虚拟现实在斜视自动测量与诊断中的准确性。

Accuracy of virtual reality in automated measurement and diagnosis of strabismus.

作者信息

Wang Yu-Meng, Liu Jiawen, Chen Wei-Wei, Jiang Mei-Xia, Fu Jing

机构信息

Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Capital Medical University, Beijing, China.

Wilmer Eye Institute, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.

出版信息

Digit Health. 2024 Dec 16;10:20552076241308713. doi: 10.1177/20552076241308713. eCollection 2024 Jan-Dec.

DOI:10.1177/20552076241308713

PMID:39691458

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11650622/

Abstract

BACKGROUND

To explore the accuracy of VR technology for strabismus screening.

METHODS

In this cross-sectional study, a total of 191 subjects were included. Examinations included VR technology based on infrared, the cover-uncover test, and the prism alternating cover test (PACT) at various gaze positions, specifically at distances of 33 cm and 6 m. The accuracy of VR in diagnosing strabismus and quantifying the degree of strabismus was evaluated by comparing the VR results to the average outcomes of manual examinations conducted by the two physicians, considered the gold standard.

RESULTS

A total of 88 healthy individuals, 81 exotropia patients, 17 esotropia patients, and five vertical strabismus patients were included in this study, and each subject was screened for less than 2 min. The sensitivity of VR for screening strabismus was 80.3% and the specificity was 80%, displaying moderately consistent with the manual results (Kappa = 0.598, .001). The sensitivity for diagnosing exotropia was 76.5% and the specificity was 91.8%, also showing strong agreement with the manual results (Kappa = 0.695, 0.001). The sensitivity for diagnosing esotropia was 94.1% and the specificity was 95.4%, with strong agreement with the manual results (Kappa = 0.755, .001). The sensitivity for diagnosing vertical strabismus was 80% and the specificity was 98.9%, with strong agreement with manual results (Kappa = 0.719, .001). For ocular deviation angle calculations, intraclass correlation coefficient (ICC) was used to compare the agreement between VR and manual results. It showed moderately agreement for exotropia in the near mode (ICC = 0.587, range, -0.036-0.826) and less agreement for exotropia in far mode (ICC = 0.349, range, -0.042-0.615). ICC was in good agreement (ICC = 0.701, range, 0.358-0.879) for the esotropic far mode results (6 m) and not statistically significant for the esotropic near mode results (33 cm). ICC was in good agreement (ICC = 0.606, range = -0.143 to 0.946) for the vertical-near-mode results (33 cm) and not statistically significant for the vertical-far-mode results (6 m).

CONCLUSIONS

This novel technique for strabismus screening, which utilizes virtual reality technology, enables quick, precise, and straightforward diagnosis of strabismus. It has also shown notable efficacy in accurately measuring the angle of deviation in cases of exotropia.

摘要

背景

探讨虚拟现实（VR）技术用于斜视筛查的准确性。

方法

在这项横断面研究中，共纳入191名受试者。检查包括基于红外线的VR技术、遮盖试验以及在不同注视位置（具体为33 cm和6 m距离）的棱镜交替遮盖试验（PACT）。通过将VR结果与两位医生进行的手动检查的平均结果（视为金标准）进行比较，评估VR在诊断斜视和量化斜视程度方面的准确性。

结果

本研究共纳入88名健康个体、81名外斜视患者、17名内斜视患者和5名垂直斜视患者，每位受试者的筛查时间少于2分钟。VR筛查斜视的敏感性为80.3%，特异性为80%，与手动检查结果中度一致（Kappa = 0.598，P < 0.001）。诊断外斜视的敏感性为76.5%，特异性为91.8%，也与手动检查结果高度一致（Kappa = 0.695，P < 0.001）。诊断内斜视的敏感性为94.1%，特异性为95.4%，与手动检查结果高度一致（Kappa = 0.755，P < 0.001）。诊断垂直斜视的敏感性为80%，特异性为98.9%，与手动检查结果高度一致（Kappa = 0.719，P < 0.001）。对于眼位偏斜角度计算，采用组内相关系数（ICC）比较VR与手动检查结果之间的一致性。在近距模式下，外斜视显示中度一致性（ICC = 0.587，范围为 -0.036至0.826），远距模式下外斜视一致性较低（ICC = 0.349，范围为 -0.042至0.615）。内斜视远距模式结果（6 m）的ICC一致性良好（ICC = 0.701，范围为0.358至0.879），内斜视近距模式结果（33 cm）差异无统计学意义。垂直近距模式结果（33 cm）的ICC一致性良好（ICC = 0.606，范围为 -0.143至0.946），垂直远距模式结果（6 m）差异无统计学意义。