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Adequacy of the Fogging Test in the Detection of Clinically Significant Hyperopia in School-Aged Children

PURPOSE: To evaluate the efficacy of the “fogging test,” performed with a +2 diopters (D) lens, in the exclusion of clinically significant hyperopia in school-aged children. METHODS: We studied 54 children between 5 and 11 years of age, with 10/10 best-corrected bilateral visual acuity (VA) without...

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Autores principales: Esteves Leandro, João, Meira, Jorge, Ferreira, Carla Sofia, Santos-Silva, Renato, Freitas-Costa, Paulo, Magalhães, Augusto, Breda, Jorge, Falcão-Reis, Fernando
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6701401/
https://www.ncbi.nlm.nih.gov/pubmed/31467692
http://dx.doi.org/10.1155/2019/3267151
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author Esteves Leandro, João
Meira, Jorge
Ferreira, Carla Sofia
Santos-Silva, Renato
Freitas-Costa, Paulo
Magalhães, Augusto
Breda, Jorge
Falcão-Reis, Fernando
author_facet Esteves Leandro, João
Meira, Jorge
Ferreira, Carla Sofia
Santos-Silva, Renato
Freitas-Costa, Paulo
Magalhães, Augusto
Breda, Jorge
Falcão-Reis, Fernando
author_sort Esteves Leandro, João
collection PubMed
description PURPOSE: To evaluate the efficacy of the “fogging test,” performed with a +2 diopters (D) lens, in the exclusion of clinically significant hyperopia in school-aged children. METHODS: We studied 54 children between 5 and 11 years of age, with 10/10 best-corrected bilateral visual acuity (VA) without significant degree of correction. VA was assessed in each eye with a “bilateral” +2 D sphere over-refraction followed by cycloplegic retinoscopy. The capacity of the test to detect hyperopia of ≥+2 D and ≥+1.5 D was evaluated by examining the respective receiver operating characteristic (ROC) curves and sensitivity and specificity values for different cutoff values of VA. RESULTS: For the detection of hyperopia ≥+2 D, the area under the ROC curve (AUC) was 0.955 (p ≤ 0.001). The VA cutoff with best discriminative capacity was ≥5/10, with a sensitivity of 100%, specificity of 79%, positive predictive value (PPV) of 57%, and negative predictive value (NPV) of 100%. In respect of ≥+1.5 D hyperopia, the test capacity was lower (AUC = 0.832; p ≤ 0.001). The best VA cutoff was also of ≥5/10, with a PPV of 81% and a NPV of 85%. CONCLUSION: The accuracy of the test was high for the evaluation of ≥+2 D hyperopia but lower for ≥+1.5 D hyperopia. For the detection of ≥+2 D hyperopia, the VA cutoff of <5/10 may permit the exclusion of clinically significant hyperopia in selected children, without the need for cycloplegia. For the same cutoff, the PPV was low, meaning that in children with ≥5/10 VA cycloplegic refraction remains obligatory.
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spelling pubmed-67014012019-08-29 Adequacy of the Fogging Test in the Detection of Clinically Significant Hyperopia in School-Aged Children Esteves Leandro, João Meira, Jorge Ferreira, Carla Sofia Santos-Silva, Renato Freitas-Costa, Paulo Magalhães, Augusto Breda, Jorge Falcão-Reis, Fernando J Ophthalmol Research Article PURPOSE: To evaluate the efficacy of the “fogging test,” performed with a +2 diopters (D) lens, in the exclusion of clinically significant hyperopia in school-aged children. METHODS: We studied 54 children between 5 and 11 years of age, with 10/10 best-corrected bilateral visual acuity (VA) without significant degree of correction. VA was assessed in each eye with a “bilateral” +2 D sphere over-refraction followed by cycloplegic retinoscopy. The capacity of the test to detect hyperopia of ≥+2 D and ≥+1.5 D was evaluated by examining the respective receiver operating characteristic (ROC) curves and sensitivity and specificity values for different cutoff values of VA. RESULTS: For the detection of hyperopia ≥+2 D, the area under the ROC curve (AUC) was 0.955 (p ≤ 0.001). The VA cutoff with best discriminative capacity was ≥5/10, with a sensitivity of 100%, specificity of 79%, positive predictive value (PPV) of 57%, and negative predictive value (NPV) of 100%. In respect of ≥+1.5 D hyperopia, the test capacity was lower (AUC = 0.832; p ≤ 0.001). The best VA cutoff was also of ≥5/10, with a PPV of 81% and a NPV of 85%. CONCLUSION: The accuracy of the test was high for the evaluation of ≥+2 D hyperopia but lower for ≥+1.5 D hyperopia. For the detection of ≥+2 D hyperopia, the VA cutoff of <5/10 may permit the exclusion of clinically significant hyperopia in selected children, without the need for cycloplegia. For the same cutoff, the PPV was low, meaning that in children with ≥5/10 VA cycloplegic refraction remains obligatory. Hindawi 2019-08-05 /pmc/articles/PMC6701401/ /pubmed/31467692 http://dx.doi.org/10.1155/2019/3267151 Text en Copyright © 2019 João Esteves Leandro et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Esteves Leandro, João
Meira, Jorge
Ferreira, Carla Sofia
Santos-Silva, Renato
Freitas-Costa, Paulo
Magalhães, Augusto
Breda, Jorge
Falcão-Reis, Fernando
Adequacy of the Fogging Test in the Detection of Clinically Significant Hyperopia in School-Aged Children
title Adequacy of the Fogging Test in the Detection of Clinically Significant Hyperopia in School-Aged Children
title_full Adequacy of the Fogging Test in the Detection of Clinically Significant Hyperopia in School-Aged Children
title_fullStr Adequacy of the Fogging Test in the Detection of Clinically Significant Hyperopia in School-Aged Children
title_full_unstemmed Adequacy of the Fogging Test in the Detection of Clinically Significant Hyperopia in School-Aged Children
title_short Adequacy of the Fogging Test in the Detection of Clinically Significant Hyperopia in School-Aged Children
title_sort adequacy of the fogging test in the detection of clinically significant hyperopia in school-aged children
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6701401/
https://www.ncbi.nlm.nih.gov/pubmed/31467692
http://dx.doi.org/10.1155/2019/3267151
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