Name: using an automated hirschberg test app to evaluate ocular alignment
Uploaded: 2020-03-24T15:00:00
Description: Watch this Scientific Journal Video about Using an Automated Hirschberg Test App to Evaluate Ocular Alignment at JoVE.com

这项工作得到了NIH授予R44EY025902和大众眼耳固化儿童补助金部分支持。

这项研究是根据《赫尔辛基宣言》的原则，在舍彭斯眼科研究所（马萨诸塞州波士顿）和斯波尔丁康复医院（马萨诸塞州波士顿）进行的。获得所有参与者的知情同意。这项研究得到了当地质量眼耳机构审查委员会（马萨诸塞州波士顿）的批准。
注：患者纳入标准是水平斜体（恒定或间歇性外向或致向）的先前诊断，没有其他视力障碍。这项研究是先前12日...

<ol>
	<li>Kemper, A. R., Clark, S. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Preschool+vision+screening+in+pediatric+practices.">Preschool vision screening in pediatric practices.</a> Clinical Pediatrics. 45 (3), 263-266 (2006).</li><li>Rowe, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+profile+of+strabismus+in+stroke+survivors.">The profile of strabismus in stroke survivors.</a> Eye. 24 (4), 682-685 (2010).</li><li>Black, K., McCarus, C., Collins, M. L. Z., Jensen, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ocular+Manifestations+of+Autism+in+Ophthalmology.">Ocular Manifestations of Autism in Ophthalmology.</a> Strabismus. 21 (2), 98-102 (2013).</li><li>Taylor, K., Elliott, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interventions+for+strabismic+amblyopia.">Interventions for strabismic amblyopia.</a> Cochrane Database of Systematic Reviews. 10 (8), (2011).</li><li>Cotter, S. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fixation+preference+and+visual+acuity+testing+in+a+population-based+cohort+of+preschool+children+with+amblyopia+risk+factors.">Fixation preference and visual acuity testing in a population-based cohort of preschool children with amblyopia risk factors.</a> Ophthalmology. 116 (1), 145-153 (2009).</li><li>Robaei, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Factors+Associated+with+Childhood+Strabismus:+Findings+from+a+Population-Based+Study.">Factors Associated with Childhood Strabismus: Findings from a Population-Based Study.</a> Ophthalmology. 113 (7), 1146-1153 (2006).</li><li>Tarczy-Hornoch, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Risk+factors+for+decreased+visual+acuity+in+preschool+children:+the+multi-ethnic+pediatric+eye+disease+and+Baltimore+pediatric+eye+disease+studies.">Risk factors for decreased visual acuity in preschool children: the multi-ethnic pediatric eye disease and Baltimore pediatric eye disease studies.</a> Ophthalmology. 118 (11), 2262-2273 (2011).</li><li>Chan, K. W., Deng, L., Weissberg, E. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Detection+of+Strabismus+by+Non-Health+Care+Professionals+in+an+Ethnically+Diverse+Set+of+Images.">Detection of Strabismus by Non-Health Care Professionals in an Ethnically Diverse Set of Images.</a> JAMA Ophthalmology. 134 (1), 30-36 (2016).</li><li>Hunter, D. G., Guyton, D. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Vertical+location+of+the+corneal+light+reflex+in+strabismus+photography.">Vertical location of the corneal light reflex in strabismus photography.</a> Archives of Ophthalmology. 116 (6), 767-771 (1998).</li><li>Eskridge, J. B., Wick, B., Perrigin, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Hirschberg+test:+a+double-masked+clinical+evaluation.">The Hirschberg test: a double-masked clinical evaluation.</a> American Journal of Optometry and Physiological Optics. 65 (9), 745-750 (1988).</li><li>Hasebe, S., Ohtsuki, H., Tadokoro, Y., Okano, M., Furuse, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+reliability+of+a+video-enhanced+Hirschberg+test+under+clinical+conditions.">The reliability of a video-enhanced Hirschberg test under clinical conditions.</a> Investigative Ophthalmology &amp; Visual Science. 36 (13), 2678-2685 (1995).</li><li>Pundlik, S., Tomasi, M., Liu, R., Houston, K., Luo, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+and+Preliminary+Evaluation+of+a+Smartphone+App+for+Measuring+Eye+Alignment.">Development and Preliminary Evaluation of a Smartphone App for Measuring Eye Alignment.</a> Translational Vision Science &amp; Technology. 8 (1), 19 (2019).</li><li>Cheng, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+EyeTurn+App+for+School+Vision+Screening.">The EyeTurn App for School Vision Screening.</a> American Academy of Optometry Annual Meeting. , (2018).</li><li>Committee on Practice and Ambulatory Medicine and Section on Ophthalmology. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Use+of+Photoscreening+for+Children's+Vision+Screening.">Use of Photoscreening for Children's Vision Screening.</a> Pediatrics. 109 (3), 524-525 (2002).</li><li>Simons, B. D., Siatkowski, R. M., Schiffman, J. C., Berry, B. E., Flynn, J. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pediatric+photoscreening+for+strabismus+and+refractive+errors+in+a+high-risk+population.">Pediatric photoscreening for strabismus and refractive errors in a high-risk population.</a> Ophthalmology. 106 (6), 1073-1080 (1999).</li><li>Kerr, N. C., Somes, G., Enzenauer, R. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effect+of+developmentally-at-risk+status+on+the+reliability+of+the+iScreen(R)+photorefractive+device+in+young+children.">The effect of developmentally-at-risk status on the reliability of the iScreen(R) photorefractive device in young children.</a> The American Journal of Orthopedics. 61, 117-123 (2011).</li><li>Arnold, R. W., O'Neil, J. W., Cooper, K. L., Silbert, D. I., Donahue, S. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+a+smartphone+photoscreening+app+to+detect+refractive+amblyopia+risk+factors+in+children+aged+1-6+years.">Evaluation of a smartphone photoscreening app to detect refractive amblyopia risk factors in children aged 1-6 years.</a> Clinical Ophthalmology. 12, 1533-1537 (2018).</li></ol>

没有专业培训的人可以使用 EyeTurn 应用程序来捕捉眼睛的图片并获得眼部对准测量，现场或远程的眼部护理专家可能会对此进行解释。该应用程序仅提供失调的大小，而不是任何解释或诊断。眼科专家（如视光师或眼科医生）应确定失调是否显著，并考虑其他因素（包括测量条件）后做出诊断。
拍摄高质量的照片对于测量至关重要。相机应放置在两只眼睛之间的位置。离中?...

在视力护理诊所经常进行眼部对准测量。棱镜中和覆盖测试是量化眼睛失调程度（斜视）的常用临床方法。这种方法需要高度的训练和经验。当患者不能完全参与检查时，如幼儿1、脑损伤或中风2或发育障碍3，准确的测量就更具挑战性。此外，在学校筛查中需要进行眼对对齐测试，因为在儿童时期，美国4人口中约有5-8%的人患有斜视，是弱视的一个巨大危险因素，大约30-40%的弱视病例归因于斜视5、6、7。6,75然而，学校护士通常没有受过培训，以进行标准覆盖测试与棱镜中和这种筛选。对于非眼部护理专业人员来说，斜视筛查的另一个挑战是间歇性斜视（不均匀并不总是表现出）和较小的错位幅度在视觉上并不明显（<15 棱镜屈光剂 []）8。
为了解决斜视在检测和测量方面的挑战，我们开发了一款智能手机应用程序（EyeTurn），通过比较眼睛之间角膜反射的位移来实现和自动化摄影Hirschberg方法9。虽然传统的摄影Hirschberg方法已被证明在诊所10，11,11具有良好的可重复性，但专用的独立设备的成本是广泛采用的障碍。通过提供一个易于使用的工具来测量眼睛与标准智能手机的对齐，我们假设它将被广泛采用在学校视力筛查和非眼科护理专业人员使用。我们以前的评估研究表明，应用测量与目前棱镜的临床标准和备用覆盖测试12一致，对于高达60Μ的分裂性致向和外向性。在一项试点的学校筛查研究中，我们还显示，该应用程序可以帮助学校护士检测间歇性外生炎的儿童，他们错过了标准学校视力筛查协议13。
出于研究目的，研究人员和临床医生目前可应要求提供该应用程序的 iOS 版本。到目前为止，请求者包括学校护士、儿科眼科医生、视光师、神经眼科医生和斜视专家。本文的目的是共享详细的应用协议，用于使用应用程序评估不同查看条件下的眼部对齐，即近距和远固定距离;带和没有眼罩打破双目融合。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>EyeTurn</td>
			<td>EyeNexo</td>
			<td></td>
			<td>Smartphone app for measureing eye misalignment</td>
		</tr>
	</tbody>
</table>

using an automated hirschberg test app to evaluate ocular alignment

已开发一个智能手机应用程序，用于执行自动摄影 Hirschberg 测试，以客观测量眼部失调。通过计算手机摄像头闪光灯相对于光圈中心产生的角膜反射相对于高分辨率图像的差异，该应用程序可以测量失调，其精度远高于执行 Hirschberg 测试的肉眼。与临床金标准棱镜和替代盖试验相比，在以前的临床评价研究中得到了验证。本文的目的是描述有关如何使用应用程序测量不同固定距离的眼部对齐，没有或用封面来打破融合，以及角度 kappa 的测试技术，以便用户可以使用该应用程序执行等效测试通常在诊所使用棱镜进行。

在本作品中，我们描述了使用执行摄影 Hirschberg 测试的智能手机应用程序评估眼部对准的协议。应用程序的界面如图1所示。用户可以选择执行盖测试或测量患者，两只眼睛同时固定在目标，无论是接近或远的固定距离。根据测试目的确定查看条件后，用户可以按照协议并拍摄患者的照片。图像处理后，应用程序将向用户显示分析结果。如图<strong clas...

Watch this Scientific Journal Video about Using an Automated Hirschberg Test App to Evaluate Ocular Alignment at JoVE.com

Using an Automated Hirschberg Test App to Evaluate Ocular Alignment

我们提出了使用智能手机应用程序执行 Hirschberg 测试的协议，用于在近和远固定条件下测量骨骼和间歇性眼部错位（斜体）。

使用自动赫希伯格测试应用程序评估眼部对齐

A smartphone app has been developed to perform the automated photographic Hirschberg test for objective measurement of ocular misalignment. By computing ...

我们开发的移动应用程序可用于测量用于研究或临床用途的斜视。这种方法，便于轻松的斜视测量，目前需要大量的培训和经验，仅使用标准手机摄像头和应用程序软件执行。在应用界面中，用户可以选择执行覆盖测试，或同时测量双眼固定在目标上的患者，距离接近或远。要测量视点，使用单个快照，并近乎固定，请启动应用程序，将模式设置为"无遮盖"。选择"靠近"，将手机定位在距离患者约 40 厘米的横向方向，后置摄像头面向患者。指示患者将手电筒固定在手电筒上，此时手电筒应关闭。对于需要精确住宿的测试，请将固定目标粘贴在手机的背面，直接在手电筒的正下方或上方。当患者确认他们正在修复时，按圆形按钮拍摄要由应用分析的快照。分析完成后，应用程序将显示检测到的肢体边界、眼睛的中心和角膜反射的位置。在验证这些特征是否检测到无明显错误后，观察与眼睛对齐相关的测量结果。然后，按"保存"按钮将当前测试保存在手机中，或按后退箭头按钮重新测试。要测量应用中远固定时间歇性眼部不对齐，请将模式设置为"覆盖测试"并选择"远"。将手机保持横向，距离患者眼睛水平约 40 厘米，闪光灯位于患者眼睛之间。指示患者在电话上方查看大约六米外的目标。让患者遮住一只眼睛，按下圆形按钮，应用程序将开始检测。在确保患者正确固定的同时，请让他们快速消除遮挡。一旦消除遮挡，应用程序将自动拍照。分析完成后，应用程序将显示检测到的肢体边界、眼睛的中心和角膜反射的位置。在验证未发现这些特征时没有明显的错误后，在保存数据或重复测试之前，请查看棱镜二点中眼睛对齐的测量结果。对于应用中的"角卡帕"测量，请选择测量卡帕角度。将手机定位在距离患者约 40 厘米的景观方向，并指示患者使用眼睛进行测试，以固定手电筒，同时覆盖另一只眼睛。在确保患者正确固定时，点按圆形按钮拍摄快照，该快照将由应用进行分析。分析完成后，应用程序将显示检测到的肢体边界、眼睛的中心和角膜反射的位置。在验证未检测到这些特征时没有明显的错误后，请查看 Kappa 角度的测量结果（度）。在此代表性分析中，正确检测了两只眼睛的肢体边界和手电筒的角膜反射，表明眼对准测量不受图像分析误差影响。在这个特殊的情况下，患者已经离开了外向性，这从左眼较大的角膜反射偏移中可以明显看出。应用程序没有报告哪个眼睛偏离了，但是，因为在一个小的斜视角度和未知的Kappa角度的情况下，这将是不可靠的应用程序来确定偏离的眼睛。为了进行比较，这里显示了一个没有斜视的示例。在此分析中，可以观察到错误的肢体检测。虽然角膜反射的检测正确，但绿色圆圈显然与边缘边界不匹配，表示应重复测试。在这项对14个受试者的分析中，10个受试者表现出外向性，4个受试者表现出外向性。线性回归分析，显示眼部斜角的测量，与临床覆盖测试测量一致。使用该应用程序时，需要记住两件重要的事情。一、正确设置每个特定测试的盖板测试和固定模式。二、检查眼部功能检测是否正确。该应用程序只允许斜视测量，它不给诊断。临床医生需要将眼部测量与其他视力测量相结合，以做出诊断。

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