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Dynamic distance direct ophthalmoscopy, a novel technique to assess accommodation in children

AIM: To describe and compare dynamic distance direct ophthalmoscopy (DDDO) with dynamic retinoscopy (DR) in assessment of accommodation in children. MATERIALS AND METHODS: This prospective observational study had four components. Component 1: to understand the characteristic digital images of DDDO....

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Autores principales: Kothari, Mihir, Balankhe, Suvarna, Paralkar, Shalaka, Nar, Deepali, Bhagat, Shreya, Ranade, Shashank
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3339069/
https://www.ncbi.nlm.nih.gov/pubmed/22446905
http://dx.doi.org/10.4103/0301-4738.94051
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author Kothari, Mihir
Balankhe, Suvarna
Paralkar, Shalaka
Nar, Deepali
Bhagat, Shreya
Ranade, Shashank
author_facet Kothari, Mihir
Balankhe, Suvarna
Paralkar, Shalaka
Nar, Deepali
Bhagat, Shreya
Ranade, Shashank
author_sort Kothari, Mihir
collection PubMed
description AIM: To describe and compare dynamic distance direct ophthalmoscopy (DDDO) with dynamic retinoscopy (DR) in assessment of accommodation in children. MATERIALS AND METHODS: This prospective observational study had four components. Component 1: to understand the characteristic digital images of DDDO. Component 2: to compare DDDO with DR for detection of accommodative defects in children (1–16 years). Component 3: to compare DDDO with DR for the detection of completeness of pharmacologically induced cycloplegia in children (5–16 years) and Component 4: to assess which one of the two techniques was more sensitive to detect onset of cycloplegia after instillation of 1% cyclopentolate eye drops. RESULTS: Component 1: image analysis of DDDO on two subjects (7 years and 35 years) demonstrated superior pupillary crescent that progressively disappeared with increasing accommodation. Concurrently an inferior crescent appeared that became bigger in size with increasing accommodation. Component 2: the prevalence of defects in accommodation was 3.3% (33/1000 children). Three had unilateral accommodation failure. Sensitivity of DDDO was 94%, specificity 100%, positive predictive value 100%, negative predictive value 99%, and clinical agreement (kappa) 0.97. Component 3: in the detection of completeness of pharmacologically induced cycloplegia (n=30), the sensitivity of DDDO was 94%, specificity 96%, positive predictive value 97%, negative predictive value 93% and kappa 0.9. DR had two false positives. DDDO had one false negative. Component 4: DDDO detected onset of pharmacologically induced cycloplegia 5 min earlier than DR (n=5). CONCLUSION: DDDO is a novel, simple, clinical and reliable method to assess accommodation in young children. This test can assess the accommodative response of both eyes simultaneously.
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spelling pubmed-33390692012-05-03 Dynamic distance direct ophthalmoscopy, a novel technique to assess accommodation in children Kothari, Mihir Balankhe, Suvarna Paralkar, Shalaka Nar, Deepali Bhagat, Shreya Ranade, Shashank Indian J Ophthalmol Original Article AIM: To describe and compare dynamic distance direct ophthalmoscopy (DDDO) with dynamic retinoscopy (DR) in assessment of accommodation in children. MATERIALS AND METHODS: This prospective observational study had four components. Component 1: to understand the characteristic digital images of DDDO. Component 2: to compare DDDO with DR for detection of accommodative defects in children (1–16 years). Component 3: to compare DDDO with DR for the detection of completeness of pharmacologically induced cycloplegia in children (5–16 years) and Component 4: to assess which one of the two techniques was more sensitive to detect onset of cycloplegia after instillation of 1% cyclopentolate eye drops. RESULTS: Component 1: image analysis of DDDO on two subjects (7 years and 35 years) demonstrated superior pupillary crescent that progressively disappeared with increasing accommodation. Concurrently an inferior crescent appeared that became bigger in size with increasing accommodation. Component 2: the prevalence of defects in accommodation was 3.3% (33/1000 children). Three had unilateral accommodation failure. Sensitivity of DDDO was 94%, specificity 100%, positive predictive value 100%, negative predictive value 99%, and clinical agreement (kappa) 0.97. Component 3: in the detection of completeness of pharmacologically induced cycloplegia (n=30), the sensitivity of DDDO was 94%, specificity 96%, positive predictive value 97%, negative predictive value 93% and kappa 0.9. DR had two false positives. DDDO had one false negative. Component 4: DDDO detected onset of pharmacologically induced cycloplegia 5 min earlier than DR (n=5). CONCLUSION: DDDO is a novel, simple, clinical and reliable method to assess accommodation in young children. This test can assess the accommodative response of both eyes simultaneously. Medknow Publications & Media Pvt Ltd 2012 /pmc/articles/PMC3339069/ /pubmed/22446905 http://dx.doi.org/10.4103/0301-4738.94051 Text en Copyright: © Indian Journal of Ophthalmology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kothari, Mihir
Balankhe, Suvarna
Paralkar, Shalaka
Nar, Deepali
Bhagat, Shreya
Ranade, Shashank
Dynamic distance direct ophthalmoscopy, a novel technique to assess accommodation in children
title Dynamic distance direct ophthalmoscopy, a novel technique to assess accommodation in children
title_full Dynamic distance direct ophthalmoscopy, a novel technique to assess accommodation in children
title_fullStr Dynamic distance direct ophthalmoscopy, a novel technique to assess accommodation in children
title_full_unstemmed Dynamic distance direct ophthalmoscopy, a novel technique to assess accommodation in children
title_short Dynamic distance direct ophthalmoscopy, a novel technique to assess accommodation in children
title_sort dynamic distance direct ophthalmoscopy, a novel technique to assess accommodation in children
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3339069/
https://www.ncbi.nlm.nih.gov/pubmed/22446905
http://dx.doi.org/10.4103/0301-4738.94051
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