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Evelyn A. Paysse - One of the best experts on this subject based on the ideXlab platform.
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the detection of simulated retinoblastoma by using Red Reflex testing
Pediatrics, 2010Co-Authors: David K. Coats, D Fung, E O Smith, Evelyn A. PaysseAbstract:OBJECTIVE: To determine the ability to detect simulated retinoblastoma by using the Red-Reflex test. METHODS: Discs that simulated retinoblastoma lesions were affixed to the retina of model eyes with an 8- or 3-mm pupil. The diameter, height, and location of the discs varied. Five examiners evaluated the Red Reflex with direct ophthalmoscopy by using straight-on and oblique viewing. The generalized estimating equation was used to assess the effects of pupil dilation and observer viewing orientation on tumor detection. RESULTS: Significant 3-way interactions between pupil dilation, observer orientation, and tumor diameter (P < .004) or height (P < .02) were detected; these relationships depended on tumor diameter and height. A similar 3-way interaction was found between pupil dilation, observer orientation, and tumor location in degrees from the fovea (P < .001). Oblique viewing and pupillary dilation improved the tumor-detection rate. With straight-on viewing, the degree of detection was <48% (95% confidence interval [CI]: 39%-57%) for even the largest lesions, compaRed with 96% (95% CI: 93%-98%) for oblique viewing. For peripheral lesions, the percentage detection for straight-on viewing was 35% (95% CI: 21%-50%) for 30 degrees from the fovea and 16% (95% CI: 2%-31%) for 60 degrees from the fovea; these detection rates significantly improved with oblique viewing to 70% or higher (P < .001). CONCLUSIONS: Detection of simulated retinoblastoma was better when lesions were large and when oblique viewing and dilation were used. Peripheral location was negatively associated with detection. Red-Reflex testing to detect leukocoria may be improved with oblique viewing and pharmacologic dilation.
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The detection of simulated retinoblastoma by using Red-Reflex testing.
Pediatrics, 2010Co-Authors: David K. Coats, Fung D, Evelyn A. PaysseAbstract:OBJECTIVE: To determine the ability to detect simulated retinoblastoma by using the Red-Reflex test. METHODS: Discs that simulated retinoblastoma lesions were affixed to the retina of model eyes with an 8- or 3-mm pupil. The diameter, height, and location of the discs varied. Five examiners evaluated the Red Reflex with direct ophthalmoscopy by using straight-on and oblique viewing. The generalized estimating equation was used to assess the effects of pupil dilation and observer viewing orientation on tumor detection. RESULTS: Significant 3-way interactions between pupil dilation, observer orientation, and tumor diameter (P < .004) or height (P < .02) were detected; these relationships depended on tumor diameter and height. A similar 3-way interaction was found between pupil dilation, observer orientation, and tumor location in degrees from the fovea (P < .001). Oblique viewing and pupillary dilation improved the tumor-detection rate. With straight-on viewing, the degree of detection was
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Detection of Red Reflex asymmetry by pediatric residents using the Brückner Reflex versus the MTI photoscreener.
Pediatrics, 2001Co-Authors: Evelyn A. Paysse, David K. Coats, Gayle C. Williams, Eric A. WilliamsAbstract:Objective. To compare the ability of pediatric residents to differentiate an asymmetric from a symmetric Red Reflex in patients with anisometropia and microstrabismus using the Bruckner Reflex and the Medical Technology Innovations (MTI) photoscreener. Methods. A prospective, masked, case-control study was performed. Twelve pediatric residents evaluated 10 study patients and 6 control subjects in a masked manner in 2 separate sessions, using the Bruckner Reflex or the MTI photoscreener, evaluating for asymmetric (abnormal) or symmetric (normal) Red Reflexes between the 2 eyes. Each study patient had asymmetric Red Reflexes and the amblyogenic risk factor of anisometropia or microstrabismus. Each control subject had symmetric Red Reflexes. Results. The pediatric residents had a mean correct score of 82% (69%–100%) using the MTI photoscreener versus a mean correct score of 65% (44%–81%) using the Bruckner Reflex (McNemar test: α Conclusions. Pediatric residents were better at detecting asymmetric Red Reflexes in patients with anisometropia and microstrabismus when evaluating MTI photoscreener photographs than when evaluating the Red Reflexes by the Bruckner Reflex. The MTI photoscreener may be a more sensitive method than the Bruckner Reflex to screen for the common amblyogenic risk factors of anisometropia and microstrabismus by easier detection of Red Reflex asymmetry.
Leonard B Nelson - One of the best experts on this subject based on the ideXlab platform.
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Can the Red Reflex Test Detect Unequal Refractive Error
The Journal of pediatrics, 2019Co-Authors: Kara C. Lamattina, Aldo Vagge, Leonard B NelsonAbstract:Objective To determine the accuracy of the Red Reflex test in the detection of anisometropia. Study design This prospective, single-masked study enrolled new patients younger than the age of 18 years who had not undergone pharmacologic pupillary dilation. A fellow who was masked to all clinical information illuminated both eyes with a direct ophthalmoscope in a darkened room from a distance of 1 m, assessing whether the Red Reflex between the 2 eyes was symmetric or asymmetric. The patient was then dilated, and cylcoplegic refraction was performed by an attending pediatric ophthalmologist. Exclusion criteria included the presence of strabismus, anisocoria, previous intraocular surgery, media opacity, leukocoria, or nystagmus. Sensitivity was compaRed with a null hypothesized value of 50% using a 1-sided binomial test. Results Ninety-two patients with a mean age of 7.3 years (range 3 months to 16 years) were enrolled. With spherical anisometropia greater than or equal to 0.125 diopters, the sensitivity of the Red Reflex test was 90.6% and the specificity was 58.3%. With cylindrical anisometropia greater than or equal to 0.25 diopters, the sensitivity of the Red Reflex test was 81.3% and the specificity was 70%. Anisometropia greater than 1.5 diopters in spherical equivalent (4 patients, range −10.625 to −2.625) or cylinder (3 patients, range 1.75-2.25) was accurately detected by Red Reflex testing in each case. Conclusions The Red Reflex test can be an accurate screening tool to detect anisometropia when performed by an ophthalmologist.
David K. Coats - One of the best experts on this subject based on the ideXlab platform.
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the detection of simulated retinoblastoma by using Red Reflex testing
Pediatrics, 2010Co-Authors: David K. Coats, D Fung, E O Smith, Evelyn A. PaysseAbstract:OBJECTIVE: To determine the ability to detect simulated retinoblastoma by using the Red-Reflex test. METHODS: Discs that simulated retinoblastoma lesions were affixed to the retina of model eyes with an 8- or 3-mm pupil. The diameter, height, and location of the discs varied. Five examiners evaluated the Red Reflex with direct ophthalmoscopy by using straight-on and oblique viewing. The generalized estimating equation was used to assess the effects of pupil dilation and observer viewing orientation on tumor detection. RESULTS: Significant 3-way interactions between pupil dilation, observer orientation, and tumor diameter (P < .004) or height (P < .02) were detected; these relationships depended on tumor diameter and height. A similar 3-way interaction was found between pupil dilation, observer orientation, and tumor location in degrees from the fovea (P < .001). Oblique viewing and pupillary dilation improved the tumor-detection rate. With straight-on viewing, the degree of detection was <48% (95% confidence interval [CI]: 39%-57%) for even the largest lesions, compaRed with 96% (95% CI: 93%-98%) for oblique viewing. For peripheral lesions, the percentage detection for straight-on viewing was 35% (95% CI: 21%-50%) for 30 degrees from the fovea and 16% (95% CI: 2%-31%) for 60 degrees from the fovea; these detection rates significantly improved with oblique viewing to 70% or higher (P < .001). CONCLUSIONS: Detection of simulated retinoblastoma was better when lesions were large and when oblique viewing and dilation were used. Peripheral location was negatively associated with detection. Red-Reflex testing to detect leukocoria may be improved with oblique viewing and pharmacologic dilation.
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The detection of simulated retinoblastoma by using Red-Reflex testing.
Pediatrics, 2010Co-Authors: David K. Coats, Fung D, Evelyn A. PaysseAbstract:OBJECTIVE: To determine the ability to detect simulated retinoblastoma by using the Red-Reflex test. METHODS: Discs that simulated retinoblastoma lesions were affixed to the retina of model eyes with an 8- or 3-mm pupil. The diameter, height, and location of the discs varied. Five examiners evaluated the Red Reflex with direct ophthalmoscopy by using straight-on and oblique viewing. The generalized estimating equation was used to assess the effects of pupil dilation and observer viewing orientation on tumor detection. RESULTS: Significant 3-way interactions between pupil dilation, observer orientation, and tumor diameter (P < .004) or height (P < .02) were detected; these relationships depended on tumor diameter and height. A similar 3-way interaction was found between pupil dilation, observer orientation, and tumor location in degrees from the fovea (P < .001). Oblique viewing and pupillary dilation improved the tumor-detection rate. With straight-on viewing, the degree of detection was
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Detection of Red Reflex asymmetry by pediatric residents using the Brückner Reflex versus the MTI photoscreener.
Pediatrics, 2001Co-Authors: Evelyn A. Paysse, David K. Coats, Gayle C. Williams, Eric A. WilliamsAbstract:Objective. To compare the ability of pediatric residents to differentiate an asymmetric from a symmetric Red Reflex in patients with anisometropia and microstrabismus using the Bruckner Reflex and the Medical Technology Innovations (MTI) photoscreener. Methods. A prospective, masked, case-control study was performed. Twelve pediatric residents evaluated 10 study patients and 6 control subjects in a masked manner in 2 separate sessions, using the Bruckner Reflex or the MTI photoscreener, evaluating for asymmetric (abnormal) or symmetric (normal) Red Reflexes between the 2 eyes. Each study patient had asymmetric Red Reflexes and the amblyogenic risk factor of anisometropia or microstrabismus. Each control subject had symmetric Red Reflexes. Results. The pediatric residents had a mean correct score of 82% (69%–100%) using the MTI photoscreener versus a mean correct score of 65% (44%–81%) using the Bruckner Reflex (McNemar test: α Conclusions. Pediatric residents were better at detecting asymmetric Red Reflexes in patients with anisometropia and microstrabismus when evaluating MTI photoscreener photographs than when evaluating the Red Reflexes by the Bruckner Reflex. The MTI photoscreener may be a more sensitive method than the Bruckner Reflex to screen for the common amblyogenic risk factors of anisometropia and microstrabismus by easier detection of Red Reflex asymmetry.
Kara C. Lamattina - One of the best experts on this subject based on the ideXlab platform.
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Can the Red Reflex Test Detect Unequal Refractive Error
The Journal of pediatrics, 2019Co-Authors: Kara C. Lamattina, Aldo Vagge, Leonard B NelsonAbstract:Objective To determine the accuracy of the Red Reflex test in the detection of anisometropia. Study design This prospective, single-masked study enrolled new patients younger than the age of 18 years who had not undergone pharmacologic pupillary dilation. A fellow who was masked to all clinical information illuminated both eyes with a direct ophthalmoscope in a darkened room from a distance of 1 m, assessing whether the Red Reflex between the 2 eyes was symmetric or asymmetric. The patient was then dilated, and cylcoplegic refraction was performed by an attending pediatric ophthalmologist. Exclusion criteria included the presence of strabismus, anisocoria, previous intraocular surgery, media opacity, leukocoria, or nystagmus. Sensitivity was compaRed with a null hypothesized value of 50% using a 1-sided binomial test. Results Ninety-two patients with a mean age of 7.3 years (range 3 months to 16 years) were enrolled. With spherical anisometropia greater than or equal to 0.125 diopters, the sensitivity of the Red Reflex test was 90.6% and the specificity was 58.3%. With cylindrical anisometropia greater than or equal to 0.25 diopters, the sensitivity of the Red Reflex test was 81.3% and the specificity was 70%. Anisometropia greater than 1.5 diopters in spherical equivalent (4 patients, range −10.625 to −2.625) or cylinder (3 patients, range 1.75-2.25) was accurately detected by Red Reflex testing in each case. Conclusions The Red Reflex test can be an accurate screening tool to detect anisometropia when performed by an ophthalmologist.
Alberto Verrotti - One of the best experts on this subject based on the ideXlab platform.
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Red Reflex examination in neonates: evaluation of 3 years of screening
International Ophthalmology, 2017Co-Authors: Carlo Cagini, Gianluigi Tosi, Fabrizio Stracci, Victoria Elisa Rinaldi, Alberto VerrottiAbstract:Purpose Red Reflex is a test that can detect potentially life-threatening ocular abnormalities. In 2012, a Red Reflex screening campaign was started in Umbria, central Italy. In this study, we report the results of the first 3 years (2012–2014) of screening. Methods Red Reflex screening was carried out in the 11 regional birth centres. On the first level, the test was performed on all newborns within the third day of life. A pathologic test was an indication for referral to the nearest Ophthalmology Hospital Department (II level). Patients were referRed to the Perugia University Ophthalmology Hospital Department if an ulterior evaluation or if treatment was necessary (III level). Results Between 1 January 2012 and 31 December 2014, 22,884 children were born in Umbria and of these, 22,272 (97.3%) were tested with the Red Reflex. Four hundRed and sixty-one (4.83%) neonates resulted having a positive or equivocal test and were sent to II level. Three of these cases (0.01%) were affected by an important eye disease, in particular two patients (0.009%) presented congenital cataract and one patient (0.005%) presented retinoblastoma. Conclusion Our results are consistent with the previous findings, although reports on Red Reflex screening are sporadic in the literature. Despite the high number of false positives, the Red Reflex test has proven to be a useful, easy to perform and low cost test for the early detection of congenital low vision diseases, and our data confirm that it must become part of normal neonatal assessments.
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Red Reflex examination in neonates: evaluation of 3 years of screening
International ophthalmology, 2016Co-Authors: Carlo Cagini, Gianluigi Tosi, Fabrizio Stracci, Victoria Elisa Rinaldi, Alberto VerrottiAbstract:Purpose Red Reflex is a test that can detect potentially life-threatening ocular abnormalities. In 2012, a Red Reflex screening campaign was started in Umbria, central Italy. In this study, we report the results of the first 3 years (2012–2014) of screening.