Research progress on commonly used visual acuity charts for preschool children / 国际眼科杂志(Guoji Yanke Zazhi)

Preschool age(3-6 years old)is a critical period for visual development, and it is crucial to detect and treat visual problems in preschool children as early as possible. Visual acuity charts are important tools for screening visual issues in children. In China, the commonly used charts are the standard logarithmic visual acuity chart and the pediatric optotype chart, while overseas, the Lea, HOTV, and ETDRS visual acuity charts are frequently employed. Numerous studies have reported the measurability, repeatability, and sensitivity of these three charts in diagnosing visual-related problems in children. However, the application of these three charts is relatively limited in China. This article provides a comprehensive review of the design principles, clinical applications, and characteristics of these three visual acuity charts, so as to better understand their applicability and limitations in preschool children, and provide reference for the selection and improvement of vision examination methods in the future.

Comparative analysis of Lea Symbols chart and ETDRS chart in Chinese preschool children's vision examination / 中华实验眼科杂志

Objective@#To compare cooperation degree and visual acuity difference between Lea Symbols chart and ETDRS chart in Chinese preschool children.@*Methods@#A prospective self-control study design was performed.Two hundred and forty-one children aged from 42 months to 78 months in Quanzhou Quangang Experimental Kindergarten were enrolled and the mean age was (61.9±10.3) months.Among them, 132 pre-school children had normal refractive index.All children completed comprehensive ophthalmological examinations and measurement of monocular visual acuity using Lea Symbols chart and ETDRS chart.All monocular visual acuity scores were recorded in LogMAR form.This study followed the Declaration of Helsinki and this study protocol was approved by Medical Ethics Committee of The Second Affiliated Hospital of Fujian Medical University (No.2017[62]). Written informed consent was obtained from all guardians before entering the study.@*Results@#The cooperation degrees of Lea Symbols chart and ETDRS chart were 96.7% and 95.0% in 42-78 months of children, respectively, with no significant difference between the two visual acuity tables (χ2=1.669, P>0.05). The visual acuity measured by Lea Symbols chart was positively correlated with that measured by ETDRS chart (rs=0.726, P<0.001). The measurement consistency of the two chart was good (Kappa=0.531). Among 132 normal refractive children, the visual acuity level measured by Lea Symbols chart was higher than that measured by ETDRS chart (W=-7.461, P<0.001); the measurement consistency of the two visual acuity chart was good (Kappa=0.467). There was no significant difference between the two charts in measuring the binocular vision difference (W=-0.889, P=0.374); the visual acuity levels of boys measured by Lea Symbols chart and ETDRS chart were higher than those of girls, and the difference was statistically significant (U=-3.352, -4.679; both at P<0.001); the visual acuity values measured by Lea Symbols chart and ETDRS chart were negatively correlated with age (rs=-0.423, -0.437; both at P<0.001); the visual acuity measured by Lea Symbols chart was higher than that measured by ETDRS chart in different age groups, and the differences were statistically significant (all at P<0.001).@*Conclusions@#The measurement of visual acuity by Lea Symbols chart and ETDRS chart can be achieved with a high cooperation degree in 42 months and older children.The visual acuity measured by Lea Symbols chart is higher than that measured by ETDRS chart.In the preschool children's vision screening, we should pay attention to the difference between the two kinds of visual charts, and be careful to judge the abnormal vision.

Comparative analysis of Lea Symbols chart and ETDRS chart in Chinese preschool children ' s vision examination / 中华实验眼科杂志

Objective To compare cooperation degree and visual acuity difference between Lea Symbols chart and ETDRS chart in Chinese preschool children. Methods A prospective self-control study design was performed. Two hundred and forty-one children aged from 42 months to 78 months in Quanzhou Quangang Experimental Kindergarten were enrolled and the mean age was (61. 9±10. 3) months. Among them,132 pre-school children had normal refractive index. All children completed comprehensive ophthalmological examinations and measurement of monocular visual acuity using Lea Symbols chart and ETDRS chart. All monocular visual acuity scores were recorded in LogMAR form. This study followed the Declaration of Helsinki and this study protocol was approved by Medical Ethics Committee of The Second Affiliated Hospital of Fujian Medical University ( No. 2017 [ 62 ] ) . Written informed consent was obtained from all guardians before entering the study. Results The cooperation degrees of Lea Symbols chart and ETDRS chart were 96. 7％ and 95. 0％ in 42-78 months of children,respectively, with no significant difference between the two visual acuity tables (χ2=1. 669,P>0. 05). The visual acuity measured by Lea Symbols chart was positively correlated with that measured by ETDRS chart (rs=0. 726,P<0. 001). The measurement consistency of the two chart was good ( Kappa=0. 531 ) . Among 132 normal refractive children, the visual acuity level measured by Lea Symbols chart was higher than that measured by ETDRS chart (W=-7. 461,P<0. 001);the measurement consistency of the two visual acuity chart was good (Kappa=0. 467). There was no significant difference between the two charts in measuring the binocular vision difference (W=-0. 889,P=0. 374);the visual acuity levels of boys measured by Lea Symbols chart and ETDRS chart were higher than those of girls,and the difference was statistically significant (U=-3. 352,-4. 679;both at P<0. 001);the visual acuity values measured by Lea Symbols chart and ETDRS chart were negatively correlated with age ( rs =-0. 423,-0. 437;both at P<0. 001 );the visual acuity measured by Lea Symbols chart was higher than that measured by ETDRS chart in different age groups,and the differences were statistically significant (all at P<0. 001). Conclusions The measurement of visual acuity by Lea Symbols chart and ETDRS chart can be achieved with a high cooperation degree in 42 months and older children. The visual acuity measured by Lea Symbols chart is higher than that measured by ETDRS chart. In the preschool children's vision screening,we should pay attention to the difference between the two kinds of visual charts, and be careful to judge the abnormal vision.

Application of ETDRS chart and mfERG in assessing pathologic myopia combined with macular CNV after treatment / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To evaluate the efficacy of anti - vascular endothelial growth factor ( VEGF ) and photodynamic therapy ( PDT) on pathological myopia ( PM) combined with choroidal neovascularization ( CNV ) using ETDRS chart and multifocal electroretinogram (mfERG). ·METHODS: Forty-three patients ( 45 eyes) diagnosed by fundus fluorescein angiography ( FFA ), indocyanine green angiograph ( ICGA ) and optical coherence tomography (OCT) with PM combined with macular CNV were recruited in this study. The patients were randomly divided into two groups for different treatments, intravitreal injection with Ranibizumab ( 20 patients, 22 eyes) and PDT (23 patients, 23 eyes). After treatment, all patients had been followed up monthly for 12mo. The further treatments were operated according to referral situations. The best corrected visual acuity ( BCVA) was recorded with the ETDRS chart and mfERG. At the last follow-up, the therapy efficacy was determined by ETDRS numbers and mfERG and analyzed. ·RESULTS: Before treatment, there was no significant difference on the baseline in ETDRS and mfERG latency of N1 wave, latency and the density values of P1 wave between ranibizumab group and PDT group. After 12mo treatment, the ETDRS number in ranibizumab group (39. 23± 20. 06) significantly increased to the baseline by 5. 88±9. 03(P<0. 05), and in PDT group (37. 38±16. 95) was not significantly improved by 0. 33±6. 94(P>0. 05). There was no significant difference in latency of N1 wave, latency and the density values of P1 wave from treatment response of mfERG in the two groups (P>0. 05). · CONCLUSION: In the treatment of macular CNV complicated by the PM, ranibizumab injection can improve visual function better than PDT, while similar on macular.

Evaluation of Ranibizumab and PDT for patients with pathologic myopia and macular CNV / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To evaluate the efficacy of anti - vascular endothelial growth factor (VEGF) and photodynamic therapy (PDT) on pathological myopia (PM) combined with choroidal neovascularization (CNV). ·METHODS: Forty-three patients (45 eyes) diagnosed by fundus fluorescein angiography (FFA), indocyanine green angiography ( ICGA ) and optical coherence tomography (OCT) with PM combined with macular CNV were recruited in this study. The patients were randomly divided into two groups for different treatments, intravitreal injection with Ranibizumab (20 patients, 22 eyes) and PDT(23 patients,23 eyes). After treatment,all patients had been followed up monthly for 12mo. The further treatments were operated according to referral situations. The best corrected visual acuity (BCVA) was recorded with the ETDRS chart and the mean defect(MD) of the center 10° visual field was measured. At the last follow-up,the therapy efficacy was determined by ETDRS numbers and MD and analyzed. ·RESULTS: Before treatment, there was no significant difference on the baseline in ETDRS and MD between ranibizumab group and PDT group (P>0.05). After 12mo treatment, the ETDRS number in ranibizumab group (39.23±20.06) significantly increased (by 5.88 ± 9.03, P<0.05), but the PDT group (37. 38 ± 16. 95) was not significantly improved(by 0.33±6.94,P>0.05). The MD in ranibizumab group decreased significantly (P<0.05), and no significant change was found in PDT group(P>0.05). · CONCLUSION: In the treatment of macular CNV complicated by the PM, ranibizumab injection can improve visual function better than PDT.