소아 굴절력 측정 및 사시 유무 평가에서의 휴대용 시력검사기의 임상적 효용성
Clinical Efficacy of the Spot Vision Screener for Measuring Refraction and Detecting Strabismus in Children
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목적: 소아 환자들을 대상으로 휴대용 시력검사기를 이용하여 굴절력 및 사시 유무를 평가하여 휴대용 시력검사기의 임상적 효용성을 확인하고자 하였다. 대상과 방법: 만 10세 이하의 소아를 대상으로 조절마비굴절검사 전 Spot Vision Screener를 이용하여 측정한 구면렌즈대응치와 난시 정도, 사시 유무를 후향적으로 분석하였다. Spot Vision Screener로 측정한 구면렌즈대응치 및 난시 정도를 조절마비굴절검사를 통해 측정한 구면렌즈대응치 및 난시 정도와 비교하였다. 교대프리즘가림검사로 확인한 사시 여부와 비교하여 Spot Vision Screener의 사시 평가 정확도를 평가하였다. 결과: 총 19명 38안이 본 연구에 포함되었다. 조절마비제 점안 전 Spot Vision Screener를 이용하여 측정한 값과 조절마비굴절검사를 통해 측정한 값을 비교한 경우 구면렌즈대응치에서는 유의한 차이가 없었다(대응표본 t-검정, -0.25 ± 1.12 diopters [D] vs. 0.04 ± 1.86D; p=0.12). 난시에서는 유의한 차이가 있었지만 그 차이가 평균 -0.25D였다(대응표본 t-검정, -1.41 ± 1.16D vs. -1.16 ± 1.25D; p=0.01). 사시 유무를 평가하는 데에 있어 Spot Vision Screener의 민감도는 42.86%, 특이도는 66.67%였다. 결론: Spot Vision Screener는 소아에서 굴절력을 확인하는 데에 있어 효용성이 있으나 사시 유무를 확인하는 데 있어서는 민감도와 특이도가 낮아 효용성이 낮은 것으로 보인다.
Abstract
Purpose: To investigate the clinical efficacy of the Spot Vision Screener in measuring refractive power and detecting strabismus in pediatric patients. Methods: We retrospectively analyzed the spherical equivalent, cylinder, and strabismus using the Spot Vision Screener before cycloplegic refraction for pediatric patients <10 years of age. We compared the spherical equivalent and cylinder using the Spot Vision Screener with the results of cycloplegic refraction, and we measured the accuracy of the Spot Vision Screener in detecting strabismus compared with the alternate prism cover test. Results: A total of 38 eyes of 19 patients were included in this study. There was no significant difference in spherical equivalent between the Spot Vision Screener before cycloplegic refraction and cycloplegic refraction (paired t-test: -0.25 ± 1.12 diopters [D] vs. 0.04 ± 1.86 D; p = 0.12). There was a significant difference in cylinder between the Spot Vision Screener before cycloplegic refraction and cycloplegic refraction, but the difference was only -0.25 D (paired t-test: -1.41 ± 1.16 D vs. -1.16 ± 1.25 D; p = 0.01). The sensitivity of the Spot Vision Screener was 42.86%, and the specificity was 66.67% for detecting strabismus. Conclusions: The Spot Vision Screener was a useful instrument to measure the refractive power in pediatric patients before cycloplegic refraction, but it had poor sensitivity and specificity for detecting strabismus.
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