Department of Ophthalmology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No 5, Fu-Shin Street, Kwei-Shan District, Tau-Yuan City, Taiwan.
BMC Ophthalmol. 2021 Jun 4;21(1):246. doi: 10.1186/s12886-021-02016-z.
To investigate the accuracy of a newly developed, eye-tracking virtual reality (VR)-based ocular deviation measurement system in strabismus patients.
A VR-based ocular deviation measurement system was designed to simulate the alternative prism cover test (APCT). A fixation target was made to alternate between two screens, one in front of each eye, to simulate the steps of a normal prism cover test. Patient's eye movements were recorded by built-in eye tracking. The angle of ocular deviation was compared between the APCT and the VR-based system.
This study included 38 patients with strabismus. The angle of ocular deviation measured by the VR-based system and the APCT showed good to excellent correlation (intraclass correlation coefficient, ICC = 0.897 (range: 0.810-0.945)). The 95% limits of agreement was 11.32 PD. Subgroup analysis revealed a significant difference between esotropia and exotropia (p < 0.001). In the esotropia group, the amount of ocular deviation measured by the VR-based system was greater than that measured by the APCT (mean = 4.65 PD), while in the exotropia group, the amount of ocular deviation measured by the VR-based system was less than that of the APCT (mean = - 3.01 PD). The ICC was 0.962 (range: 0.902-0.986) in the esotropia group and 0.862 (range: 0.651-0.950) in the exotropia group. The 95% limits of agreement were 6.62 PD and 11.25 PD in the esotropia and exotropia groups, respectively.
This study reports the first application of a consumer-grade and commercial-grade VR-based device for assessing angle of ocular deviation in strabismus patients. This device could provide measurements with near excellent correlation with the APCT. The system also provides the first step to digitize the strabismus examination, as well as the possibility for its application in telemedicine.
研究一种新开发的、基于眼动追踪的虚拟现实（VR）眼位测量系统在斜视患者中的准确性。
设计了一种基于 VR 的眼位测量系统，以模拟交替棱镜遮盖试验（APCT）。制作一个注视目标，在两眼前的两个屏幕之间交替，以模拟正常棱镜遮盖试验的步骤。内置眼动追踪器记录患者的眼球运动。比较 APCT 和基于 VR 的系统测量的眼位偏斜角度。
本研究纳入 38 例斜视患者。基于 VR 的系统和 APCT 测量的眼位偏斜角度具有良好到极好的相关性（组内相关系数 ICC=0.897（范围：0.810-0.945））。95%一致性界限为 11.32 PD。亚组分析显示内斜视和外斜视之间存在显著差异（p<0.001）。在内斜视组中，基于 VR 的系统测量的眼位偏斜量大于 APCT 测量的量（平均值=4.65 PD），而在外斜视组中，基于 VR 的系统测量的眼位偏斜量小于 APCT 测量的量（平均值=-3.01 PD）。内斜视组的 ICC 为 0.962（范围：0.902-0.986），外斜视组的 ICC 为 0.862（范围：0.651-0.950）。内斜视和外斜视组的 95%一致性界限分别为 6.62 PD 和 11.25 PD。
本研究首次报道了一种使用消费级和商业级基于 VR 的设备评估斜视患者眼位偏斜角度的应用。该设备可以提供与 APCT 接近的卓越相关性测量值。该系统还为斜视检查数字化迈出了第一步，也为远程医疗的应用提供了可能。
