Diagnostic Validity of Clinical Signs Associated with a Large Exophoria at Near
Purpose. To analyze the diagnostic validity of accommodative and binocular tests in a sample of patients with a large near exophoria with moderate to severe symptoms. Methods. Two groups of patients between 19 and 35 years were recruited from a university clinic: 33 subjects with large exophoria at...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Journal of Ophthalmology |
| Online Access: | http://dx.doi.org/10.1155/2013/549435 |
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| author | Pilar Cacho-Martínez Ángel García-Muñoz María Teresa Ruiz-Cantero |
| author_facet | Pilar Cacho-Martínez Ángel García-Muñoz María Teresa Ruiz-Cantero |
| author_sort | Pilar Cacho-Martínez |
| collection | DOAJ |
| description | Purpose. To analyze the diagnostic validity of accommodative and binocular tests in a sample of patients with a large near exophoria with moderate to severe symptoms. Methods. Two groups of patients between 19 and 35 years were recruited from a university clinic: 33 subjects with large exophoria at near vision and moderate or high visual discomfort and 33 patients with normal heterophoria and low visual discomfort. Visual discomfort was defined using the Conlon survey. A refractive exam and an exhaustive evaluation of accommodation and vergence were assessed. Diagnostic validity by means of receiver operator characteristic (ROC) curves, sensitivity (S), specificity (Sp), and positive and negative likelihood ratios (LR+, LR−) were assessed. This analysis was also carried out considering multiple tests as serial testing strategy. Results. ROC analysis showed the best diagnostic accuracy for receded near point of convergence (NPC) recovery (area = 0.929) and binocular accommodative facility (BAF) (area = 0.886). Using the cut-offs obtained with ROC analysis, the best diagnostic validity was obtained for the combination of NPC recovery and BAF (S = 0.77, Sp = 1, LR+ = value tending to infinity, LR− = 0.23) and the combination of NPC break and recovery with BAF (S = 0.73, Sp = 1, LR+ = tending to infinity, LR− = 0.27). Conclusions. NPC and BAF tests were the tests with the best diagnostic accuracy for subjects with large near exophoria and moderate to severe symptoms. |
| format | Article |
| id | doaj-art-9e011f0638744d98b6e6165162f19e53 |
| institution | Kabale University |
| issn | 2090-004X 2090-0058 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj-art-9e011f0638744d98b6e6165162f19e532025-02-03T01:32:14ZengWileyJournal of Ophthalmology2090-004X2090-00582013-01-01201310.1155/2013/549435549435Diagnostic Validity of Clinical Signs Associated with a Large Exophoria at NearPilar Cacho-Martínez0Ángel García-Muñoz1María Teresa Ruiz-Cantero2Departamento de Óptica, Farmacología y Anatomía, Apartado 99, Universidad de Alicante, 03080 Alicante, SpainDepartamento de Óptica, Farmacología y Anatomía, Apartado 99, Universidad de Alicante, 03080 Alicante, SpainCIBERESP, Área de Medicina Preventiva y Salud Pública, Apartado 99, Universidad de Alicante, 03080 Alicante, SpainPurpose. To analyze the diagnostic validity of accommodative and binocular tests in a sample of patients with a large near exophoria with moderate to severe symptoms. Methods. Two groups of patients between 19 and 35 years were recruited from a university clinic: 33 subjects with large exophoria at near vision and moderate or high visual discomfort and 33 patients with normal heterophoria and low visual discomfort. Visual discomfort was defined using the Conlon survey. A refractive exam and an exhaustive evaluation of accommodation and vergence were assessed. Diagnostic validity by means of receiver operator characteristic (ROC) curves, sensitivity (S), specificity (Sp), and positive and negative likelihood ratios (LR+, LR−) were assessed. This analysis was also carried out considering multiple tests as serial testing strategy. Results. ROC analysis showed the best diagnostic accuracy for receded near point of convergence (NPC) recovery (area = 0.929) and binocular accommodative facility (BAF) (area = 0.886). Using the cut-offs obtained with ROC analysis, the best diagnostic validity was obtained for the combination of NPC recovery and BAF (S = 0.77, Sp = 1, LR+ = value tending to infinity, LR− = 0.23) and the combination of NPC break and recovery with BAF (S = 0.73, Sp = 1, LR+ = tending to infinity, LR− = 0.27). Conclusions. NPC and BAF tests were the tests with the best diagnostic accuracy for subjects with large near exophoria and moderate to severe symptoms.http://dx.doi.org/10.1155/2013/549435 |
| spellingShingle | Pilar Cacho-Martínez Ángel García-Muñoz María Teresa Ruiz-Cantero Diagnostic Validity of Clinical Signs Associated with a Large Exophoria at Near Journal of Ophthalmology |
| title | Diagnostic Validity of Clinical Signs Associated with a Large Exophoria at Near |
| title_full | Diagnostic Validity of Clinical Signs Associated with a Large Exophoria at Near |
| title_fullStr | Diagnostic Validity of Clinical Signs Associated with a Large Exophoria at Near |
| title_full_unstemmed | Diagnostic Validity of Clinical Signs Associated with a Large Exophoria at Near |
| title_short | Diagnostic Validity of Clinical Signs Associated with a Large Exophoria at Near |
| title_sort | diagnostic validity of clinical signs associated with a large exophoria at near |
| url | http://dx.doi.org/10.1155/2013/549435 |
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