Infection & Global Health Division, School of Medicine, Medical and Biological Sciences Building, North Haugh, St Andrews, KY16 9TF, UK.
Ninewells Hospital, NHS Tayside, James Arrott Dr, Dundee, DD2 1SG, UK.
Eye (Lond). 2023 Jan;37(1):160-162. doi: 10.1038/s41433-021-01901-7. Epub 2021 Dec 23.
We compare the optical quality and design characteristic a new low cost solar powered binocular indirect ophthalmoscope (BIO), Holo, to Keeler BIO.
Twenty-four participants each examined 10 simulation eyes using both the Holo and the Keeler BIO with a 30-diopter condensing lens. Number of Lea symbols printed on the retina of simulation eyes seen and time taken to identify them was recorded. Stereoacuity of 12 participants was tested while using the BIOs. Using 7-point Likert scale, participants gave feedback on design characteristic of both BIOs.
There was no statistical difference in number of Lea symbols correctly identified (15.63/20 for Holo vs. 15/20 for Keeler BIO, p = 0.366, paired t test) or time taken to correctly identify each symbol (Holo 0.39 s faster; 95% confidence interval -2.24 to 3.03 s, p = 0.763) using each device. 12 out of 12 participants achieved stereoacuity of 60 arcsec using the Holo while with the Keeler BIO 11 achieved 60 arcsec and one 90 arcsec. There was no statistically significant difference in the scores for clarity of view, quality of illumination, field of view, binocularity, eye strain and robustness between the two devices. The Holo, scored higher for ease of use (6.5 vs. 6, p = 0.00488, Wilcoxon signed-rank test), comfort of wear (6 vs. 5, p = 0.000337) and portability (7 vs. 6, p = 0.000148).
The Holo has the potential to be a clinically useful yet affordable diagnostic tool suitable for the first time of equipping eye care workers in low resource settings with a BIO at volume.
我们比较了一种新型低成本太阳能 binocular indirect ophthalmoscope（BIO）Holo 与 Keeler BIO 的光学质量和设计特点。
24 名参与者每人使用 Holo 和 Keeler BIO 检查 10 个模拟眼睛，均使用 30 屈光度的聚光透镜。记录模拟眼睛视网膜上打印的 Lea 符号数量以及识别它们所需的时间。12 名参与者的立体视锐度在使用 BIO 时进行了测试。参与者使用 7 分李克特量表对两种 BIO 的设计特点进行了反馈。
使用两种设备正确识别的 Lea 符号数量（Holo 为 15.63/20，Keeler BIO 为 15/20，p=0.366，配对 t 检验）或正确识别每个符号所需的时间（Holo 快 0.39 秒；95%置信区间 -2.24 至 3.03 秒，p=0.763）均无统计学差异。使用 Holo，12 名参与者中有 12 名达到了 60 弧秒的立体视锐度，而使用 Keeler BIO，有 11 名达到了 60 弧秒，1 名达到了 90 弧秒。两种设备在视图清晰度、照明质量、视野、 binocularity、眼疲劳和坚固性等方面的评分均无统计学差异。Holo 在易用性（6.5 分对 6 分，p=0.00488，Wilcoxon 符号秩检验）、佩戴舒适性（6 分对 5 分，p=0.000337）和便携性（7 分对 6 分，p=0.000148）方面得分更高。
Holo 有可能成为一种具有临床应用价值且价格合理的诊断工具，适用于首次为资源匮乏地区的眼保健工作者配备 BIO 以实现批量供应。
