Erkan Turan Kadriye, Taylan Sekeroglu Hande, Karahan Sevilay, Sanac Ali Sefik
Department of Ophthalmology, Hacettepe University Faculty of Medicine, 06100, Ankara, Turkey.
Department of Biostatistics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Int Ophthalmol. 2017 Dec;37(6):1305-1310. doi: 10.1007/s10792-016-0403-4. Epub 2016 Dec 8.
The purpose of this study was to analyze the reliability of the fixation preference test (FPT) in the detection of amblyopia, and to determine interexaminer agreement.
Eighty patients whose visual acuity could be tested objectively and had a horizontal misalignment of more than 10 prism diopters were enrolled. The best corrected visual acuity (BCVA) and orthoptic findings were all recorded. Non-preferred eye in primary position and fixation preference grade were assessed independently by two masked experienced examiners. The primary outcome measures were reliability of FPT in terms of its correlation with BCVA and interexaminer agreement.
There was no significant correlation between fixation preference grades and interocular visual acuity difference as well as the type and amount of deviation, the presence of fusion, stereopsis, anisometropia, and previous strabismus surgery for none of the examiners (p > 0.05 for all). Sensitivity was 52.0% for examiner 1 and 54.0% for examiner 2 while specificity was 50.0 and 46.7%, respectively. Interexaminer agreement was 76.7% (p < 0.001) for all patients.
FPT is widely used in children particularly when the visual acuity cannot be determined in an objective manner. The test may not be accurate and reliable in the detection of amblyopia and also in predicting the visual acuity difference between both eyes, even though it was found to show a high degree of agreement between examiners. In conclusion, it should be kept in mind that the reliability of FPT may be limited and the results should be interpreted with caution and be supported by other tests.
本研究旨在分析注视偏好测试（FPT）在弱视检测中的可靠性，并确定检查者之间的一致性。
纳入80例视力可客观检测且水平斜视度超过10棱镜度的患者。记录最佳矫正视力（BCVA）和斜视检查结果。由两名经验丰富的盲法检查者独立评估原在位非优势眼和注视偏好等级。主要观察指标为FPT与BCVA的相关性以及检查者之间的一致性方面的可靠性。
对于所有检查者，注视偏好等级与双眼视力差异、斜视类型和度数、融合、立体视、屈光参差以及既往斜视手术之间均无显著相关性（所有p>0.05）。检查者1的敏感度为52.0%，检查者2的敏感度为54.0%，而特异度分别为50.0%和46.7%。所有患者的检查者间一致性为76.7%（p<0.001）。
FPT广泛应用于儿童，尤其是在无法客观确定视力的情况下。该测试在弱视检测以及预测双眼视力差异方面可能并不准确可靠，尽管检查者之间显示出高度一致性。总之，应牢记FPT的可靠性可能有限，其结果应谨慎解释并需其他测试的支持。
