The Ohio State University College of Optometry, Columbus, Ohio, USA.
Ophthalmic Physiol Opt. 2024 May;44(3):501-513. doi: 10.1111/opo.13301. Epub 2024 Mar 19.
This study evaluated the ability of QuickSee to detect children at risk for significant vision conditions (significant refractive error [RE], amblyopia and strabismus).
Non-cycloplegic refraction (using QuickSee without and with +2 dioptre (D) fogging lenses) and unaided binocular near visual acuity (VA) were measured in 4- to 12-year-old children. Eye examination findings (VA, cover testing and cycloplegic retinoscopy) were used to determine the presence of vision conditions. QuickSee performance was summarised by area under the receiver operating characteristic curve (AUC), sensitivity and specificity for various levels of RE. QuickSee referral criteria for each vision condition were chosen to maximise sensitivity at a specificity of approximately 85%-90%. Sensitivity and specificity to detect vision conditions were calculated using multiple criteria. Logistic regression was used to evaluate the benefit of adding near VA (6/12 or worse) for detecting hyperopia. A paired t-test compared QuickSee without and with fogging lenses.
The mean age was 8.2 (±2.5) years (n = 174). RE ranged up to 9.25 D myopia, 8 D hyperopia, 5.25 D astigmatism and 3.5 D anisometropia. The testability of the QuickSee was 94.3%. AUC was ≥0.92 (excellent) for each level of RE. For the detection of any RE, sensitivity and specificity were 84.2% and 87.3%, respectively, using modified Orinda criteria and 94.5% and 78.2%, respectively, using the American Academy for Pediatric Ophthalmology and Strabismus (AAPOS) guidelines. For the detection of any significant vision condition, the sensitivity and specificity of QuickSee were 81.1% and 87.9%, respectively, using modified Orinda criteria and 93% and 78.6%, respectively, using AAPOS criteria. There was no significant benefit of adding near VA to QuickSee for the detection of hyperopia ≥+2.00 (p = 0.34). There was no significant difference between QuickSee measurements of hyperopic refractive error with and without fogging lenses (difference = -0.09 D; p = 0.51).
QuickSee had high discriminatory power for detecting children with hyperopia, myopia, astigmatism, anisometropia, any significant refractive error or any significant vision condition.
本研究评估了 QuickSee 检测儿童发生重大视力问题（显著屈光不正[RE]、弱视和斜视）风险的能力。
对 4 至 12 岁儿童进行非睫状肌麻痹验光（使用无雾视和加 2 屈光度[D]雾视的 QuickSee）和未矫正双眼近视力（VA）检查。通过视力检查结果（VA、遮盖试验和睫状肌麻痹检影验光）确定是否存在视力问题。通过受试者工作特征曲线（ROC）下面积（AUC）、不同 RE 水平的敏感性和特异性来总结 QuickSee 的性能。为了使特异性约为 85%-90%，选择了每个视力条件的 QuickSee 转诊标准，以最大化敏感性。使用多种标准计算检测视力条件的敏感性和特异性。使用逻辑回归评估添加近视力（6/12 或更差）检测远视的益处。配对 t 检验比较了无雾视和加雾视的 QuickSee。
平均年龄为 8.2（±2.5）岁（n=174）。RE 范围高达 9.25 D 近视、8 D 远视、5.25 D 散光和 3.5 D 屈光参差。QuickSee 的可检测性为 94.3%。对于每个 RE 水平，AUC 均≥0.92（优秀）。使用改良的 Orinda 标准，检测任何 RE 的敏感性和特异性分别为 84.2%和 87.3%，使用美国儿科学会眼科学和斜视学分会（AAPOS）指南，敏感性和特异性分别为 94.5%和 78.2%。使用改良的 Orinda 标准，检测任何重大视力问题的敏感性和特异性分别为 81.1%和 87.9%，使用 AAPOS 标准，敏感性和特异性分别为 93%和 78.6%。添加近视力并不能显著提高 QuickSee 检测远视≥+2.00 的能力（p=0.34）。加雾视和不加雾视时，远视屈光度的 QuickSee 测量值之间无显著差异（差值=-0.09 D；p=0.51）。
QuickSee 对检测远视、近视、散光、屈光参差、任何显著屈光不正或任何显著视力问题具有较高的鉴别能力。
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