Data from: Do picture-based charts overestimate visual acuity? Comparison of Kay Pictures, Lea Symbols, HOTV and Keeler logMAR charts with Sloan Letters in adults and children

Purpose: Children may be tested with a variety of visual acuity (VA) charts during their ophthalmic care and differences between charts can complicate the interpretation of VA measurements. This study compared VA measurements across four pediatric charts with Sloan letters and identified chart design features that contributed to inter-chart differences in VA. Methods: VA was determined for right eyes of 25 adults and 17 children (4-9 years of age) using Crowded Kay Pictures, Crowded linear Lea Symbols, Crowded Keeler logMAR, Crowded HOTV and Early Treatment of Diabetic Retinopathy Study (ETDRS) charts in focused and defocused (+1.00 DS optical blur) conditions. In a separate group of 25 adults, we compared the VA from individual Kay Picture optotypes with uncrowded Landolt C VA measurements. Results: Crowded Kay Pictures generated significantly better VA measurements than all other charts in both adults and children (p < 0.001; 0.15 to 0.30 logMAR). No significant differences were found between other charts in adult participants; children achieved significantly poorer VA measurements on the ETDRS chart compared with pediatric acuity tests. All Kay Pictures optotypes produced better VA (p < 0.001), varying from -0.38 ± 0.13 logMAR (apple) to -0.57 ± 0.10 logMAR (duck), than the reference Landolt C task (mean VA -0.19 ± 0.08 logMAR). Conclusion: Kay Pictures over-estimated VA in all participants. Variability between Kay Pictures optotypes suggests that shape cues aid in optotype determination. Other pediatric charts offer more comparable VA measures and should be used for children likely to progress to letter charts.【研究目的】儿童在眼科诊疗过程中，可能需接受多种视力（visual acuity, VA）检查表检测，不同检查表间的差异会增加视力测量结果解读的难度。本研究对比了四款搭载斯隆字母（Sloan letters）的儿童视力检查表的视力测量结果，并明确了导致不同检查表间视力测量结果差异的设计特征。 【研究方法】本研究分别在清晰成像与离焦（+1.00 DS 光学模糊）条件下，使用拥挤式凯氏图片检查表、拥挤式线性Lea符号检查表、拥挤式Keeler logMAR检查表、拥挤式HOTV检查表以及糖尿病视网膜病变早期治疗研究（ETDRS）检查表，对25名成人与17名4~9岁儿童的右眼进行视力测量。另外，本研究还纳入另一组25名成人受试者，对比了单个凯氏图片视标的视力测量结果与非拥挤式兰多尔特环（Landolt C）视力测量结果。 【研究结果】在成人与儿童受试者中，拥挤式凯氏图片检查表所测得的视力结果均显著优于其余所有检查表（p < 0.001；差值范围0.15~0.30 logMAR）。在成人受试者中，其余各检查表间的视力测量结果无显著差异；与儿童专用视力测试检查表相比，儿童在ETDRS检查表上测得的视力结果显著更差。所有凯氏图片视标的视力测量结果均优于参照组的兰多尔特环测试（平均视力为-0.19 ± 0.08 logMAR），差异具有统计学意义（p < 0.001），其视力值范围为-0.38 ± 0.13 logMAR（苹果图案）至-0.57 ± 0.10 logMAR（鸭子图案）。 【研究结论】所有受试者中，凯氏图片检查表均高估了视力水平。不同凯氏图片视标的视力结果存在差异，这表明形状线索有助于视标识别。其余儿童视力检查表所测得的视力结果可比性更强，适合用于即将过渡到字母视力检查表的儿童受试者。