New pediatric vision screener, part II: electronics, software, signal processing and validation.
New pediatric vision screener, part II: electronics, software, signal processing and validation.
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DOI：
10.1186/s12938-016-0128-7
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发表时间：
2016-02-04
影响因子：
3.9
通讯作者：
Guyton DL
中科院分区：
文献类型：
--
作者：
Gramatikov BI;Irsch K;Wu YK;Guyton DL
我们开发了一种改进的儿科视力筛查仪（PVS），可以可靠地检测中心注视，眼睛对准和焦点。该仪器识别弱视的风险因素，即眼睛错位和散焦。该设备利用人类中央凹（视网膜最敏感的部分）的双折射。以前已经更详细地报道了光学器件。本文重点介绍了电子和分析算法使用。本研究的目的是优化模拟设计，数据采集，噪声抑制技术，分类算法和决策阈值，以及验证研究仪器的性能对初始组的年轻测试受试者-18例已知视力异常的患者（8名男性和10名女性），年龄4-25岁（只有一名超过18岁）和19名对照，证明缺乏视力问题。使用四种统计方法推导出最佳区分异常患者与对照组的决策阈值。计算每种方法的灵敏度和特异性，并选择最合适的方法。中心固定和焦点检测标准都稳健地工作，并且允许正常测试受试者和有症状受试者之间的可靠分离。该仪器对中心注视和焦点检测的灵敏度均为100%。中心注视的特异性为100%，病灶检测的特异性为89.5%.总的敏感性为100%，总的特异性为94.7%。尽管初始样本量相对较小，但我们相信PVS仪器设计、所采用的分析方法以及整个设备将被证明对儿童的大规模筛查有价值。
We have developed an improved pediatric vision screener (PVS) that can reliably detect central fixation, eye alignment and focus. The instrument identifies risk factors for amblyopia, namely eye misalignment and defocus. The device uses the birefringence of the human fovea (the most sensitive part of the retina). The optics have been reported in more detail previously. The present article focuses on the electronics and the analysis algorithms used. The objective of this study was to optimize the analog design, data acquisition, noise suppression techniques, the classification algorithms and the decision making thresholds, as well as to validate the performance of the research instrument on an initial group of young test subjects—18 patients with known vision abnormalities (eight male and 10 female), ages 4–25 (only one above 18) and 19 controls with proven lack of vision issues. Four statistical methods were used to derive decision making thresholds that would best separate patients with abnormalities from controls. Sensitivity and specificity were calculated for each method, and the most suitable one was selected. Both the central fixation and the focus detection criteria worked robustly and allowed reliable separation between normal test subjects and symptomatic subjects. The sensitivity of the instrument was 100 % for both central fixation and focus detection. The specificity was 100 % for central fixation and 89.5 % for focus detection. The overall sensitivity was 100 % and the overall specificity was 94.7 %. Despite the relatively small initial sample size, we believe that the PVS instrument design, the analysis methods employed, and the device as a whole, will prove valuable for mass screening of children.