Schepens Eye Research Institute, Massachusetts Eye and Ear, Boston, MA, USA.
Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
Transl Vis Sci Technol. 2022 Feb 1;11(2):40. doi: 10.1167/tvst.11.2.40.
The purpose of this study was to evaluate the potential feasibility of using a smartphone app in myopia screening.
The app estimates myopic refractive error by measuring the far point distance for reading three 20/20 Tumbling E letters. In total, 113 myopic subjects with astigmatism no greater than -1.75 diopters (D) were enrolled from 5 sites. The mean age was 22 ± 8.5 years. The app measurement was compared with noncycloplegic subjective refraction measurement or autorefractor if subjective refraction was not available. In addition, 22 subjects were tested with the app for repeatability.
For 201 eyes included, the range of spherical equivalent refraction error was 0 to -10.2 D. The app measurement and clinical measurement was highly correlated (Pearson R = 0.91, P < 0.001). There was a small bias (0.17 D) in the app measurement overall, and it was significantly different across the 5 sites due to different age of subjects enrolled at those sites (P = 0.001) - young adults in their 20s were underestimated the most by 0.49 D, whereas children were overestimated by 0.29 D. The mean absolute deviation of the app measurement was 0.65 D. The repeatability of multiple testing in terms of 95% limit of agreement was ±0.61 D.
Overall, the app measurement is consistent with clinical measurement performed by vision care professionals. The repeatability is comparable with that of some autorefractors. Age-associated human factors may influence the app measurement.
The app could be potentially used as a mass screening tool for myopia.
本研究旨在评估使用智能手机应用程序进行近视筛查的潜在可行性。
该应用程序通过测量阅读三个 20/20 Tumbling E 字母的远距距离来估计近视屈光不正。总共从 5 个地点招募了 113 名散光不超过-1.75 屈光度（D）的近视受试者。平均年龄为 22 ± 8.5 岁。如果无法进行主观验光，则将应用程序测量结果与非睫状肌麻痹主观验光或自动验光仪进行比较。此外，对 22 名受试者进行了应用程序的可重复性测试。
对于包括的 201 只眼睛，球镜等效屈光误差范围为 0 至-10.2 D。应用程序测量值与临床测量值高度相关（Pearson R = 0.91，P < 0.001）。整体上，应用程序测量值存在较小的偏差（0.17 D），并且由于在这些地点招募的受试者年龄不同，应用程序测量值在 5 个地点之间存在显著差异（P = 0.001）-20 多岁的年轻人被低估了 0.49 D，而儿童则被高估了 0.29 D。应用程序测量值的平均绝对偏差为 0.65 D。以 95%一致性界限表示的多次测试的重复性为±0.61 D。
总体而言，应用程序测量值与视力保健专业人员进行的临床测量值一致。重复性与某些自动验光仪相当。与年龄相关的人为因素可能会影响应用程序的测量值。
Zhonglin Li
