研究目的
To evaluate the interobserver reproducibility of objective ocular torsion measurements in infantile esotropia using fundus photography analysis.
研究成果
Objective ocular torsion assessment using fundus photography and the described procedure is reliable and reproducible, with high interobserver agreement (ICC up to 0.98 and Kappa up to 0.91). It can be routinely used by orthoptists and ophthalmologists without prior training for managing infantile esotropia. Future work could involve automated software for quicker analysis.
研究不足
Fundus photography requires cooperation and fixation, which can be challenging for subjects with impaired visual acuity or amblyopia. Head tilt can induce torsion and cause measurement bias. High-quality pictures with sufficient brightness and contrast are needed for accurate fovea location. The study only compared two operators; more operators could be included in future studies.
1：Experimental Design and Method Selection:
A retrospective observational study was conducted to assess interobserver agreement for quantitative and qualitative objective ocular torsion using fundus photography analysis. The study used Adobe Photoshop software for image analysis, with interclass correlation coefficient (ICC) for quantitative measurements and Cohen's Kappa coefficient for qualitative assessments.
2：Sample Selection and Data Sources:
Children aged 4 to 17 years with infantile esotropia (onset <6 months, signs of abnormal retinal correspondence, no nervous system disorders) who underwent unilateral horizontal rectus surgery for significant horizontal deviation (>15 prism dioptres) were included. Fundus photographs were taken before and one year after surgery using a Topcon retinal camera.
3：List of Experimental Equipment and Materials:
Topcon retinal camera (model NW6S), Adobe Photoshop software, chin rest and head support for positioning, cycloplegic refraction for pupil dilation.
4：Experimental Procedures and Operational Workflow:
Fundus photography was performed by an experienced orthoptist with attention to head position. Two observers (orthoptist and ophthalmologist) independently analyzed the photographs using Photoshop to measure the disc-foveal angle for quantitative torsion and assess fovea position for qualitative torsion. The center of the optic disc was determined by drawing a rectangle and its diagonals.
5：Data Analysis Methods:
Statistical analyses were performed using R version 3.2.3 software. ICC was used for quantitative data consistency, and Cohen's Kappa was used for qualitative data reproducibility, with 95% confidence intervals.
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