Ophthalmic and Physiological Optics最新文献

{"title":"Exploring the relationship between 24-2 visual field and widefield optical coherence tomography data across healthy, glaucoma suspect and glaucoma eyes.","authors":"Janelle Tong, Jack Phu, David Alonso-Caneiro, Jason Kugelman, Sieu Khuu, Ashish Agar, Minas Coroneo, Michael Kalloniatis","doi":"10.1111/opo.13368","DOIUrl":"10.1111/opo.13368","url":null,"abstract":"<p><strong>Purpose: </strong>To utilise ganglion cell-inner plexiform layer (GCIPL) measurements acquired using widefield optical coherence tomography (OCT) scans spanning 55° × 45° to explore the link between co-localised structural parameters and clinical visual field (VF) data.</p><p><strong>Methods: </strong>Widefield OCT scans acquired from 311 healthy, 268 glaucoma suspect and 269 glaucoma eyes were segmented to generate GCIPL thickness measurements. Estimated ganglion cell (GC) counts, calculated from GCIPL measurements, were plotted against 24-2 SITA Faster visual field (VF) thresholds, and regression models were computed with data categorised by diagnosis and VF status. Classification of locations as VF defective or non-defective using GCIPL parameters computed across eccentricity- and hemifield-dependent clusters was assessed by analysing areas under receiver operating characteristic curves (AUROCCs). Sensitivities and specificities were calculated per diagnostic category.</p><p><strong>Results: </strong>Segmented linear regression models between GC counts and VF thresholds demonstrated higher variability in VF defective locations relative to non-defective locations (mean absolute error 6.10-9.93 dB and 1.43-1.91 dB, respectively). AUROCCs from cluster-wide GCIPL parameters were similar across methods centrally (p = 0.06-0.84) but significantly greater peripherally, especially when considering classification of more central locations (p < 0.0001). Across diagnoses, cluster-wide GCIPL parameters demonstrated variable sensitivities and specificities (0.36-0.93 and 0.65-0.98, respectively), with the highest specificities observed across healthy eyes (0.73-0.98).</p><p><strong>Conclusions: </strong>Quantitative prediction of VF thresholds from widefield OCT is affected by high variability at VF defective locations. Prediction of VF status based on cluster-wide GCIPL parameters from widefield OCT could become useful to aid clinical decision-making in appropriately targeting VF assessments.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":"1484-1499"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of lens and fitting characteristics upon scleral lens centration.","authors":"Damien Fisher, Michael J Collins, Stephen J Vincent","doi":"10.1111/opo.13367","DOIUrl":"10.1111/opo.13367","url":null,"abstract":"<p><strong>Purpose: </strong>To quantify the impact of varying central fluid reservoir depth, lens thickness/mass and the addition of a peripheral fenestration upon scleral lens centration.</p><p><strong>Methods: </strong>Ten young, healthy adults participated in a series of repeated-measures experiments involving short-term (90 min) open eye scleral lens wear. Scleral lens parameters (material, back optic zone radius, diameter, back vertex power and landing zone) were controlled across all experiments, and the central fluid reservoir depth (ranging from 144 to 726 μm), lens thickness (ranging from 150 to 1200 μm), lens mass (101-241 mg) and lens design (with or without a single 0.3 mm peripheral fenestration) were altered systematically. Scleral lens decentration was quantified using over-topography maps.</p><p><strong>Results: </strong>On average, scleral lens centration varied by <0.10 mm over 90 min of wear. Medium and high initial fluid reservoir conditions resulted in 0.17 mm more temporal and 0.55 mm more inferior lens decentration, compared to the low fluid reservoir depth (p < 0.001). Changes in lens thickness or the addition of a peripheral fenestration did not cause clinically significant changes in centration (<0.10 mm on average) when controlling for fluid reservoir depth. Central fluid reservoir depth was the best predictor of horizontal and vertical lens decentration, explaining 62-73% of the observed variation, compared to 40-44% for lens thickness and mass.</p><p><strong>Conclusion: </strong>Scleral lens decentration remained relatively stable over 90 min of lens wear. A greater initial central fluid reservoir depth resulted in significantly more lens decentration, particularly inferiorly. Large variations in lens thickness, mass or the addition of a single peripheral fenestration did not substantially affect lens centration.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":"1530-1538"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A method to determine the retinal radiant exposure caused by ophthalmoscopy.","authors":"Charles Campbell","doi":"10.1111/opo.13374","DOIUrl":"10.1111/opo.13374","url":null,"abstract":"<p><strong>Purpose: </strong>To introduce a method to calculate retinal irradiance caused by ophthalmoscopy. This may be used to verify the compliance of an instrument with the radiation limits set by light hazard standards. The proposed method is simpler to use and less prone to error than the methods currently found in the light hazard standards.</p><p><strong>Methods: </strong>The optical properties of the standardised human eye, specified by current light hazard standards, are used to calculate the magnification of an aerial image of the retinal surface by the combination of the optics of eye and the auxiliary lens used for ophthalmoscopy. The magnification of the aerial image is used to transform the spectral irradiance of the instrument illumination source to retinal irradiation values. The spectral irradiance of the instrument illumination source can be measured directly as the aerial image is located in the focal plane of the viewing optics of the ophthalmoscope. These spectral irradiation values are then processed using weightings specified by current light hazard standards to give a weighted irradiance which is converted directly to a retinal irradiance value.</p><p><strong>Results: </strong>A single formula is provided to calculate the retinal irradiance using the processed, measured spectral irradiance values of the illumination source.</p><p><strong>Conclusion: </strong>The new method introduced here is simpler to use, requires fewer physical measurements and is less likely to introduce measurement error than that currently found in light hazard standards. The only physical measurement that needs to be taken is the illumination source spectral irradiance measured in the viewing focal plane of the instrument. These values are weighted using given in the light hazard standards. The combined irradiance value is then converted to retinal irradiance using the formula given in this paper.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":"1513-1516"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation techniques in optometric education: Is a model eye for tonometry a valuable instruction tool?","authors":"Kate Doorduyn, Rebekka Heitmar, Lauren Coetzee","doi":"10.1111/opo.13377","DOIUrl":"10.1111/opo.13377","url":null,"abstract":"<p><strong>Purpose: </strong>Simulation techniques are used in healthcare education to support the development of clinical skills. The aim of this study was to investigate the perceived value of a tonometry model eye (TME) when used in teaching and learning the clinical skill of Goldmann applanation tonometry (GAT) in optometric education in the UK.</p><p><strong>Methods: </strong>A retrospective two-armed cross-sectional study was conducted to investigate the perceived value of using a model eye for teaching and learning GAT in optometric education. Focus group discussion (FGD) was employed to explore the views of academic experts experienced in teaching GAT using a TME. Semi-structured surveys were conducted to elicit the opinions of optometry students following GAT simulation training. Qualitative thematic analysis of the FGD and open-ended survey questions was undertaken. Quantitative data based on rated student responses was assessed using Chi-square analysis to examine differences between year-group responses.</p><p><strong>Results: </strong>The TME was reported to be a useful experiential tool, facilitating a safe learning environment for students to develop the technical skills required to perform GAT before moving on to real-eye experiences. Whilst limitations of the model eye were noted, these did not diminish the value of the model eye as an instructional tool. Students reported improved confidence (86%) and would highly recommend (82%) the TME to other students.</p><p><strong>Conclusion: </strong>The model eye for tonometry was perceived by academic tutors and optometry students to be a valuable instruction tool as part of a scaffolded process for learning GAT. Irrespective of their learning stage, students reported a range of benefits from the model eye, such as being able to make mistakes, taking repeat measurements and getting used to the equipment, all whilst not having to worry about patient safety.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":"1569-1581"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vessel density, macula thickness and foveal avascular zone measurements in young African adults with moderate myopia: A pilot study.","authors":"Alvin J Munsamy, Lehlomela Monthati, Mlambo Minenhle, Mngomezulu Zwelakhe, Ndlovu Nokubongwa, Radebe Mthobisi","doi":"10.1111/opo.13385","DOIUrl":"10.1111/opo.13385","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to investigate the association between macula thickness and vessel density in African myopic and emmetropic eyes through the use of Spectral Domain Optical Coherence Tomography (OCT).</p><p><strong>Methods: </strong>The study population comprised African adults aged 18-35 years old. The study was conducted at a University eye clinic located in Durban, South Africa. Purposive sampling was utilised to obtain 59 participants of whom 24 were myopes and 35 were emmetropes. Vessel density (VD), foveal avascular zone (FAZ) and retinal thickness (RT) were obtained using the Heidelberg Spectralis OCT with angiography. Thereafter, a multivariate linear regression was used to investigate associations between the spherical equivalent myopic refractive error and VD, FAZ and RT for the myopic group only.</p><p><strong>Results: </strong>Myopic participants had a mean spherical equivalent (MSE) and standard deviation (SD) of -4.79 D (1.27) while the emmetropic group had an MSE (SD) of -0.32 D (0.46). Both superficial and deep VD were significantly decreased at the central fovea (radius (r) = 0.4 mm), peri-foveal (r = 1.10-1.45 mm) and para-foveal (r = 0.75-1.10 mm) sectors in myopes when compared with emmetropes. Myopes showed a significant reduction in RT in the inner retinal layer across the inferior and temporal zones of the peri-foveal region as well as the inferior and temporal zones of the para-foveal region when compared with emmetropes. A significantly smaller FAZ was found at both the superficial and deep vascular plexuses (p < 0.001). In African myopes, significant associations were not found between MSE and VD or FAZ and macula retinal thickness.</p><p><strong>Conclusion: </strong>Retinal vascular and thickness reduction may occur in young African adults with moderate myopia. A broad-based study targeting VD and IRT in African myopes is proposed to confirm preclinical myopic macula disruptions in adults of African ethnicity. OCT angiography should be considered when monitoring progressive myopia.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":"1453-1463"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the astigmatic power of the crystalline lens and eye from ocular biometry.","authors":"Tanya Evans, Jos J Rozema","doi":"10.1111/opo.13387","DOIUrl":"10.1111/opo.13387","url":null,"abstract":"<p><strong>Purpose: </strong>To estimate the astigmatic power of the crystalline lens and the whole eye without phakometry using a set of linear equations and to provide estimates for the astigmatic powers of the crystalline lens surfaces.</p><p><strong>Methods: </strong>Linear optics expresses astigmatic powers in the form of matrices and uses paraxial optics and a 4 × 4 ray transfer matrix to generalise Bennett's method comprehensively to include astigmatic elements. Once this is established, the method is expanded to estimate the contributions of the front and back lens surfaces. The method is illustrated using two examples. The first example is of an astigmatic model eye and compares the calculated results to the original powers. In the second example, the method is applied to the biometry of a real eye with large lenticular astigmatism.</p><p><strong>Results: </strong>When the calculated powers for the astigmatic model eye were compared to the actual powers, the difference in the power of the eye was <math> <semantics> <mrow> <msup> <mfenced><mrow><mn>0.03</mn> <mspace></mspace> <mn>0.13</mn> <mspace></mspace> <mn>0.04</mn></mrow> </mfenced> <mi>T</mi></msup> <mspace></mspace> <mi>D</mi></mrow> </semantics> </math> (where T represents the matrix transpose) and for the crystalline lens, the difference was <math> <semantics> <mrow> <msup> <mfenced><mrow><mn>0.08</mn> <mspace></mspace> <mn>0.29</mn> <mspace></mspace> <mn>0.08</mn></mrow> </mfenced> <mi>T</mi></msup> <mspace></mspace> <mi>D</mi></mrow> </semantics> </math> (power vector format). A second example applies the method to a real eye, obtaining lenticular astigmatism of -5.84 × 175.</p><p><strong>Conclusions: </strong>The method provides an easy-to-code way of estimating the astigmatic powers of the crystalline lens and the eye.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":"1433-1443"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jacobi-Fourier phase masks as ophthalmic elements to correct presbyopia.","authors":"Ángel Salas-Sanchez, Enrique González-Amador, Alfonso Padilla-Vivanco, Carina Toxqui-Quitl, Justo Arines, Eva Acosta","doi":"10.1111/opo.13389","DOIUrl":"10.1111/opo.13389","url":null,"abstract":"<p><strong>Purpose: </strong>Investigations into the correction of presbyopia have considered lens design, clinical implications and the development of objective metrics such as the visual Strehl ratio. This study investigated the Jacobi-Fourier phase mask as an ophthalmic element in the correction of presbyopia. The goal was to develop a contact or intraocular lens whose performance was largely insensitive to changes in pupil diameter.</p><p><strong>Methods: </strong>Numerical simulations based on Fourier optics were performed to evaluate three different Jacobi-Fourier polynomials, with the aim of providing a range of clear vision (1 Dioptre (D)). Performance was evaluated for three pupil sizes (6, 4 and 2 mm), while polychromatic images were simulated using three different wavelengths (656.3, 587.6 and 486.1 nm). The Neural Transfer function was included in the simulation. To validate the method and results, we used the Visual Strehl combined objective metric (VS_Combined) currently used in visual optics. This metric gives more weight to the phase transfer function and is more suitable for non-symmetrical phase functions.</p><p><strong>Results: </strong>Numerical validation showed the suitability of the Jacobi-Fourier phase masks for extending the range of clear vision of presbyopic eyes, providing a visual acuity of at least 0.10 logMAR (6/7.5 Snellen) at all distances between 1 and 6 m. The results show a range of clear vision of 1D was not affected by changes in pupil size, an increase in retinal image contrast accompanied by image artefact reduction by increasing the radial order of the Jacobi-Fourier phase mask and a reduction of wavelength dependence of the retinal images. These results are supported by simulated images and the objective criterion VS_Combined.</p><p><strong>Conclusions: </strong>The use of Jacobi-Fourier phase masks as ophthalmic elements for presbyopic correction show promising results, with a good range of clear vision and reduced dependence on pupil size and chromatic aberration.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":"1552-1560"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated visual acuity estimation by optokinetic nystagmus using a stepped sweep stimulus.","authors":"Jason Turuwhenua, Zaw LinTun, Mohammad Norouzifard, Misty Edmonds, Rebecca Findlay, Joanna Black, Benjamin Thompson","doi":"10.1111/opo.13391","DOIUrl":"10.1111/opo.13391","url":null,"abstract":"<p><strong>Purpose: </strong>To describe an automatic system for objective measurement of visual acuity (VA) using optokinetic nystagmus (OKN). This pilot study tested the system's sensitivity and specificity for detecting reduced VA in healthy adults by comparing VA-OKN to VA with an Early Treatment of Diabetic Retinopathy Study (ETDRS) chart (VA-ETDRS).</p><p><strong>Methods: </strong>Adult participants (age 30 ± 12 years) with either reduced VA (n = 11, VA-ETDRS > 0.20 logMAR) or normal VA (n = 12, VA-ETDRS ≤ 0.20 logMAR) completed monocular VA-OKN measurements in each eye. The VA-OKN stimulus was an array of drifting (5°/s) vanishing discs presented in descending/ascending size order (0.00-1.00 logMAR in 0.10 steps). The stimulus was stepped every 2 s, and 10 sweeps were shown per eye (five ascending and five descending). Eye-tracking data determined when OKN activity ceased (descending sweep) or began (ascending sweep), which was used to determine VA-OKN for each sweep. The estimates were averaged across sweeps to produce an automated VA-OKN. The automated sweeps were then provided in randomised order to a reviewer blinded to the VA-ETDRS findings who determined a final VA-OKN for an eye.</p><p><strong>Results: </strong>A single randomly selected eye from each observer was used for analysis. The sensitivity and specificity of VA-OKN using the same 0.20 logMAR threshold as VA-ETDRS was 100%. Comparisons between the VA-OKN and VA-ETDRS measures were made for participants in the reduced VA group. There was no significant difference between VA-OKN and VA-ETDRS (p = 0.55) and the two measures produced comparable values (r² = 0.84, 95% limits of agreement = 0.19 logMAR, intra-class correlation coefficient = 0.90 [95% CI:0.68-0.97]).</p><p><strong>Conclusions: </strong>Visual acuity using optokinetic nystagmus correctly identified a VA deficit in adults and for those with a VA deficit, VA-OKN was strongly correlated with the gold-standard clinical measure of VA. OKN is a promising method which has the potential for use in cognitively impaired adults and pre-verbal children.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":"1500-1512"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the impact of OCT imaging of the crystalline lens on the accuracy and precision of cataract assessment.","authors":"Niamh Burke, Pádraig J Mulholland, Pearse A Keane, Julie-Anne Little","doi":"10.1111/opo.13383","DOIUrl":"10.1111/opo.13383","url":null,"abstract":"<p><strong>Purpose: </strong>To determine if supplementing standard clinical assessments with Optical Coherence Tomography (OCT) imaging of the crystalline lens improves the accuracy and precision of lens opacity assessment and associated clinical management decisions by optometrists.</p><p><strong>Methods: </strong>Fifty optometrists registered in the UK or Éire undertook a clinical vignette study where participants graded lens opacities and made associated clinical management decisions based on the image(s)/information displayed. Three forms of vignettes were presented: (1) Slit-lamp (SL) images of the lens, (2) SL and OCT images and (3) SL, OCT and visual function measures. Vignettes were constructed using anonymised data from 50 patients with varying cataract severity, each vignette being presented twice in a randomised order (total vignette presentations = 300). The accuracy of opacity and management decisions were evaluated using descriptive statistics and non-parametric Bland-Altman analysis where assessments from experienced clinicians were the reference. The precision of assessments was examined for each vignette form using non-parametric Bland-Altman analysis.</p><p><strong>Results: </strong>All (n = 50) participants completed the study, with 36 working in primary eyecare (primary eyecare) settings and 14 in hospital eyecare services (HES). Agreement was highest where vignettes contained all clinical data (i.e., SL, OCT and visual function data-grading: 51.0%, management: 50.5%), and systematically reduced with decreasing vignette content (p < 0.001). A larger number of vignettes containing imaging and visual function measures exhibited below reference (i.e., less conservative) grading compared with vignettes containing imaging data alone (all p < 0.05). HES-based optometrists were more likely to grade lens opacities lower than clinicians working in primary eyecare (p < 0.001). Good measurement precision was evident for all vignettes, with a mean bias close to zero and limits of agreement below one grading step for all conditions.</p><p><strong>Conclusions: </strong>The addition of anterior segment OCT to SL images improved the accuracy of lens opacity grading. Structural assessment alone yielded more conservative decision making, which reversed once visual functional data was available.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":"1539-1551"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating a web-based visual acuity and refractive error self-assessment tool in myopic children.","authors":"Janneau L J Claessens, Marloes A Janssen, Casper van der Zee, Jan Roelof Polling, Magda A Meester-Smoor, Caroline C W Klaver, Robert P L Wisse","doi":"10.1111/opo.13370","DOIUrl":"10.1111/opo.13370","url":null,"abstract":"<p><strong>Introduction: </strong>Demands for myopia management are rising. A web-based tool that allows home-performed self-assessments of visual acuity (VA) and refractive error may enable hybrid care pathways and aid in identifying those with deteriorating visual performance. The tool has been validated in adult populations, but has yet to be evaluated in children. This study compared home-performed VA and refraction self-assessments to conventional measurements obtained at the clinic in a population of myopic children.</p><p><strong>Methods: </strong>Myopic children aged ≥6 years old were invited to perform web-based eye tests at home, assisted by a parent. At two myopia control clinics, they also underwent measurements of VA using a Snellen chart and refractive error using cycloplegic autorefraction. Agreement between the tests, repeatability of the web-based test and associations between clinical characteristics and web-based test accuracy were evaluated.</p><p><strong>Results: </strong>A total of 147 children were enrolled, of whom 116 (51% male; mean age 13 ± 3 years; mean spherical equivalent refraction (SEQ) -5.58 ± 3.05) performed the web-based tests at home. Overall, the home-performed VA self-assessment and the Snellen chart assessment at the clinic agreed well (mean difference 0.03 ± 0.11 logMAR). A significant proportional bias was identified (β 0.65, p < 0.001), indicating underestimated web-based VA scores when the child's vision declined. The sensitivity to detect VA poorer than 0.10 logMAR was 94%; the specificity was 71%. The web-based refractive error algorithm measured more myopia progression compared to clinic observations (mean difference SEQ 0.40 ± 0.51 dioptres). Age, sex or use of atropine drops were not significantly associated with test accuracy.</p><p><strong>Conclusions: </strong>The web-based test for self-assessing vision, performed at home by children with assistance from their parents, yielded VA scores with a precision similar to Snellen chart testing conducted in a clinical setting. However, the web-based refractive error algorithm overestimated myopia progression and requires recalibration for this specific age group.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":" ","pages":"1444-1452"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}