Normative Distribution of Visual Acuity in 3-to 6-Year-Old Chinese Preschoolers: The Shenzhen Kindergarten Eye Study
Normative Distribution of Visual Acuity in 3-to 6-Year-Old Chinese Preschoolers: The Shenzhen Kindergarten Eye Study
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DOI：
10.1167/iovs.14-15422
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发表时间：
2015-03-01
影响因子：
4.4
通讯作者：
He, Mingguang
中科院分区：
文献类型：
--
作者：
Guo, Xinxing;Fu, Min;He, Mingguang
目的。目的：研究中国学龄前儿童未矫正视力（UCVA）的分布情况，并探讨其对视力转诊的影响。从深圳幼儿园招募3 ~ 6岁学龄前儿童。通过早期治疗糖尿病视网膜病变研究翻滚E图评估未矫正视力，随后进行睫状体屈光和眼部检查。参考人群定义为无临床显著的眼部异常，球面等效屈光度大于-0.50至小于+2.00屈光度(D)，散光小于0.75 D，屈光参差小于2.00 D的儿童。特定年龄的UCVA临界值由参考人群单侧95%百分比下降的线确定。在1255名入组儿童中，共有483人被视为参考人口。3岁时单眼UCVA截线为20/63,4岁时为20/50,5岁和6岁时为20/40。使用不优于这些线作为标准，在不同年龄的普通人群中转诊率为9.4%至27.8%，近视和弱视的检出率分别为83.3%和90.0%以上。使用未校正的两道或两道以上眼间差的人群约占3.6%至4.3%，但仅识别出约20.0%的弱视患者。学龄前儿童的视力甚至在6岁时仍在发育。大多数近视和弱视儿童可以在视力筛查中使用滚动E图识别特定年龄的单眼UCVA截止点，假阳性率可容忍。需要进一步的研究来确定没有明显屈光不正的儿童达到20/20 UCVA的年龄。
PURPOSE. To document the distribution of uncorrected visual acuity (UCVA) in a defined population of Chinese preschoolers and to discuss its implications for vision referral.METHODS. Preschoolers aged 3 to 6 years old were recruited from kindergartens in Shenzen. Uncorrected visual acuity was estimated by using Early Treatment Diabetic Retinopathy Study Tumbling E charts, followed by cycloplegic refraction and ocular examination. The reference population was defined as children without clinically significant ocular abnormalities, with spherical equivalent refraction greater than -0.50 to less than +2.00 diopters (D), astigmatism less than 0.75 D, and anisometropia less than 2.00 D. The age-specific UCVA cutoffs were defined by the line where the single-sided 95th percentile of the reference population fell.RESULTS. A total of 483 of the 1255 children enrolled were considered the reference population. The monocular UCVA cutoff fell on the line of 20/63 at age 3, 20/50 at age 4, and 20/40 at ages 5 and 6. Using no better than these lines as criteria generated referral rates of 9.4% to 27.8% in the general population at different ages, and detected 83.3% and more than 90.0% of those with myopia and amblyopia, respectively. Using uncorrected interocular difference of two or more lines referred 3.6% to 4.3% of the population but identified only approximately 20.0% of those with amblyopia.CONCLUSIONS. Visual acuity is still developing in preschoolers even at age 6. Most children with myopia and amblyopia can be identified with age-specific, monocular UCVA cutoffs in vision screening using Tumbling E charts, with tolerable false-positive rates. Further studies are needed to define the age at which children without significant refractive errors reach 20/20 UCVA.