Abstract
Purpose :
To explore the accuracy and reproducibility of VR technology for strabismus screening.
Methods :
This is a cross-sectional study. Two hundred and twenty three subjects were included, VR based on infrared, cover-uncover test, prism alternating cover test(PACT) with different gaze positions at 33cm and 6m were examined. Two doctors performed the examination and repeatability test. The accuracy of VR in diagnosing strabismus and measuring the number of degrees of strabismus was assessed using the mean of manual examination by two doctors as the gold standard.
Results :
A total of 110 normal subjects, 89 patients with exotropia, 29 patients with esotropia, and 5 patients with vertical strabismus were included in this study, and each subject was screened for less than 2 min. The sensitivity of VR for screening strabismus was 82.1% and the specificity was 77%, which was moderately consistent with the manual results (Kappa=0.592, p<0.001). The sensitivity for diagnosing exotropia was 76.4% and the specificity was 91.8%, with strong agreement with the manual results (Kappa=0.695, p<0.001). The sensitivity for diagnosing esotropia was 93.1% and the specificity was 93.8%, with strong agreement with the manual results (Kappa=0.758, p<0.001). The sensitivity for diagnosing vertical strabismus was 80% and the specificity was 99.1%, with strong agreement with manual results (Kappa=0.720, p<0.001). Reproducibility of VR with manual results, expressed as intraclass correlation efficient (ICC), was moderately reproducible in external strabismus (ICC=0.508, range, 0.045-0.741) and not statistically significant in any of the other groups.
Conclusions :
This is a new technique for strabismus screening that incorporates virtual reality technology to quickly, accurately, and easily diagnose and stereotype strabismus, and has demonstrated good performance in measuring the angle of deviation in exotropia.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.