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评估一款免费的公共智能手机应用程序在检测1至6岁高危儿童白瞳症中的应用

Evaluation of a Free Public Smartphone Application to Detect Leukocoria in High-Risk Children Aged 1 to 6 Years.

作者信息

Vagge Aldo, Wangtiraumnuay Nutsuchar, Pellegrini Marco, Scotto Riccardo, Iester Michele, Traverso Carlo Enrico

出版信息

J Pediatr Ophthalmol Strabismus. 2019 Jul 1;56(4):229-232. doi: 10.3928/01913913-20190516-01.


DOI:10.3928/01913913-20190516-01
PMID:31322712
Abstract

PURPOSE: To determine whether a white-eye detector smartphone application (app) can be used as a screening tool to detect early signs of leukocoria in a clinical practice. METHODS: A prospective, single-visit study of children aged 1 to 6 years presenting to the University Eye Clinic of Genova for a complete pediatric ophthalmologic examination was conducted. All children who met the enrollment criteria were screened by an orthoptist with the CRADLE (Computer Assisted Detector of Leukocoria) smartphone app for an iPhone operating system (iOS) (iPhone 7; Apple, Cupertino, CA). Cycloplegic retinoscopy and fundus examination were performed 30 minutes after one to two drops of a pediatric combination drop, comprising tropicamide 1% and phenylephrine 2.5%, were instilled. A comparison between the two methods yielded sensitivity, specificity, and negative likelihood ratio values. RESULTS: A total of 244 eyes of 122 children were included in the study. Nine eyes of 244 (3.6%) had leukocoria evaluable by penlight caused by amblyogenic cataract, 1 (0.4%) patient had retinopathy of prematurity stage 5, and 3 (1.2%) patients had retinoblastoma. The sensitivity of the white-eye detector app was 15.38% (95% confidence interval [CI]: 1.92% to 45.45%), the specificity was 100% (95% CI: 98.48% to 100.00%), and the negative likelihood ratio was 0.85 (95% CI: 0.67 to 1.07). CONCLUSIONS: A smartphone photoscreening app able to detect leukocoria may provide valuable support for children's parents. However, it cannot be considered an alternative to the ophthalmoscope for children. [J Pediatr Ophthalmol Strabismus. 2019;56(4):229-232.].

摘要

目的:确定一款白眼检测智能手机应用程序(应用)能否作为一种筛查工具,在临床实践中检测出白瞳症的早期迹象。 方法:对前往热那亚大学眼科诊所进行全面儿科眼科检查的1至6岁儿童进行了一项前瞻性、单次就诊研究。所有符合纳入标准的儿童均由一名视光师使用适用于苹果iOS操作系统(iPhone 7;苹果公司,库比蒂诺,加利福尼亚州)的CRADLE(白瞳症计算机辅助检测仪)智能手机应用进行筛查。在滴入一到两滴由1%托吡卡胺和2.5%去氧肾上腺素组成的儿科复方滴眼液30分钟后,进行睫状肌麻痹视网膜检影和眼底检查。两种方法之间的比较得出了敏感性、特异性和阴性似然比数值。 结果:该研究共纳入了122名儿童的244只眼睛。244只眼中有9只(3.6%)因致弱视性白内障导致手电筒照射下可评估的白瞳症,1名(0.4%)患者患有5期早产儿视网膜病变,3名(1.2%)患者患有视网膜母细胞瘤。白眼检测应用的敏感性为15.38%(95%置信区间[CI]:1.92%至45.45%),特异性为100%(95%CI:98.48%至100.00%),阴性似然比为0.85(95%CI:0.67至1.07)。 结论:一款能够检测白瞳症的智能手机照片筛查应用可能会为儿童家长提供有价值的帮助。然而,对于儿童来说,它不能被视为检眼镜的替代品。[《小儿眼科与斜视杂志》。2019;56(4):229 - 232。]

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[3]
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[4]
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[5]
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[6]
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[7]
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