Levitt Alexa H, Martin Samuel J, Arnold Robert W
Human and Organizational Development, Vanderbilt University, Nashville, TN, USA.
Research Department, Alaska Blind Child Discovery, Anchorage, AK, USA.
Clin Ophthalmol. 2020 Aug 10;14:2237-2244. doi: 10.2147/OPTH.S256991. eCollection 2020.
A low-detail, glowing fixation device was added to GoCheck Kids (GCK) photoscreener in the hope of unmasking hyperopia and amblyopia risk factors (ARF).
Pediatric eye patients were screened by GCK and 2WIN photoscreeners, and Retinomax autorefractor before being compared to AAPOS ARFs.
Screening was attempted by 131 children who then had school bus accommodation-relaxing skiascopy (SBA-RS) before cycloplegic examination. By 2013 AAPOS uniform guidelines, sensitivity/specificity for GCK was 87%/68%, for 2WIN 87%/71% and for Retinomax 79%/68%. Detection of amblyopia had sensitivity/specificity by GCK of 78%/63%, for 2WIN 79%/65% and for Retinomax 77%/68%. Inconclusive screens were seven for GCK, six for 2WIN and 13 for Retinomax. Mean hyperopia for GCK (+2.49±0.74 D) was similar to cycloplegic refraction (+2.93±0.72 D) and SBA-RS (+2.80±0.82 D) while GCK was slightly more than Retinomax (+1.59±0.93 D, =0.13) but significantly more than 2WIN (+1.02±0.49 D, p<0.01).
GCK, 2WIN and Retinomax had similar validity detecting uniform amblyopia risk factors and amblyopia itself. The nondetailed glow fixation device allowed GCK to uncover substantial hyperopia while the detailed flashing fixation devices on 2WIN and Retinomax seemed to stimulate accommodation in some hyperopic children.
NCT04297969. Data Access: http://www.abcd-vision.org/references/GCK%20glow%202WIN%20deidentify.pdf.
PRÉCIS: A glow fixation device on a smart phone photoscreener allowed robust detection of hyperopia.
在GoCheck Kids(GCK)照片筛查仪中添加了一种低细节、发光的注视装置,以期发现远视和弱视风险因素(ARF)。
对儿科眼科患者使用GCK和2WIN照片筛查仪进行筛查,并在与美国儿科学会眼科学会(AAPOS)的ARF进行比较之前,使用Retinomax自动验光仪进行检查。
131名儿童尝试进行了筛查,随后在睫状肌麻痹检查前进行了校巴调节放松视网膜检影法(SBA-RS)。根据2013年AAPOS统一指南,GCK的敏感度/特异度为87%/68%,2WIN为87%/71%,Retinomax为79%/68%。GCK对弱视的检测敏感度/特异度为78%/63%,2WIN为79%/65%,Retinomax为77%/68%。GCK有7次筛查结果不明确,2WIN有6次,Retinomax有13次。GCK测得的平均远视度数(+2.49±0.74 D)与睫状肌麻痹验光结果(+2.93±0.72 D)和SBA-RS结果(+2.80±0.82 D)相似,而GCK略高于Retinomax(+1.59±0.93 D,P=0.13),但显著高于2WIN(+1.02±0.49 D,P<0.01)。
GCK、2WIN和Retinomax在检测统一的弱视风险因素和弱视本身方面具有相似的有效性。GCK的非详细发光注视装置能够发现大量远视,而2WIN和Retinomax上的详细闪烁注视装置似乎在一些远视儿童中刺激了调节。
NCT04297969。数据获取:http://www.abcd-vision.org/references/GCK%20glow%202WIN%20deidentify.pdf。
智能手机照片筛查仪上的发光注视装置能够可靠地检测远视。