Danish College of Optometry and Visual Science, Randers, Denmark.
Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark.
Acta Ophthalmol. 2019 Jun;97(4):394-400. doi: 10.1111/aos.13957. Epub 2018 Oct 18.
To determine the sensitivity and specificity of school nurse screening for hypermetropia and convergence insufficiency exophoria (CIE) in schoolchildren.
Near point of convergence and distance visual acuity with +2.00D lenses were measured in 2097 children (6-15 years) during standard school nurse screening in the municipality of Randers, Denmark. One hundred and ninety-four children with positive screening results (near point of convergence >10 cm and/or distance visual acuity improved or maintained with +2.00D) and 182 controls with negative screening results received a full vision assessment, including cycloplegic refraction and orthoptic evaluation.
Sensitivity and specificity of screening was 0.75 and 0.69 for CIE and 0.59 and 0.87 for hypermetropia (≥+2.00), respectively. While precision of screening for CIE was significantly higher for symptomatic children aged 9-15 than for younger and asymptomatic children, precision of screening for hypermetropia was independent of age and presence of visually related symptoms.
While precision of screening for CIE and hypermetropia (>+2.00) was low, additional vision evaluation of children older than 9 years with asthenopic symptoms identified most children with CIE with a low absolute number of false positives.
为了确定学校护士在儿童中筛查远视和集合不足外斜视（CIE）的敏感性和特异性。
在丹麦兰讷斯市的标准学校护士筛查中，对 2097 名儿童（6-15 岁）进行了集合近点和远距视力+2.00D 镜片测量。对 194 名筛查结果阳性（集合近点>10cm 和/或远距视力提高或维持+2.00D）和 182 名筛查结果阴性的儿童进行了全面视力评估，包括睫状肌麻痹验光和斜视评估。
筛查对 CIE 的敏感性和特异性分别为 0.75 和 0.69，对远视（≥+2.00）的敏感性和特异性分别为 0.59 和 0.87。虽然 9-15 岁有症状儿童的 CIE 筛查准确性明显高于年龄较小和无症状儿童，但远视筛查的准确性与年龄和视力相关症状的存在无关。
虽然 CIE 和远视（>+2.00）筛查的准确性较低，但对 9 岁以上有视疲劳症状的儿童进行额外的视力评估，可以识别出大多数患有 CIE 的儿童，假阳性的绝对数量较少。
