of Electronics Engineering and Computer Science and the School of Psychological and Cognitive Sciences of Peking University. Methods: Prospective clinical study. From February 2018 to October 2021, using the AACP jointly developed by multiple colleges and departments of Peking University, children aged 5 months to 6 years old were tested automatically, and the Teller Acuity Card II (TAC-II) was used for manual detection at the same time. The results of the two tests were compared. The Wilcoxon sign rank test, Spearman rank correlation, and Bland-Altman plots were used to compare the differentiation, correlation and consistency between AACP and TAC- II. Results: All 33 children (66 eyes) aged 3-6 years completed the binocular visual acuity test of AACP and TAC-II. Among them, 30 children (54 eyes) completed the monocular visual acuity test of AACP and TAC-II. The completion rate of the binocular visual acuity test was 100%, and the completion rate of the monocular visual acuity test was 90.0%. Among 194 infants (388 eyes) aged 5-30 months, 141 infants (282 eyes) completed the binocular visual acuity test of the two methods and obtained effective data, with a completion rate of 72.7%. The AACP of 33 children aged 3-6 years was positively correlated with TAC- II binocular visual acuity and monocular visual acuity (r=0.40, P=0.021; r=0.55, P<0.001). There was a strong correlation between AACP and TAC-II binocular vision in 141 infants aged 5-30 months (r=0.88, P<0.001), and the correlation coefficient was higher than that of children aged 3-6 years, the Bland-Altman test showed 90.8 % points were all within the consistent range. There was a significant positive correlation between AACP and TAC-II visual acuity between different months of age (r=0.82-0.94, all P<0.05), and there was a statistically significant difference in AACP visual acuity between different months of age (H=32.02, P<0.001), with a trend that increased with age. Conclusion: There was a positive correlation between the visual acuity results obtained by the AACP and the TAC-II, especially with better results in young infants. The AACP is expected to become a useful tool suitable for clinical grating acuity evaluation and infant vision screening.