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O'Connor AR, Warburton A, Farrelly-Waters M, England L, Clarke R, Kay H. Evaluation of the Amblyopia tracker app. Graefes Arch Clin Exp Ophthalmol 2024; 262:2675-2683. [PMID: 38413448 PMCID: PMC11271332 DOI: 10.1007/s00417-024-06413-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 02/09/2024] [Accepted: 02/10/2024] [Indexed: 02/29/2024] Open
Abstract
PURPOSE The Amblyopia tracker app has been developed to be a tool for parents to monitor changes in vision at home during amblyopia treatment. The aims of this study were to evaluate the feasibility and repeatability of parents testing their children at home and to compare home test results to an assessment in clinic by an orthoptist. METHODS Children (age < 18 years) with amblyopia (interocular acuity difference of ≥ 0.2logMAR) were recruited. Parents were asked to test their child with the app three times during a two week period followed by an online questionnaire about the usability. Participants also tested within 48 h of their appointment where the measurement was repeated by an orthoptist. RESULTS Out of 277 potential participants contacted, 37 completed three home measurements, mean age 6.8 years (SD 2.94). Home tests comparisons were made between test two and three to ensure familiarity with the process. Paired t-tests showed no statistically significant difference for either eye or the interocular acuity difference (IAD). However, 29% had a difference in IAD of more than 0.1logMAR on repeated testing, with a maximum of 0.4logMAR difference in the IAD. Questionnaire responses from the parents who participated were predominantly positive with 97% of respondents saying they would use it if were available. Comparison of home and clinical measurements (n = 23, mean age 6.72 SD 2.60) showed no statistically significant differences for either eye or interocular acuity difference (paired t-test, p > 0.3 in all cases). CONCLUSION Results show no statistically significant differences for the Amblyopia tracker app when used by parents at home on repeated testing, or between the home test by a parent and the test by a clinician. However, variability in the results does indicate that further improvements are required to ensure the results can be used as a reliable clinical tool.
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Affiliation(s)
- Anna R O'Connor
- School of Health Sciences, University of Liverpool, Thompson Yates Building, Brownlow Hill, Liverpool, L69 3GB, UK.
| | - Ashli Warburton
- School of Health Sciences, University of Liverpool, Thompson Yates Building, Brownlow Hill, Liverpool, L69 3GB, UK
| | | | - Laura England
- Orthoptic Department, Manchester Royal Eye Hospital, Manchester, UK
| | - Rachel Clarke
- Orthoptic Department, Manchester Royal Eye Hospital, Manchester, UK
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Skerswetat J, He J, Shah JB, Aycardi N, Freeman M, Bex PJ. A new, adaptive, self-administered, and generalizable method used to measure visual acuity. Optom Vis Sci 2024; 101:451-463. [PMID: 39110980 PMCID: PMC11323045 DOI: 10.1097/opx.0000000000002160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2024] Open
Abstract
SIGNIFICANCE Angular Indication Measurement (AIM) is an adaptive, self-administered, and generalizable orientation-judgment method designed to interrogate visual functions. We introduce AIM Visual Acuity (VA) and show its features and outcome measures. Angular Indication Measurement VA's ability to detect defocus was comparable with that of an Early Treatment of Diabetic Retinopathy Study (ETDRS) letter chart and showed greater sensitivity to astigmatic blur. PURPOSE This proof-of-concept study introduces Angular Indication Measurement and applies it to VA. METHODS First, we compared the ability of AIM-VA and ETDRS to detect defocus and astigmatic blur in 22 normally sighted adults. Spherical and cylindrical lenses in the dominant eye induced blur. Second, we compared repeatability over two tests of AIM-VA and ETDRS. RESULTS A repeated-measure analysis of variance showed a main effect for defocus blur and test. For the astigmatism experiment, an interaction between blur and orientation was found. Pairwise comparisons showed that AIM was more sensitive to astigmatic-induced VA loss than ETDRS. Bland-Altman plots showed small bias and no systematic learning effect for either test type and improved repeatability with more than two adaptive steps for AIM-VA. CONCLUSIONS Angular Indication Measurement VA's ability to detect defocus was comparable with that of an ETDRS letter chart and showed greater sensitivity to induced astigmatic blur, and AIM-VA's repeatability is comparable with ETDRS when using two or more adaptive steps. Angular Indication Measurement's self-administered orientation judgment approach is generalizable to interrogate other visual functions, e.g., contrast, color, motion, and stereovision.
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Affiliation(s)
| | | | - Jay Bijesh Shah
- Department of Psychology, Northeastern University, Boston, Massachusetts
| | - Nicolas Aycardi
- Department of Psychology, Northeastern University, Boston, Massachusetts
| | - Michelle Freeman
- Department of Psychology, Northeastern University, Boston, Massachusetts
| | - Peter John Bex
- Department of Psychology, Northeastern University, Boston, Massachusetts
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Samanta A, Santineau K, Park A, Nguyen D, Kim Cavdar I, Nelson P. Measuring Vision at Home in 2023. Telemed J E Health 2024; 30:e1606-e1614. [PMID: 38564179 DOI: 10.1089/tmj.2023.0368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Introduction: The ability to measure a patient's visual acuity at home (HVA) is by far the most desired remote telemedicine capability sought by ophthalmologists. Methods: A systematic literature review was done using Pubmed to search for publications from 2010 to 2022 in English reporting on 10 studies that compared a patient's HVA to the clinic visual acuity (CVA). Results: Approaches to measuring HVA included using a phone-based application, a physical chart, a computer, and a website. The most accurate of these was the use of personal computers (COMPlog, Macustat, Web based test) at home with a bias of 1 letter. The most accessible and reliable was the use of a printable visual acuity chart, available in the public domain, which had adifference between HVA and CVA of 1 to 3.5 letters. Phone apps (Verana Vision) and stand-alone websites (Farsight.com) both had a greater mean difference of about 6 letters, respectively,with a moderate correlation coefficient. Discussion: Overall, all three methodologies demonstrated a good negative predictive value demonstrating their potential use as an effective screening tool to flag drastic vision decline between clinic visits.
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Affiliation(s)
- Anindya Samanta
- Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA
| | - Kaitlyn Santineau
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Alexander Park
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Dang Nguyen
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Irina Kim Cavdar
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
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Gobira M, Freire V, de Aquino GSA, Dib V, Gobira M, Carricondo PC, Dias A, Negreiros MA. Evaluating the precision of an online visual acuity test tool. J Telemed Telecare 2024:1357633X241252454. [PMID: 38766707 DOI: 10.1177/1357633x241252454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
OBJECTIVE The aim of this study was to assess the precision of a web-based tool in measuring visual acuity (VA) in ophthalmic patients, comparing it to the traditional in-clinic evaluation using a Snellen chart, considered the gold standard. METHODS We conducted a prospective and in-clinic validation comparing the Eyecare Visual Acuity Test® to the standard Snellen chart, with patients undergoing both tests sequentially. Patients wore their standard spectacles as needed for both tests. Inclusion criteria involved individuals above 18 years with VA equal to or better than +1 logMar (20/200) in each eye. VA measurements were converted from Snellen to logMAR, and statistical analyses included Bland-Altman and descriptive statistics. RESULTS The study, encompassing 322 patients and 644 eyes, compared Eyecare Visual Acuity Test® to conventional methods, revealing a statistically insignificant mean difference (0.01 logMAR, P = 0.1517). Bland-Altman analysis showed a narrow 95% limit of agreement (0.22 to -0.23 logMAR), indicating concordance, supported by a significant Pearson correlation (r = 0.61, P < 0.001) between the two assessments. CONCLUSION The Eyecare Visual Acuity Test® demonstrates accuracy and reliability, with the potential to facilitate home monitoring, triage, and remote consultation. In future research, it is important to validate the Eyecare Visual Acuity Test® accuracy across varied age cohorts, including pediatric and geriatric populations, as well as among individuals presenting with specific comorbidities like cataract, uveitis, keratoconus, age-related macular disease, and amblyopia.
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Affiliation(s)
- Mauro Gobira
- Department of Ophthalmology, Vision Institute, Instituto Paulista de Estudos e Pesquisas em Oftalmologia (IPEPO), São Paulo, SP, Brazil
- Department of Ophthalmology, Eyecare Health Company, São Paulo, SP, Brazil
| | - Vinícius Freire
- Department of Ophthalmology, Universidade São Paulo (USP), São Paulo, SP, Brazil
| | | | - Vanessa Dib
- Department of Ophthalmology, Hospital Evangélico de Belo Horizonte, Belo Horizonte, MG, Brazil
| | - Matheus Gobira
- Department of Ophthalmology, Faculdade de Minas (FAMINAS), Belo Horizonte, MG, Brazil
| | | | - Ariadne Dias
- Department of Ophthalmology, Eyecare Health Company, São Paulo, SP, Brazil
| | - Marco Antonio Negreiros
- Department of Ophthalmology, Vision Institute, Instituto Paulista de Estudos e Pesquisas em Oftalmologia (IPEPO), São Paulo, SP, Brazil
- Department of Ophthalmology, Eyecare Health Company, São Paulo, SP, Brazil
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Wu Y, Keel S, Carneiro VLA, Zhang S, Wang W, Liu C, Tang X, Han X, He M. Real-world application of a smartphone-based visual acuity test (WHOeyes) with automatic distance calibration. Br J Ophthalmol 2024:bjo-2023-324913. [PMID: 38514167 DOI: 10.1136/bjo-2023-324913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/29/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND To develop and assess the usability of a smartphone-based visual acuity (VA) test with an automatic distance calibration (ADC) function, the iOS version of WHOeyes. METHODS The WHOeyes was an upgraded version with a distinct feature of ADC of an existing validated VA testing app called V@home. Three groups of Chinese participants with different ages (≤20, 20-40, >40 years) were recruited for distance and near VA testing using both an Early Treatment Diabetic Retinopathy Study (ETDRS) chart and the WHOeyes. The ADC function would determine the testing distance. Infrared rangefinder was used to determine the testing distance for the ETDRS, and actual testing distance for the WHOeyes. A questionnaire-based interview was administered to assess the satisfaction. RESULTS The actual testing distance determined by the WHOeyes ADC showed an overall good agreement with the desired testing distance in all three age groups (p>0.50). Regarding the distance and near VA testing, the accuracy of WHOeyes was equivalent to ETDRS. The mean difference between the WHOeyes and ETDRS ranged from -0.084 to 0.012 logMAR, and the quadratic weighted kappa (QWK) values were >0.75 across all groups. The test-retest reliability of WHOeyes was high for both near and distance VA, with a mean difference ranging from -0.040 to 0.004 logMAR and QWK all >0.85. The questionnaire revealed an excellent user experience and acceptance of WHOeyes. CONCLUSIONS WHOeyes could provide accurate measurement of the testing distance as well as the distance and near VA when compared to the gold standard ETDRS chart.
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Affiliation(s)
- Yi Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Stuart Keel
- Department of Noncommunicable Diseases, Vision and eye care programme, World Health Organisation, Geneva, Switzerland
| | - Vera Lúcia Alves Carneiro
- Department of Noncommunicable Diseases, Vision and eye care programme, World Health Organisation, Geneva, Switzerland
| | - Shiran Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Chi Liu
- Faculty of Data Science, City University of Macau, Macao SAR, China
| | - Xuanzhang Tang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiaotong Han
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Osborne D, Steele A, Evans M, Ellis H, Pancholi R, Harding T, Dee J, Leary R, Bradshaw J, O'Flynn E, Self JE. Children's visual acuity tests without professional supervision: a prospective repeated measures study. Eye (Lond) 2023; 37:3762-3767. [PMID: 37328509 PMCID: PMC10697985 DOI: 10.1038/s41433-023-02597-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 04/11/2023] [Accepted: 05/19/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Home visual acuity tests could ease pressure on ophthalmic services by facilitating remote review of patients. Home tests may have further utility in giving service users frequent updates of vision outcomes during therapy, identifying vision problems in an asymptomatic population, and engaging stakeholders in therapy. METHODS Children attending outpatient clinics had visual acuity measured 3 times at the same appointment: Once by a registered orthoptist per clinical protocols, once by an orthoptist using a tablet-based visual acuity test (iSight Test Pro, Kay Pictures), and once by an unsupervised parent/carer using the tablet-based test. RESULTS In total, 42 children were recruited to the study. The mean age was 5.6 years (range 3.3 to 9.3 years). Median and interquartile ranges (IQR) for clinical standard, orthoptic-led and parent/carer-led iSight Test Pro visual acuity measurements were 0.155 (0.18 IQR), 0.180 (0.26 IQR), and 0.300 (0.33 IQR) logMAR respectively. The iSight Test Pro in the hands of parents/carers was significantly different from the standard of care measurements (P = 0.008). In the hands of orthoptists. There was no significant difference between orthoptists using the iSight Test Pro and standard of care (P = 0.289), nor between orthoptist iSight Test Pro and parents/carer iSight Test Pro measurements (P = 0.108). CONCLUSION This technique of unsupervised visual acuity measures for children is not comparable to clinical measures and is unlikely to be valuable to clinical decision making. Future work should focus on improving the accuracy of the test through better training, equipment/software or supervision/support.
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Affiliation(s)
- Daniel Osborne
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK.
- University of Southampton, Faculty of Medicine, Southampton, UK.
| | - Aimee Steele
- University of Southampton, Faculty of Medicine, Southampton, UK
| | - Megan Evans
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK
| | - Helen Ellis
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK
| | - Roshni Pancholi
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK
| | - Tomos Harding
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK
| | - Jessica Dee
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK
| | - Rachel Leary
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK
| | - Jeremy Bradshaw
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK
| | - Elizabeth O'Flynn
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK
| | - Jay E Self
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK
- University of Southampton, Faculty of Medicine, Southampton, UK
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Ghasemi Fard F, Mirzaei H, Hosseini SA, Riazi A, Ebadi A, Hooshmandzadeh N. Development and clinimetric assessment of a performance-based functional vision tool in visually impaired children. Front Pediatr 2023; 11:1275726. [PMID: 38027280 PMCID: PMC10656732 DOI: 10.3389/fped.2023.1275726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Objective Appropriate functional vision is vital for the development of visually impaired (VI) children. However, the literature currently lacks a performance-based tool for assessing functional vision, unlike the existing self-reported tools. The objective of this study is to develop and conduct a clinimetric study on a Performance-Based Functional Vision Tool (PB-FVT) specifically designed for VI children aged 3-7 and 7-10 years old. Methods This methodological study was conducted to assess the clinimetric properties of the PB-FVT. The assessment included face validity (evaluated through cognitive interviews and an Impact Score >1.5), content validity (with criteria including content validity ratio >0.63, item content validity index >0.78, scale content validity index or average >0.8, and Kappa value >0.7), criterion validity (assessed through a concurrent test using visual acuity scores), construct validity (utilizing the known group method), relative reliability (measured by the intra-class correlation coefficient), absolute reliability (determined by the standard error of measurement and minimal detectable changes), interpretability, responsiveness, sensitivity, and specificity (analyzed via ROC curve analysis). Results The PB-FVT was developed with 32 items, divided into five components: activities of daily living, instrumental activities of daily living, education, play, and social interaction. The results indicate that the scale demonstrates suitability in terms of validity, reliability, and other measurement characteristics. Conclusions The valid and reliable PB-FVT may accurately assess the level of functional vision during early childhood, helping to prevent negative impacts on a child's overall development. By utilizing the PB-FVT, any functional vision impairments can be identified appropriately, enabling the planning and implementation of effective rehabilitation interventions.
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Affiliation(s)
- Fatemeh Ghasemi Fard
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hooshang Mirzaei
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Ali Hosseini
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Abbas Riazi
- Low Vision Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran university of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Narges Hooshmandzadeh
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Ping X, Pye D. A proposed methodology for conducting a remote rigid gas permeable contact lens consultation. Cont Lens Anterior Eye 2023; 46:101893. [PMID: 37482438 DOI: 10.1016/j.clae.2023.101893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/17/2023] [Accepted: 07/16/2023] [Indexed: 07/25/2023]
Abstract
PURPOSE COVID-19 spread to numerous countries, overwhelming healthcare systems and economies worldwide. COVID-19 restrictions have prevented patients from attending consultations in person and led to the further development of telemedicine to provide health care. The situation also applies to contact lens (CL) practitioners and their patients; telemedicine enables practitioners to provide patients with regular and continuing care. This study aimed to investigate available tools to enable continuing care for rigid gas permeable (RGP) CL wearers who are unable to attend face-to-face consultations. METHODS The study consists of three components. Firstly, an approach to enable the assessment of a patient's CL fitting and cornea remotely. Secondly, to find an affordable and reliable method to obtain a patient's visual acuity (VA), and thirdly, to develop a questionnaire to provide practitioners with information to deliver optimal patient care. RESULTS The use of a macro lens, smartphone, and auxiliary materials enables high-quality images of the anterior eye and RGP CL to be obtained. Two free and validated smartphone applications (apps) for VA measurements were identified which are available on Android and iOS systems. Two questionnaires were also developed to enable practitioners to obtain additional patient information to facilitate optimal patient care. CONCLUSION This study has developed the components of a remote CL consultation to enable patients who cannot attend scheduled appointments to receive care and advice to ensure the safety of their RGP CL wear. The tools involved in this study are low-cost, affordable, and an adjunct, not a substitute, for face-to-face consultations.
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Affiliation(s)
- Xiaona Ping
- School of Optometry & Vision Science, University of New South Wales, Sydney, NSW, Australia
| | - David Pye
- School of Optometry & Vision Science, University of New South Wales, Sydney, NSW, Australia.
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Sii SSZ, Chean CS, Kuht H, Bunce C, Thomas MG, Rufai SR. Home-based screening tools for amblyopia: a systematic review. Eye (Lond) 2023; 37:2649-2658. [PMID: 36828959 PMCID: PMC9951845 DOI: 10.1038/s41433-023-02412-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/15/2022] [Accepted: 01/18/2023] [Indexed: 02/26/2023] Open
Abstract
Amblyopia is an important public health concern. While home-based screening may present an effective solution, this has not been rigorously assessed in a systematic review. A systematic review was performed using Ovid MEDLINE, PubMed, The Cochrane Library, Embase, Web of Science Core Collection, and Clinicaltrials.gov. All studies reporting the diagnostic accuracy of home-based screening tools for amblyopia among children were included. Studies involving orthoptist or ophthalmologist-led screening and adult subjects were excluded. The main outcome measure was the diagnostic accuracy expressed as sensitivity and specificity. Among 3670 studies identified, 28 were eligible for inclusion in our systematic review. The age range of patients were less than 1 month to 16 years old. 7 studies used internet-based tools, 16 used smartphone/tablet applications, 3 used digital cameras, and 3 used home-based questionnaires and visual acuity tools. All studies included a reference standard except one, which was a longitudinal study. 21 studies had full ophthalmological examination whilst 6 studies had validated visual acuity measurement tools as gold standards. Of the 27 studies which compared against a reference test, only 25 studies reported sensitivity and specificity values. Using the QUADAS-2 tool, 50% of studies were deemed to have applicability concern due to patient selection from tertiary centres and unclear methods for recruitment. There is a need to improve the quality of diagnostic accuracy studies, standardise thresholds for detecting amblyopia, and ensure consistent reporting of results. Further research is needed to evaluate the suitability of these tools for amblyopia screening.
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Affiliation(s)
| | - Chung Shen Chean
- University of Leicester Ulverscroft Eye Unit, Leicester Royal Infirmary, Leicester, UK
| | - Helen Kuht
- University of Leicester Ulverscroft Eye Unit, Leicester Royal Infirmary, Leicester, UK
| | - Catey Bunce
- The Royal Marsden NHS Foundation Trust, London, UK
| | - Mervyn G Thomas
- University of Leicester Ulverscroft Eye Unit, Leicester Royal Infirmary, Leicester, UK.
| | - Sohaib R Rufai
- University of Leicester Ulverscroft Eye Unit, Leicester Royal Infirmary, Leicester, UK.
- Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children, London, UK.
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Skerswetat J, He J, Shah JB, Aycardi N, Freeman M, Bex PJ. AIM (Angular Indication Measurement)- Visual Acuity: An adaptive, self-administered, and generalizable vision assessment method used to measure visual acuity. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.25.529586. [PMID: 36909639 PMCID: PMC10002620 DOI: 10.1101/2023.02.25.529586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
This proof-of-concept study introduces Angular Indication Measurement and applies it to VA (AIM-VA). First, we compared the ability of AIM-VA and ETDRS to detect defocus and astigmatic blur in 22 normally-sighted adults. Spherical and cylindrical lenses (±0.00D, +0.25D, +0.50D, +0.75D, +1.00D, +2.00D and +0.50D, +1.00D, +2.00D each at 0°, 90°, 135°, respectively) in the dominant eye induced blur. Second, we compared repeatability over two tests of AIM-VA and ETDRS. A 2-way-ANOVA showed a main effect for defocus-blur and test with no interaction. A 3-way-ANOVA for the astigmatism experiment revealed main effects for test type, blur, and direction and with no interactions. Planned multiple comparisons showed AIM had greater astigmatic-induced VA loss than ETDRS. Bland-Altman plots showed small bias and no systematic learning effect for either test type and improved repeatability with >2 adaptive steps for AIM-VA. AIM-VA's ability to detect defocus was comparable with that of an ETDRS letter chart and showed greater sensitivity to astigmatic blur, and AIM-VA's repeatability is comparable with ETDRS when using 2 or more adaptive steps. AIM's self-administered orientation judgment approach is generalizable to interrogate other visual functions, e.g., contrast, color, motion, stereo-vision.
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11
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Karampatakis V, Almaliotis D, Talimtzi P, Almpanidou S. Design and Validation of a Novel Smartphone-Based Visual Acuity Test: The K-VA Test. Ophthalmol Ther 2023; 12:1657-1670. [PMID: 36961662 PMCID: PMC10037403 DOI: 10.1007/s40123-023-00697-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/27/2023] [Indexed: 03/25/2023] Open
Abstract
INTRODUCTION Visual acuity (VA) testing is a critical screening examination for the assessment of visual function. This study describes the development and validation of a smartphone-based VA test: the K-VA test. METHODS A total of 171 patients with various ocular diseases were examined in our outpatient unit at Aristotle University of Thessaloniki, School of Medicine in Greece. Participants underwent VA examination using the standard Early Treatment Diabetic Retinopathy Study (ETDRS) charts and the K-VA smartphone-based test. The K-VA test was performed by participants themselves. The Bland-Altman method was employed to assess the agreement between the ETDRS charts and the new test for the examination of VA at 1 m and 40 cm. Test-retest reliability was also calculated. A questionnaire regarding the participants' feedback on the K-VA test was completed. RESULTS No significant bias was observed between the gold standard ETDRS charts and the K-VA test measurements. The mean difference (95% limits of agreement, LoA) between the K-VA test at 1 m and the ETDRS chart at 4 m was -0.006 (95% LoA -0.129 to 0.117) logarithm of the minimal angle of resolution (logMAR). The agreement of the K-VA test at 40 cm with the near ETDRS chart was also high with a mean difference of -0.007 (95% LoA -0.105 to 0.090) logMAR. Test-retest reliability was found to be high with a mean difference of 0.003 (95% LoA -0.045 to 0.033) logMAR and 0.005 (95% LoA -0.065 to 0.076) logMAR for the K-VA test at 1 m and 40 cm, respectively. A total of 97 participants answered the questionnaire and 71 (73.2%) stated that the test was easy to very easy to use for self-performance. CONCLUSIONS The study demonstrated that the K-VA application performed well compared with the ETDRS charts and provides reliable and repeatable measurements of VA across a wide range of VA.
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Affiliation(s)
- Vasileios Karampatakis
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Diamantis Almaliotis
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Persefoni Talimtzi
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavroula Almpanidou
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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12
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Mortazavi SAA, Akhlaghi M, Dehghani A, Pourazizi M, Malekahmadi M, Fazel M, Tavakoli M, Noorshargh P. Diabetic retinopathy and corneal endothelial parameters: an analytical cross-sectional study. BMC Ophthalmol 2022; 22:427. [DOI: 10.1186/s12886-022-02667-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 11/02/2022] [Indexed: 11/11/2022] Open
Abstract
Abstract
Background
To investigate the possible association of different pattern of diabetic retinopathy (DR) on corneal endothelium cells in type 2 diabetes mellitus patients.
Methods
In this descriptive-analytical cross-sectional study, corneal endothelium parameters including endothelial cell density (ECD), average cell size (AVG), coefficient of variation in cell size (CV), and hexagonality (Hex) were evaluated by non-contact specular microscopy.
Results
One hundred and thirty-four eyes of 134 diabetic patients including 77 females (57.5%) with a mean age of 61.03 ± 8.08 years were enrolled. The overall corneal parameters in diabetic patients with and without retinopathy were not significantly different (P > 0.05). There is a significant relationship between CV and the duration of the disease with age variable control (B = 0.369, p-value < 0.001).
Conclusions
Corneal endothelial parameters were not associated with DM in patients without and with DR. There is a significant relationship between CV and the duration of the disease with age variable control.
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13
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Iskander M, Hu G, Sood S, Heilenbach N, Sanchez V, Ogunsola T, Chen D, Elgin C, Patel V, Wronka A, Al-Aswad LA. Validation of the New York University Langone Eye Test Application, a Smartphone-Based Visual Acuity Test. OPHTHALMOLOGY SCIENCE 2022; 2:100182. [PMID: 36245756 PMCID: PMC9560635 DOI: 10.1016/j.xops.2022.100182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE To validate and assess user satisfaction and usability of the New York University (NYU) Langone Eye Test application, a smartphone-based visual acuity (VA) test. DESIGN Mixed-methods cross-sectional cohort study. PARTICIPANTS Two hundred forty-four eyes of 125 participants were included. All participants were adults 18 years of age or older. Participants' eyes with a VA of 20/400 (1.3 logarithm of the minimum angle of resolution [logMAR]) or worse were excluded. METHODS Patients were tested using the clinical standard Rosenbaum near card and the NYU Langone Eye Test application on an iPhone and Android device. Each test was performed twice to measure reliability. Ten patients were selected randomly for subsequent semistructured qualitative interviews with thematic analysis. MAIN OUTCOME MEASURES Visual acuity was the parameter measured. Bland-Altman analysis was used to measure agreement between the results of the NYU Langone Eye Test application and Rosenbaum card, as well as test-retest reliability of each VA. The correlation between results was calculated using the intraclass correlation coefficient. Satisfaction survey and semistructured interview questions were developed to measure usability and acceptability. RESULTS Bland-Altman analysis revealed an agreement between the application and the Rosenbaum near card of 0.017 ± 0.28 logMAR (iPhone) and 0.009 ± 0.29 logMAR (Android). The correlation between the application and the Rosenbaum near card was 0.74 for both the iPhone and Android. Test-retest reliability was 0.003 ± 0.22 logMAR (iPhone), 0.01 ± 0.25 logMAR (Android), and 0.01 ± 0.23 logMAR (Rosenbaum card). Of the 125 participants, 97.6% found the application easy to use, and 94.3% were overall satisfied with the application. Thematic analysis yielded 6 key themes: (1) weaknesses of application, (2) benefits of the application, (3) tips for application improvement, (4) difficulties faced while using the application, (5) ideal patient for application, and (6) comparing application with traditional VA testing. CONCLUSIONS The NYU Langone Eye Test application is a user-friendly, accurate, and reliable measure of near VA. The application's integration with the electronic health record, accessibility, and easy interpretation of results, among other features, make it ideal for telemedicine use.
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Affiliation(s)
- Mina Iskander
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
- New York Medical College, New York, New York
| | - Galen Hu
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
| | - Shefali Sood
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
| | - Noah Heilenbach
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
| | - Victor Sanchez
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
| | - Titilola Ogunsola
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
- New York Medical College, New York, New York
| | - Dinah Chen
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
| | - Ceyhun Elgin
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
- Bogazici University, Istanbul, Turkey
| | - Vipul Patel
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
| | - Andrew Wronka
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
| | - Lama A. Al-Aswad
- Department of Ophthalmology, Grossman School of Medicine, New York University, New York, New York
- Department of Population Health, Grossman School of Medicine, New York University, New York, New York
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14
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Koriat Y, Saveliev N, Koriat A, Heller D. Tele-ophthalmology as an aid tool for primary care physicians in the IDF, during the Covid-19 lockdown. Int Ophthalmol 2022; 42:2741-2748. [PMID: 35366137 PMCID: PMC8976161 DOI: 10.1007/s10792-022-02263-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 03/12/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To describe tele-ophthalmology consultations for primary-physicians in the IDF during the Covid-19 lockdown. METHODS Retrospective cross-sectional study. Medical records of tele-ophthalmology consultations from March to June 2020 were reviewed. RESULTS The study included 245 cases in which an ophthalmologist was consulted. In 62.0% cell-phone camera photographs were used. The mean age was 21.5 ± 6.4 years. The most common diagnoses were acute-conjunctivitis (8.6%); conjunctival-hyperemia (non-specific diagnosis, 8.2%); scleritis/episcleritis (7.3%); chronic allergic-conjunctivitis (7.3%); chalazion (7.3%) hordeolum (6.5%); acute allergic-conjunctivitis (4.5%). 37.6% of patients received primary physician-based treatment, 24.9% of patients received specialist-based treatment. 13.1% were referred to the ER. The consult prevented ER referral for 39.2% and changed the physician's treatment plan in 70.6% of cases. Foreign-body sensation complaints were more likely treated by a primary-physician (p = 0.015). Cases with suspected foreign-body diagnosis were referred more to the ER (p < 0.001). For most cases of eyelid complaints and diagnoses, primary physician care was sufficient (p < 0.001). Conjunctival complaints and diagnoses received significantly more ophthalmologist-based treatment (p < 0.001). Corneal disorders were significantly referred more to the ER (p = 0.001). CONCLUSION Despite of possible ethical and legal problems and clinical limitations of this instrument, Tele-ophthalmology using objective aids such as smartphone photography can be an efficient tool in aiding the primary-physician, especially for patients with low access to ophthalmologists, with major impact on patient management.
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Affiliation(s)
- Yehonatan Koriat
- Medical Corps, Israel Defense Forces, Tel Hashomer, Ramat Gan, Israel.,Faculty of Medicine, Military Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Natali Saveliev
- Medical Corps, Israel Defense Forces, Tel Hashomer, Ramat Gan, Israel.,Faculty of Medicine, Military Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Adi Koriat
- Medical Corps, Israel Defense Forces, Tel Hashomer, Ramat Gan, Israel
| | - Dan Heller
- Medical Corps, Israel Defense Forces, Tel Hashomer, Ramat Gan, Israel. .,Faculty of Medicine, Military Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
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15
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Macnamara A, Schinazi VR, Chen C, Coussens S, Loetscher T. The effect of age-related macular degeneration on cognitive test performance. Sci Rep 2022; 12:4033. [PMID: 35260721 PMCID: PMC8904792 DOI: 10.1038/s41598-022-07924-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/21/2022] [Indexed: 11/24/2022] Open
Abstract
The reliable assessment of cognitive functioning is critical to the study of brain-behaviour relationships. Yet conditions that are synchronous which ageing, including visual decline, are easily overlooked when interpreting cognitive test scores. The purpose of this study was to demonstrate the negative consequences of visual impairments on cognitive tests performance. Moderate to severe levels of age-related macular degeneration were simulated, with a set of goggles, in a sample of twenty-four normally sighted participants while they completed two cognitive tasks: a vision-dependent reaction time task and a vision-independent verbal fluency test. Performance on the reaction time task significantly decreased (p < 0.001) in the simulated age-related macular degeneration condition, by as much as 25 percentile ranks. In contrast, performance on the verbal fluency test were not statistically different between the simulated and normal vision conditions (p = 0.78). The findings highlight the importance of considering visual functioning when assessing cognitive function. When vision is not accounted for, low test scores may inaccurately indicate poor cognition. Such false attributions may have significant ramification for diagnosis and research on cognitive functioning.
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Affiliation(s)
- Anne Macnamara
- Cognitive Ageing and Impairment Neurosciences Laboratory, Justice and Society, University of South Australia, Adelaide, SA, Australia.
| | - Victor R Schinazi
- Department of Psychology, Faculty of Society and Design, Bond University, Gold Coast, QLD, Australia
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Celia Chen
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, Adelaide, SA, Australia
| | - Scott Coussens
- Cognitive Ageing and Impairment Neurosciences Laboratory, Justice and Society, University of South Australia, Adelaide, SA, Australia
| | - Tobias Loetscher
- Cognitive Ageing and Impairment Neurosciences Laboratory, Justice and Society, University of South Australia, Adelaide, SA, Australia
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Morjaria P, Bergson S, Bastawrous A, Watts E, Pant S, Gudwin E, Zinn M, Chan VF. Delivering Refractive Care to Populations With Near and Distance Vision Impairment: 2 Novel Social Enterprise Models. Asia Pac J Ophthalmol (Phila) 2022; 11:59-65. [PMID: 35114685 DOI: 10.1097/apo.0000000000000470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Vision impairment due to refractive error affects crucial time periods across the life course-the educational years for children and working years for adults. Refractive error is easily and safely corrected with glasses, but many potential beneficiaries remain uncorrected due to various barriers, which can be addressed with innovative service delivery models. This review describes evidence-based initiatives from 2 social enterprises, Peek Vision and VisionSpring, addressing barriers to refractive error correction in children and working adults, particularly in low-resource settings. The reach, implementation challenges, adoption, and future development of these 2 novel models are described, and research evidence of program effectiveness is presented.
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Affiliation(s)
- Priya Morjaria
- Peek Vision, UK
- International Centre for Eye Health, Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Andrew Bastawrous
- Peek Vision, UK
- International Centre for Eye Health, Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Elanor Watts
- Peek Vision, UK
- Tennent Institute of Ophthalmology, Glasgow, UK
| | | | | | | | - Ving Fai Chan
- Centre for Public Health, Queen's University Belfast, Northern Ireland, UK
- College of Health Sciences, University KwaZulu Natal, Durban, South Africa
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17
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Macnamara A, Schinazi VR, Chen C, Coussens S, Loetscher T. Vision impairments reduce cognitive test performance. NATURE AGING 2021; 1:975-976. [PMID: 37118337 DOI: 10.1038/s43587-021-00135-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- Anne Macnamara
- Cognitive Ageing & Impairment Neurosciences Laboratory, UniSA Justice & Society, University of South Australia, Adelaide, South Australia, Australia
| | - Victor R Schinazi
- Department of Psychology, Faculty of Society & Design, Bond University, Gold Coast, Queensland, Australia
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Celia Chen
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Scott Coussens
- Cognitive Ageing & Impairment Neurosciences Laboratory, UniSA Justice & Society, University of South Australia, Adelaide, South Australia, Australia
| | - Tobias Loetscher
- Cognitive Ageing & Impairment Neurosciences Laboratory, UniSA Justice & Society, University of South Australia, Adelaide, South Australia, Australia.
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18
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Sii S, Chean CS, Kuht HJ, Thomas MG, Rufai SR. Home-based screening tools for amblyopia: a systematic review protocol. BMJ Open 2021; 11:e051830. [PMID: 34452969 PMCID: PMC8404433 DOI: 10.1136/bmjopen-2021-051830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Amblyopia is an important public health concern associated with functional vision loss and detrimental impact on the physical and mental well-being of children. The gold standard for diagnosis of amblyogenic conditions currently involves screening by orthoptists and/or ophthalmologists. The bloom of technology enables the use of home-based screening tools to detect these conditions at an early stage by the layperson in community, which could reduce the burden of screening in the community, especially during restrictions associated with the COVID-19 pandemic. Here, we propose a systematic review aiming to evaluate the accuracy and reliability of home-based screening tools compared with the existing gold standard. METHODS AND ANALYSIS We aim to search for studies involving home-based screening tools for amblyopia among children aged under 18 years. Oxford Centre for Evidence-Based Medicine Level 4 evidence and above will be included, without language or time restrictions. The following platforms will be searched from inception to 31 August 2021: PubMed, Medline, The Cochrane Library, Embase, Web of Science Core Collection and Clinicaltrials.gov. Two independent reviewers will identify studies for inclusion based on a screening questionnaire. The search and screening will start on 14 August 2021 until 1 October 2021. We aim to complete our data analysis by 30 November 2021. Risk of bias will be assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool for diagnostic accuracy studies only. Our primary outcome measure is the diagnostic accuracy of home-based screening tools, while secondary outcome measures include validity, feasibility, reproducibility and cost-effectiveness, where available. ETHICS AND DISSEMINATION Ethical approval is not necessary as no primary data will be collected. The findings will be disseminated through presentations at scientific meetings and peer-reviewed journal publication. PROSPERO REGISTRATION NUMBER CRD42021233511.
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Affiliation(s)
- Samantha Sii
- Department of Ophthalmology, Kettering General Hospital NHS Trust, Kettering, UK
| | - Chung Shen Chean
- Department of Ophthalmology, Northampton General Hospital, Northampton, UK
| | - Helen J Kuht
- University of Leicester Ulverscroft Eye Unit, Leicester Royal Infirmary, Leicester, UK
| | - Mervyn G Thomas
- University of Leicester Ulverscroft Eye Unit, Leicester Royal Infirmary, Leicester, UK
| | - Sohaib R Rufai
- University of Leicester Ulverscroft Eye Unit, Leicester Royal Infirmary, Leicester, UK
- Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children, London, UK
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Wong SH, Tsai JC. Telehealth and Screening Strategies in the Diagnosis and Management of Glaucoma. J Clin Med 2021; 10:3452. [PMID: 34441748 PMCID: PMC8396962 DOI: 10.3390/jcm10163452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/31/2021] [Accepted: 08/02/2021] [Indexed: 11/16/2022] Open
Abstract
Telehealth has become a viable option for glaucoma screening and glaucoma monitoring due to advances in technology. The ability to measure intraocular pressure without an anesthetic and to take optic nerve photographs without pharmacologic pupillary dilation using portable equipment have allowed glaucoma screening programs to generate enough data for assessment. At home, patients can perform visual acuity testing, web-based visual field testing, rebound tonometry, and video visits with the physician to monitor for glaucomatous progression. Artificial intelligence will enhance the accuracy of data interpretation and inspire confidence in popularizing telehealth for glaucoma.
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Affiliation(s)
- Sze H. Wong
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA;
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20
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Abstract
Technological advances provide a number of options for glaucoma monitoring outside the office setting, including home-based tonometry and perimetry. This has the potential to revolutionize management of this chronic disease, improve access to care, and enhance patient engagement. Here, we provide an overview of existing technologies for home-based glaucoma monitoring. We also discuss areas for future research and the potential applications of these technologies to telemedicine, which has been brought to the forefront during the ongoing COVID-19 pandemic.
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Affiliation(s)
- Inas F Aboobakar
- Department of Ophthalmology , Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - David S Friedman
- Department of Ophthalmology , Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
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