Walshe Ayrton, Daly Ed, Ryan Lisa
Department of Sports, Exercise, and Nutrition, Atlantic Technological University, H91 T8NW Galway City, Ireland.
J Funct Morphol Kinesiol. 2024 Sep 4;9(3):157. doi: 10.3390/jfmk9030157.
Ocular tools and technologies may be used in the diagnosis of sport-related concussions (SRCs), but their clinical utility can vary. The following study aimed to review the literature pertaining to the reliability and diagnostic accuracy of such assessments. The preferred reporting items for systematic reviews and meta-analysis (PRISMA) extension for scoping reviews was adhered to. Reference standard reliability (RSR ≥ 0.75) and diagnostic accuracy (RSDA ≥ 0.80) were implemented to aid interpretation. In total, 5223 articles were screened using the PCC acronym (Population, Concept, Context) with 74 included in the final analysis. Assessments included the King-Devick (KD) (n = 34), vestibular-ocular motor screening (VOMs) and/or near point of convergence (NPC) (n = 25), and various alternative tools and technologies (n = 20). The KD met RSR, but RSDA beyond amateur sport was limited. NPC met RSR but did not have RSDA to identify SRCs. The VOMs had conflicting RSR for total score and did not meet RSR in its individual tests. The VOMs total score did perform well in RSDA for SRCs. No alternative tool or technology met both RSR and RSDA. Ocular tools are useful, rapid screening tools but should remain within a multi-modal assessment for SRCs at this time.
眼科工具和技术可用于诊断与运动相关的脑震荡（SRC），但其临床效用可能有所不同。以下研究旨在回顾有关此类评估的可靠性和诊断准确性的文献。本研究遵循了系统评价和Meta分析的首选报告项目（PRISMA）扩展版用于范围综述的要求。采用参考标准可靠性（RSR≥0.75）和诊断准确性（RSDA≥0.80）来辅助解释。总共使用PCC首字母缩写词（人群、概念、背景）筛选了5223篇文章，最终分析纳入了74篇。评估包括King-Devick（KD）测试（n = 34）、前庭眼动筛查（VOMs）和/或集合近点（NPC）测试（n = 25），以及各种替代工具和技术（n = 20）。KD测试达到了参考标准可靠性，但在业余运动之外的诊断准确性有限。NPC测试达到了参考标准可靠性，但没有诊断准确性来识别SRC。VOMs总分的参考标准可靠性存在冲突，且在其单项测试中未达到参考标准可靠性。VOMs总分在SRC的诊断准确性方面表现良好。没有替代工具或技术同时达到参考标准可靠性和诊断准确性。眼科工具是有用的快速筛查工具，但目前在SRC的多模式评估中仍应处于辅助地位。
