Diagnostic validity of clinical signs associated with a large exophoria at near

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Title: Diagnostic validity of clinical signs associated with a large exophoria at near
Authors: Cacho-Martínez, Pilar | García-Muñoz, Ángel | Ruiz-Cantero, María Teresa
Research Group/s: Salud Pública
Center, Department or Service: Universidad de Alicante. Departamento de Óptica, Farmacología y Anatomía | Universidad de Alicante. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia
Keywords: Diagnostic validity | Large near exophoria | Accommodative and binocular tests
Knowledge Area: Óptica | Medicina Preventiva y Salud Pública
Issue Date: 2013
Publisher: Hindawi Publishing Corporation
Citation: Pilar Cacho-Martínez, Ángel García-Muñoz, and María Teresa Ruiz-Cantero, “Diagnostic Validity of Clinical Signs Associated with a Large Exophoria at Near,” Journal of Ophthalmology, vol. 2013, Article ID 549435, 10 pages, 2013. doi:10.1155/2013/549435
Abstract: 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.
URI: http://hdl.handle.net/10045/33700
ISSN: 2090-004X (Print) | 2090-0058 (Online)
DOI: 10.1155/2013/549435
Language: eng
Type: info:eu-repo/semantics/article
Rights: © 2013 Pilar Cacho-Martínez et al. 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.
Peer Review: si
Publisher version: http://dx.doi.org/10.1155/2013/549435
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