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Comparison of applicability of different visual acuity charts for pediatric outpatient visual tests
Insights
This study compared three visual acuity charts for pediatric eye exams. The digital LogMAR chart demonstrated better reproducibility, while ETDRS and logarithm charts showed higher consistency in measuring visual acuity in children.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Visual Acuity Testing
Background:
- Accurate visual acuity measurement is crucial for pediatric eye care.
- Standardizing visual acuity charts in outpatient settings is essential for reliable pediatric vision screening.
Purpose of the Study:
- To assess the applicability and consistency of different visual acuity charts for pediatric outpatient testing.
- To compare the performance of digital LogMAR, ETDRS, and standard logarithm visual acuity charts in children aged 4-8 years.
Main Methods:
- Fifty-three children (4-8 years) underwent best corrected visual acuity (BCVA) testing using three charts: digital LogMAR, ETDRS, and a standard logarithm chart.
- Each chart's measurements were repeated twice, and Bland-Altman analysis was used to evaluate consistency and reproducibility.
- Paired comparisons analyzed differences in visual acuity measurements between charts.
Main Results:
- The digital LogMAR chart showed the highest consistency (0.068 LogMAR difference) between repeated measurements.
- ETDRS and standard logarithm charts exhibited higher consistency (0.072 and 0.090 LogMAR differences, respectively) but lower reproducibility compared to the digital LogMAR chart.
- Visual acuity measurements varied significantly between the digital LogMAR and ETDRS charts (P < 0.01).
Conclusions:
- All three visual acuity charts are suitable for outpatient pediatric vision testing.
- The digital LogMAR chart offers superior reproducibility, while ETDRS and logarithm charts provide greater consistency.
- Determining the single most suitable chart for cooperative children remains challenging due to differing performance characteristics.
Purpose:
To evaluate the applicability of different visual acuity charts for outpatient pediatric visual tests.
Methods:
Fifty-three children (53 eyes) aged 4-8 years undergoing visual acuity tests as outpatients were randomly selected for this study. The best corrected visual acuity (BCVA) of the eye with better visual acuity was measured for each child using the digital LogMAR visual chart, the ETDRS visual chart, and a new standard logarithm visual chart; all measurements were repeated twice and the BCVA was recorded. Paired comparisons were made between the LogMAR visual acuity chart and ETDRS chart measurements or between the ETDRS chart and logarithm visual acuity chart measurements for statistical analysis of the differences in measurement of visual acuity. The results of different measurements by the same chart were compared to evaluate the consistency of the measurement results. Bland-Altman analysis was employed to evaluate the most suitable chart for outpatient measurement of visual acuity in children.
Results:
Bland-Altman analysis revealed that the mean visual acuity measured was (0.447 ± 0.017 LogMAR) by the digital LogMAR chart, (0.301 ± 0.024 LogMAR) by the standard logarithm visual acuity chart, and (0.309 ± 0.018 LogMAR) by the ETDRS visual acuity chart. The BCVA was significantly lower when measured by the LogMAR visual acuity chart than by the ETDRS chart (P < 0.01). The BCVA was slightly higher when measured by the logarithm visual acuity chart than by the ETDRS chart, but the difference was not statistically significant (P > 0.05). The Bland-Altman plot showed that the highest consistency was obtained with the digital LogMAR chart, with a difference between two repeated measurements of 0.068 LogMAR, compared to 0.090 and 0.072 LogMAR for the logarithm and ETDRS visual acuity charts, respectively.
Conclusion:
All three types of visual acuity charts are applicable for outpatient measurement of pediatric visual acuity. The ETDRS and logarithm visual acuity charts have a higher consistency, but the LogMAR visual acuity chart shows better reproducibility. Consequently, it is difficult to identify and distinguish which acuity chart is most suitable for cooperative children.
