Wright K W, Edelman P M, Walonker F, Yiu S
Arch Ophthalmol. 1986 Apr;104(4):549-53. doi: 10.1001/archopht.1986.01050160105023.
We evaluated the sensitivity and specificity of standard fixation preference testing and the 10-prism diopter (PD) fixation test in 427 patients. Standard fixation preference testing showed good sensitivity and specificity for than 10 PD. Patients with small angle tropias, however, had a high false-positive rate, with 40% of nonamblyopic patients inappropriately responding with strong fixation preference. The 10-PD fixation test reduced this high false-positive rate and showed only 1.5% false-positive results. Unfortunately, this shift to equal fixation preference was also seen in some patients with amblyopia, as five of 19 patients with three or more lines difference alternated fixation with the 10-PD fixation test. Retesting disclosed that, although these children would briefly alternate to the amblyopic eye while viewing a stationary target, they would not hold fixation with the amblyopic eye through smooth pursuit. Our conclusion is that standard fixation preference testing can be used to diagnose moderate to severe amblyopia in patients with tropias greater than 10 PD. Patients with small angle deviations or straight eyes should be examined with the 10-PD fixation test, with the criterion for equal vision being the ability to hold fixation well with either eye through smooth pursuit.
我们评估了标准注视偏好测试和10棱镜度（PD）注视测试在427例患者中的敏感性和特异性。标准注视偏好测试对超过10 PD的情况显示出良好的敏感性和特异性。然而，小角度斜视患者的假阳性率较高，40%的非弱视患者对强烈的注视偏好有不适当的反应。10-PD注视测试降低了这种高假阳性率，仅显示1.5%的假阳性结果。不幸的是，在一些弱视患者中也出现了向同等注视偏好的转变，19例有三条或更多行差异的患者中有5例在10-PD注视测试中交替注视。重新测试发现，尽管这些儿童在观看静止目标时会短暂地交替到弱视眼，但他们不会通过平稳跟踪保持弱视眼的注视。我们的结论是，标准注视偏好测试可用于诊断斜视大于10 PD的患者中的中度至重度弱视。小角度偏差或正视眼患者应使用10-PD注视测试进行检查，同等视力的标准是通过平稳跟踪用任何一只眼都能很好地保持注视的能力。
