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

AI Article Synopsis

  • The study aimed to assess how effective the "fogging test" with a +2 diopters lens is in identifying significant hyperopia (farsightedness) in children aged 5 to 11 years.
  • Results showed the test is very accurate for detecting hyperopia of ≥+2 D, achieving 100% sensitivity, though it was less effective for ≥+1.5 D hyperopia.
  • The findings suggest that a visual acuity cutoff of ≥5/10 can be used to potentially exclude significant hyperopia in some children, but for those with ≥5/10 visual acuity, further testing (cycloplegic refraction) is necessary.

Article Abstract

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 ( ≤ 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; ≤ 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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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6701401PMC
http://dx.doi.org/10.1155/2019/3267151DOI Listing

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