Plusoptix photoscreening may replace cycloplegic examination in select pediatric ophthalmology patients
Plusoptix photoscreening may replace cycloplegic examination in select pediatric ophthalmology patients
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DOI：
10.1016/j.jaapos.2012.11.008
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发表时间：
2013-04-01
期刊：
影响因子：
1.6
通讯作者：
Andersen, Kristen
中科院分区：
文献类型：
--
作者：
Silbert, David I.;Matta, Noelle S.;Andersen, Kristen
目的 确定就诊于儿科眼科医生并发现 Plusoptix 光筛查仪（PlusoptiX GmbH，德国纽伦堡）结果正常、视力正常（3 岁以上儿童）和正常排列/活动能力的儿童是否能从散瞳眼底检查中获得额外益处。 方法 2007 年至 2010 年间在一家儿科眼科诊所就诊的所有儿童的医疗记录均被编码为患有过眼底检查。对照片筛查进行了回顾性审查。在已确定的记录总数中，随机选择了一半进行审查。首次就诊时接受 plusoptiX 筛查的患者也被纳入其中。排列异常和/或视力异常的患者以及因医疗或眼科状况而需要散瞳眼底检查而转诊的患者被排除在外。 结果 在确定的 1,377 名患者中，随机选择了 697 名患者进行记录审查。其中，451 人接受了初步 plusoptiX 筛查。共有 222 例结果正常。在分析的 190 名患者中，散瞳检查仅为 4 名儿童提供了额外的诊断信息：1 名患有视力不明显的先天性白内障，1 名患有中度散光导致的屈光性弱视，1 名患有中度远视，后来发现有调节性内斜视，以及 1 名拔罐增加但 TOP 正常。 结论 正常的 plusoptiX 结果，结合正常的排列/运动评估和视力发现对眼科病理（包括显着屈光不正）具有 98% 的阴性预测值。 plusoptiX 和简短的眼部检查可能会避免某些儿童进行散瞳的需要。
PURPOSE To determine whether children presenting to a pediatric ophthalmologist and found to have a normal Plusoptix photoscreener (PlusoptiX GmbH, Nuremberg, Germany) result, normal visual acuity (children age 3 +), and normal alignment/motility receive additional benefit from a dilated fundus examination.METHODS The medical records of all children seen at one pediatric ophthalmology practice between 2007 and 2010 who were coded as having had a photoscreening were retrospectively reviewed. Of the total number of records identified, one-half were selected randomly for review. Patients who underwent plusoptiX screening on the first visit were included. Patients with abnormal alignment and/or abnormal vision as well as those referred for examination as determined by a medical or ophthalmic condition that required a dilated fundus examination were excluded.RESULTS Of 1,377 patients identified, 697 were selected randomly for record review. Of these, 451 had had an initial plusoptiX screening. A total of 222 had a normal result. Of the 190 patients analyzed, cycloplegic examination provided additional diagnostic information for only 4 children: 1 with nonvisually significant congenital cataract, 1 with refractive amblyopia from moderate astigmatism, 1 with moderate hyperopia who later was found to have accommodative esotropia, and 1 with increased cupping but normal TOP.CONCLUSIONS A normal plusoptiX result, combined with normal alignment/motility evaluation and visual acuity was found to have a 98% negative predictive value for ophthalmic pathology, including significant refractive error. The plusoptiX and an abbreviated eye examination may obviate the need for dilation in select children.