Ophthalmology Department, Robert Debré Hospital, Paris.
Strabismus. 2023 Jun;31(2):73-81. doi: 10.1080/09273972.2023.2204886. Epub 2023 May 18.
The gold standard of angle measurement is the prism alternating cover test (PCT). This method requires cooperation from the child, experience, and presents a significant inter-observer variability. (SK) is a new simple tool for objective and semi-automated angle measurement. Our purpose is to evaluate in children undergoing surgery for comitant horizontal strabismus. The study population was divided into 3 groups: infantile esotropia, partially accommodative esotropia and intermittent exotropia. The primary endpoint was the agreement between and the PCT. A total of 44 children were included prospectively. The correlation between the angle measured by the PCT and the angle measured by SK was strong ( = 0.87). The mean absolute difference in the angle measured by the two methods was Δ = 11.9+/- 9.8 diopters. The Bland-Altman plot shows a 95% interval limit between -30.0 [-34.4; -25.6] and 31.0 [26.7; 35.4] diopters. SK is an interesting tool to evaluate the angle of strabismus in children. However, the residual discordance between PCT and SK leads us to question the real value of the angle, which can only be approximated. A better clinical experience of this new tool in relation to the clinical condition and the PCT will allow to have a more accurate idea on the true angle and will probably help the surgeon to adapt this procedure.
角度测量的金标准是棱镜交替遮盖试验（PCT）。这种方法需要孩子的配合、经验，并且存在显著的观察者间变异性。（SK）是一种用于客观和半自动化角度测量的新工具。我们的目的是评估在接受共同性水平斜视手术的儿童中的应用。研究人群分为 3 组：婴儿性内斜视、部分调节性内斜视和间歇性外斜视。主要终点是与 PCT 之间的一致性。共有 44 名儿童前瞻性纳入。PCT 测量的角度与 SK 测量的角度之间具有很强的相关性（ = 0.87）。两种方法测量的角度之间的平均绝对差异为 Δ = 11.9+/- 9.8 屈光度。Bland-Altman 图显示 95%的间隔限制在-30.0 [-34.4; -25.6] 和 31.0 [26.7; 35.4] 屈光度之间。SK 是一种评估儿童斜视角度的有趣工具。然而，PCT 和 SK 之间的残余差异使我们对角度的实际值产生了疑问，该值只能近似。这种新工具与临床情况和 PCT 的更深入的临床经验将使我们更准确地了解真实的角度，并可能有助于外科医生调整该手术。
