Keck School of Medicine, University of Southern California, USA.
The Vision Center at Children's Hospital Los Angeles, USA.
J Telemed Telecare. 2023 Jul;29(6):461-466. doi: 10.1177/1357633X20985394. Epub 2021 Jan 20.
The purpose of this study was to assess the validity of using video glasses as part of an asynchronous telemedicine screening protocol for paediatric blepharoptosis.
A physician assistant wearing Pivothead SMART Series glasses recorded videos of paediatric patients referred for blepharoptosis in primary, down and upgaze while holding a ruler next to the eyes. An oculoplastic surgeon viewed the stored videos and recorded margin-reflex distance 1 and levator function. Using these measurements, the surgeon determined whether surgical intervention was recommended and, if so, which procedure was recommended. The surgeon recorded the same parameters for each patient based on an in-person examination performed later that day. Videos were reviewed eight months later and the same parameters were recorded.
Twenty-nine children ( = 58 eyes) were enrolled. Margin-reflex distance 1 and levator function measurements based on same-day video review agreed with in-person examination 94.8% (intraclass correlation coefficient = 0.82) and 98.3% (intraclass correlation coefficient = 0.96) of the time, respectively. Margin-reflex distance 1 and levator function measurements based on later video review agreed with in-person examination 93.1% (intraclass correlation coefficient = 0.85) and 94.8% (intraclass correlation coefficient = 0.93) of the time, respectively. Agreement in identifying surgical candidates was almost perfect (= = 0.93) for same-day video review and substantial (= = 0.73) for later video review. Sensitivity of identifying surgical patients was 100% for both same-day video review and later video review; though specificity was lower at 94.1% for same-day video review and 76.5% for later video review.
Asynchronous telemedicine encounters employing video glasses are a useful screening modality for identifying surgical paediatric blepharoptosis patients.
本研究旨在评估在小儿上睑下垂的异步远程医疗筛选方案中使用视频眼镜的有效性。
一名医师助理佩戴 Pivothead SMART 系列眼镜，在直视、下视和上视时，用尺子靠近眼睛，记录小儿上睑下垂患者的视频。一名眼整形外科医生观看存储的视频并记录 1 毫米上睑缘位置和提上睑肌功能。根据这些测量结果，外科医生决定是否推荐手术干预，如果是，推荐哪种手术。当天晚些时候，外科医生根据亲自检查，为每位患者记录相同的参数。八个月后复查视频并记录相同的参数。
共有 29 名儿童（=58 只眼睛）入组。基于当天视频复查的 1 毫米上睑缘位置和提上睑肌功能测量值与亲自检查的一致性分别为 94.8%（组内相关系数=0.82）和 98.3%（组内相关系数=0.96）。基于后期视频复查的 1 毫米上睑缘位置和提上睑肌功能测量值与亲自检查的一致性分别为 93.1%（组内相关系数=0.85）和 94.8%（组内相关系数=0.93）。当天视频复查和后期视频复查在识别手术候选者方面的一致性几乎为完美（=0.93）和实质性（=0.73）。当天视频复查和后期视频复查在识别手术患者方面的敏感性均为 100%；而特异性分别为 94.1%和 76.5%。
使用视频眼镜的异步远程医疗会诊是一种有用的筛查方式，可用于识别需要手术治疗的小儿上睑下垂患者。
