Sensitivity and Specificity of Red Reflex Test in Newborn Eye Screening
Sensitivity and Specificity of Red Reflex Test in Newborn Eye Screening
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DOI：
10.1016/j.jpeds.2016.08.048
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发表时间：
2016-12-01
影响因子：
5.1
通讯作者：
Zhao, Bojun
中科院分区：
文献类型：
--
作者：
Sun, Ming;Ma, Aihua;Zhao, Bojun
目的 验证孤立红反射试验检测新生儿眼前段和后段眼部异常的敏感性。 研究设计 对 7641 名新生儿进行了红反射试验和综合眼部检查，包括外部检查、瞳孔检查、手持式裂隙灯检查和 RetCam 眼底成像（Clarity Medical Systems，普莱森顿，加利福尼亚州）。所有结果均记录为阴性或阳性。以综合眼部检查作为参考标准计算红反射试验的敏感性和特异性。将前段异常与后段异常分开，计算各组红反射试验的敏感性。结果 前段组红反射试验正确分类的异常比例（敏感性= 99.6％，95％CI 97.1％-100％）高于后段组（敏感性= 4.1％，95％CI） 3.3%-5.1%，chi(2) = 1521.382，phi = 0.836，P < .001)。 结论 红色反射测试是检测前牙异常的有用通用筛查工具；然而，该测试在检测后部异常方面存在局限性。可能需要进一步将这些结果推广到婴儿和儿童以及具有不同专业水平的观察者。
Objectives To validate the sensitivity of an isolated red reflex test in detection of ocular abnormalities of the anterior and posterior segments in newborns.Study design Red reflex test and comprehensive eye examinations including external inspection, pupil examination, hand-held slit lamp examination, and RetCam fundus imaging (Clarity Medical Systems, Pleasanton, California) were performed in 7641 newborns. All results were documented as negative or positive. Sensitivity and specificity of red reflex test were calculated by the use of comprehensive eye examinations as the reference standard. Anterior abnormalities were separated from posterior abnormalities, and the sensitivity of red reflex test for each group was calculated.Results The proportion of abnormalities that were correctly classified by red reflex test was greater in anterior segment group (sensitivity = 99.6%, 95% CI 97.1%-100%) than in the posterior group (sensitivity = 4.1%, 95% CI 3.3%-5.1%, chi(2) = 1521.382, phi = 0.836, P < .001).Conclusions The red reflex test was a useful universal screening tool in detection of anterior abnormalities; however, the test has limitations in detection of posterior abnormalities. The generalization of these results to infants and children and observers with varying levels of expertise may need to be established further.