Background/Objective

Can measuring interocular brightness disparity, acuity, and colour vision classify children with amblyopia?

Subjects/Methods

Two hundred eight subjects (3–14 years) were recruited for a prospective, observational protocol to measure interocular brightness disparity, uniocular acuities with and without a pinhole, and colour vision using an iPad. Subjects looked through polarizing filters and chose the brighter of two spaceships to measure interocular brightness disparity. The differential brightness of image pairs was varied through a staircase algorithm until equal brightness was perceived. Acuities and colour vision were tested with tumbling Es and AO-HRR colour plates, respectively. Unilateral amblyopia was later confirmed in two subjects.

Results

Binocular brightness balance on the iPad detected amblyopes with 100% sensitivity and specificity. Using 20/30 as cutoff for normal acuity, 1 of the amblyopes was detected, and non-amblyopes were excluded by visual acuity pinhole testing. The mean difference between iPad and E-Chart visual acuities with pinhole was 0.02 logMAR with limits of agreement from −0.08 to +0.11 logMAR. iPad and printed plates Colour vision testing produced identical results. Testing times were brief and exit pleasure responses were positive. Mean and range testing times for Brightness Sense, Colour vision, and Visual Acuity were 32.7 s (range = 12–63 s), 52.8 min (range = 17–95 s), and 88.75 s (range = 41–188 s), respectively.

Conclusions

Interocular brightness disparity, acuity, and colour vision can be measured in children as young as 3 years old solely through playing a game on a mobile device. Interocular brightness disparity is a sensitive and specific method to detect unilateral amblyopia.

中文翻译：

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使用移动图形设备对儿童进行自动视力筛查

背景/目标

测量眼间亮度差异、敏锐度和色觉可以对弱视儿童进行分类吗？

主题/方法

招募了 208 名受试者（3-14 岁）进行前瞻性观察方案，以使用 iPad 测量眼间亮度差异、有或没有针孔的单眼视力以及色觉。受试者通过偏振滤光片观看，并选择两艘宇宙飞船中较亮的一艘来测量眼间亮度差异。通过阶梯算法改变图像对的差异亮度，直到感知到相同的亮度。分别使用翻滚的 Es 和 AO-HRR 色板测试敏锐度和色觉。随后两名受试者被证实患有单侧弱视。

结果

iPad 上的双眼亮度平衡检测弱视的灵敏度和特异性均为 100%。使用 20/30 作为正常视力的截止值，检测到 1 名弱视，并通过视敏度针孔测试排除非弱视。iPad 和带有针孔的 E-Chart 视力之间的平均差异为 0.02 logMAR，一致性范围为 -0.08 至 +0.11 logMAR。iPad 和印刷板色觉测试产生相同的结果。测试时间很短，退出愉快反应是积极的。亮度感、色觉和视敏度的平均和范围测试时间分别为 32.7 秒（范围 = 12–63 秒）、52.8 分钟（范围 = 17–95 秒）和 88.75 秒（范围 = 41–188 秒），分别。

结论

只需通过在移动设备上玩游戏即可测量 3 岁儿童的眼间亮度差异、敏锐度和色觉。眼间亮度差异是检测单侧弱视的一种敏感且特异的方法。