AIM： To validate the Peek Acuity mobile phone application in pediatric populations and compare its utility, both economic and diagnostic, against conventional screening methods using a pediatric ophthalmologist exami...AIM： To validate the Peek Acuity mobile phone application in pediatric populations and compare its utility, both economic and diagnostic, against conventional screening methods using a pediatric ophthalmologist examination as the gold standard.METHODS： A cohort of 393 subjects from Fernando de la Mora, Paraguay（ages 6-16 y） were enrolled in the study. Subjects were randomly assigned a starting screening modality among： Peek Acuity, a single line of tumbling E optotypes set at 20/40, and Spot Vision Screener. Once completing the first screening modality, the subjects completed the two remaining techniques. Referral criteria were established based on the most current American Association of Pediatric Ophthalmology and Strabismus（AAPOS） recommendations： 20/40 for Peek Acuity and the tumbling E, and refractive error detection for the Spot Vision Screener. Subjects that failed to achieve the cutoff for any of the three screening techniques or subjects that passed the screening but were randomly selected to perform a comprehensive eye exam to determine the false negative rate, were evaluated by a pediatric ophthalmologist. This evaluation was considered the gold standard, and included vision assessment by a Snellen chart, strabismus evaluation, and cycloplegic refraction with dilated fundoscopy.RESULTS： We obtained 48% sensitivity, 83% specificity, 43% positive predictive value, and 86% negative predictive value for Peek Acuity＇s ability to refer compared to evaluation by a pediatric ophthalmologist, failing to achieve a desired sensitivity for implementation. Peek Acuity trended to overestimate the subject＇s visual acuity, providing a higher visual acuity that would not indicate referral for a comprehensive eye examination. However, its high specificity accurately predicted a significant number of children who did not need further evaluation. When comparing the three screening methods, no single screening modality outperformed the others. Peek Acuity represented a technology that was economically展开更多
文摘近年来人工智能(artificial intelligence,AI)技术发展迅猛,在医学领域的实践与应用为医疗行业的发展带来新可能。在普通眼科领域,基于机器学习(machine learning,ML)的人工智能技术极大提高了诊断效率,但在小儿眼科方面取得的进展较少。目前人工智能技术已运用于自动检测早产儿视网膜病变(retinopathy of prematurity,ROP)、儿童白内障,检测斜视和屈光不正,预测未来高度近视,通过眼动追踪诊断阅读障碍以及对眼科图像的研究等方面。本文对人工智能在小儿眼科的应用现状、进展与未来发展做一综述。
基金Supported by the Dan and Ellie Albert Student Vision Research AwardDoolittle Professorship Fund+2 种基金Research to Prevent Blindness, Inc.Combat Blindness InternationalFundación Visión
文摘AIM： To validate the Peek Acuity mobile phone application in pediatric populations and compare its utility, both economic and diagnostic, against conventional screening methods using a pediatric ophthalmologist examination as the gold standard.METHODS： A cohort of 393 subjects from Fernando de la Mora, Paraguay（ages 6-16 y） were enrolled in the study. Subjects were randomly assigned a starting screening modality among： Peek Acuity, a single line of tumbling E optotypes set at 20/40, and Spot Vision Screener. Once completing the first screening modality, the subjects completed the two remaining techniques. Referral criteria were established based on the most current American Association of Pediatric Ophthalmology and Strabismus（AAPOS） recommendations： 20/40 for Peek Acuity and the tumbling E, and refractive error detection for the Spot Vision Screener. Subjects that failed to achieve the cutoff for any of the three screening techniques or subjects that passed the screening but were randomly selected to perform a comprehensive eye exam to determine the false negative rate, were evaluated by a pediatric ophthalmologist. This evaluation was considered the gold standard, and included vision assessment by a Snellen chart, strabismus evaluation, and cycloplegic refraction with dilated fundoscopy.RESULTS： We obtained 48% sensitivity, 83% specificity, 43% positive predictive value, and 86% negative predictive value for Peek Acuity＇s ability to refer compared to evaluation by a pediatric ophthalmologist, failing to achieve a desired sensitivity for implementation. Peek Acuity trended to overestimate the subject＇s visual acuity, providing a higher visual acuity that would not indicate referral for a comprehensive eye examination. However, its high specificity accurately predicted a significant number of children who did not need further evaluation. When comparing the three screening methods, no single screening modality outperformed the others. Peek Acuity represented a technology that was economically
