Prabhu Avinash V, Thomas Jyothi, Ve Ramesh S, Biswas Sayantan
Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
J Curr Ophthalmol. 2020 Jul 4;32(3):268-273. doi: 10.4103/JOCO.JOCO_76_20. eCollection 2020 Jul-Sep.
To evaluate the performance of Plusoptix A09 in detecting ametropia, warranted against frequently-used technique of retinoscopy in children attending school (5-15 years) and its probability as a screening tool.
This study was the subset of a larger epidemiological study visual acuity refractive error squint conducted in schools to determine the prevalence of ocular morbidity among the 5-15 years' school children population. Every 7 student in the class (each school had mean value of 100 students) was randomly selected for this study after ascertaining their eligibility as per the inclusion criteria. A cohort of a total of 150 children within the age group of 5-15 (mean, 10.21 ± 2.83) years were recruited from 11 schools of Udupi district. Students with best corrected visual acuity of 20/20, refractive error within ±5.00 diopter (D), without any eccentric fixation, and no history of ocular pathology or seizures were recruited. Refractive error was tested by Plusoptix photorefractor followed by non-cycloplegic and cycloplegic retinoscopic techniques. The examiners performing these tests were masked and unware of the findings. Bland Altman plotted the agreement between the techniques, followed by the receiver operating characteristic curve (ROC), and sensitivity of Plusoptix.
One-way analysis of variance calculated statistical differences among Plusoptix, objective retinoscopy, and cycloplegic retinoscopy for mean spherical value (1.12 ± 1.16 D, 0.65 ± 0.69 D, and 0.8 ± 0.82 D), cylindrical value (-0.83 D ± 1.27, -0.32 D ± 0.86, and -0.34 D ± -0.93), and spherical equivalent value (0.71 D ± 1.06, 0.45 D ± 0.7, and 0.61 D ± 0.81), with = 0.0001, 0.0001, and 0.097, respectively. Bland Altman plots showed good agreement for spherical equivalent values of Plusoptix and objective retinoscopy. However, the area under the ROC curve (0.386) suggests that lower diagnostic ability of this device in this age group population in comparison to retinoscopy (0.575) with the sensitivity and specificity of Plusoptix was 69.2% and 84.8%.
This study fails to report ideal sensitivity mandated for a screening tool, although good specificity and agreement are observed. Along with retinoscopy, this tool will be effective in screening a children's population aged between the age group of 5 and 15 years.
评估Plusoptix A09在检测屈光不正方面的性能，与常用于5至15岁在校儿童的检影技术相对比，并评估其作为筛查工具的可能性。
本研究是一项更大规模的流行病学研究的子集，该研究在学校中进行，旨在确定5至15岁学龄儿童群体中眼病的患病率。在根据纳入标准确定每个班级（每个学校平均有100名学生）的学生符合条件后，每7名学生被随机选入本研究。从乌杜皮地区的11所学校招募了150名年龄在5至15岁（平均10.21±2.83岁）的儿童。招募最佳矫正视力为20/20、屈光不正度数在±5.00屈光度（D）以内、无偏心注视且无眼部病理或癫痫病史的学生。先用Plusoptix验光仪检测屈光不正，然后采用非散瞳和散瞳检影技术。进行这些测试的检查人员对结果不知情。Bland Altman图展示了两种技术之间的一致性，随后绘制了受试者工作特征曲线（ROC）以及Plusoptix的敏感性。
单因素方差分析计算出Plusoptix、客观检影和散瞳检影在平均球镜值（1.12±1.16 D、0.65±0.69 D和0.8±0.82 D）、柱镜值（-0.83 D±1.27、-0.32 D±0.86和-0.34 D±-0.93）以及等效球镜值（0.71 D±1.06、0.45 D±0.7和0.61 D±0.81）方面的统计学差异，p值分别为0.0001、0.0001和0.097。Bland Altman图显示Plusoptix和客观检影的等效球镜值具有良好的一致性。然而，ROC曲线下面积（0.386）表明，与检影（0.575）相比，该设备在该年龄组人群中的诊断能力较低，Plusoptix的敏感性和特异性分别为69.2%和84.8%。
本研究未报告筛查工具所需的理想敏感性，尽管观察到了良好的特异性和一致性。与检影一起，该工具在筛查5至15岁儿童群体时将是有效的。
