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The Arclight Ophthalmoscope: A Reliable Low-Cost Alternative to the Standard Direct Ophthalmoscope.

Lowe J, Cleland CR, Mgaya E, Furahini G, Gilbert CE, Burton MJ, Philippin H - J Ophthalmol (2015)

Bottom Line: The number of examinations that yielded an estimation of the VCDR was significantly higher for the Arclight ophthalmoscope (125/144, 85%) compared to the Heine ophthalmoscope (88/144, 61%) (p < 0.001).The overall EOU score was significantly higher for the Arclight ophthalmoscope (p < 0.001).Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Eastbourne District General Hospital, Kings Drive, Eastbourne BN21 2UD, UK.

ABSTRACT
Background. The Arclight ophthalmoscope is a low-cost alternative to standard direct ophthalmoscopes. This study compared the Arclight ophthalmoscope with the Heine K180 direct ophthalmoscope to evaluate its reliability in assessing the vertical cup disc ratio (VCDR) and its ease of use (EOU). Methods. Eight medical students used both the Arclight and the Heine ophthalmoscopes to examine the optic disc in 9 subjects. An EOU score was provided after every examination (a higher score indicating that the ophthalmoscope is easier to use). A consultant ophthalmologist provided the reference standard VCDR. Results. 288 examinations were performed. The number of examinations that yielded an estimation of the VCDR was significantly higher for the Arclight ophthalmoscope (125/144, 85%) compared to the Heine ophthalmoscope (88/144, 61%) (p < 0.001). The mean difference from the reference standard VCDR was similar for both instruments, with a mean of -0.078 (95% CI: -0.10 to -0.056) for the Arclight and -0.072 (95% CI: -0.097 to -0.046) for Heine (p = 0.69). The overall EOU score was significantly higher for the Arclight ophthalmoscope (p < 0.001). Conclusion. The Arclight ophthalmoscope performs as well as, and is easier to use than, a standard direct ophthalmoscope, suggesting it is a reliable, low-cost alternative.

No MeSH data available.


Bland-Altman plots showing the difference between the examiner's estimate of vertical cup : disc ratio (VCDR) and the reference standard, split by instrument. Plot (a) represents the Arclight direct ophthalmoscope and plot (b) represents the Heine K180 direct ophthalmoscope. Where there is exact agreement between the examiner and the reference standard the difference in VCDR is noted as 0. Any deviation from 0 represents underestimation (if negative) or overestimation (if positive) of the VCDR compared with the reference standard. The horizontal dotted line represents the mean of all observations (i.e., their mean deviation from the reference standard), and the grey area represents the proportion of all observations lying within 95% of the normal distribution for each of the two ophthalmoscopes. The size of each black dot is proportional to the number of observations it represents.
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fig2: Bland-Altman plots showing the difference between the examiner's estimate of vertical cup : disc ratio (VCDR) and the reference standard, split by instrument. Plot (a) represents the Arclight direct ophthalmoscope and plot (b) represents the Heine K180 direct ophthalmoscope. Where there is exact agreement between the examiner and the reference standard the difference in VCDR is noted as 0. Any deviation from 0 represents underestimation (if negative) or overestimation (if positive) of the VCDR compared with the reference standard. The horizontal dotted line represents the mean of all observations (i.e., their mean deviation from the reference standard), and the grey area represents the proportion of all observations lying within 95% of the normal distribution for each of the two ophthalmoscopes. The size of each black dot is proportional to the number of observations it represents.

Mentions: There was a very small difference between the reference standard VCDR measure and the Arclight measurements: mean difference −0.078 (95% CI: −0.10 to −0.056). There was a similar, very small difference for the comparison between the reference standard and Heine ophthalmoscope measurements: mean difference −0.072 (95% CI: −0.097 to −0.046). There was no difference in this mean performance between the two measures (p = 0.69). Bland-Altman plots were constructed for the difference in VCDR estimates between examiners and the reference standard (Figure 2).


The Arclight Ophthalmoscope: A Reliable Low-Cost Alternative to the Standard Direct Ophthalmoscope.

Lowe J, Cleland CR, Mgaya E, Furahini G, Gilbert CE, Burton MJ, Philippin H - J Ophthalmol (2015)

Bland-Altman plots showing the difference between the examiner's estimate of vertical cup : disc ratio (VCDR) and the reference standard, split by instrument. Plot (a) represents the Arclight direct ophthalmoscope and plot (b) represents the Heine K180 direct ophthalmoscope. Where there is exact agreement between the examiner and the reference standard the difference in VCDR is noted as 0. Any deviation from 0 represents underestimation (if negative) or overestimation (if positive) of the VCDR compared with the reference standard. The horizontal dotted line represents the mean of all observations (i.e., their mean deviation from the reference standard), and the grey area represents the proportion of all observations lying within 95% of the normal distribution for each of the two ophthalmoscopes. The size of each black dot is proportional to the number of observations it represents.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4589625&req=5

fig2: Bland-Altman plots showing the difference between the examiner's estimate of vertical cup : disc ratio (VCDR) and the reference standard, split by instrument. Plot (a) represents the Arclight direct ophthalmoscope and plot (b) represents the Heine K180 direct ophthalmoscope. Where there is exact agreement between the examiner and the reference standard the difference in VCDR is noted as 0. Any deviation from 0 represents underestimation (if negative) or overestimation (if positive) of the VCDR compared with the reference standard. The horizontal dotted line represents the mean of all observations (i.e., their mean deviation from the reference standard), and the grey area represents the proportion of all observations lying within 95% of the normal distribution for each of the two ophthalmoscopes. The size of each black dot is proportional to the number of observations it represents.
Mentions: There was a very small difference between the reference standard VCDR measure and the Arclight measurements: mean difference −0.078 (95% CI: −0.10 to −0.056). There was a similar, very small difference for the comparison between the reference standard and Heine ophthalmoscope measurements: mean difference −0.072 (95% CI: −0.097 to −0.046). There was no difference in this mean performance between the two measures (p = 0.69). Bland-Altman plots were constructed for the difference in VCDR estimates between examiners and the reference standard (Figure 2).

Bottom Line: The number of examinations that yielded an estimation of the VCDR was significantly higher for the Arclight ophthalmoscope (125/144, 85%) compared to the Heine ophthalmoscope (88/144, 61%) (p < 0.001).The overall EOU score was significantly higher for the Arclight ophthalmoscope (p < 0.001).Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Eastbourne District General Hospital, Kings Drive, Eastbourne BN21 2UD, UK.

ABSTRACT
Background. The Arclight ophthalmoscope is a low-cost alternative to standard direct ophthalmoscopes. This study compared the Arclight ophthalmoscope with the Heine K180 direct ophthalmoscope to evaluate its reliability in assessing the vertical cup disc ratio (VCDR) and its ease of use (EOU). Methods. Eight medical students used both the Arclight and the Heine ophthalmoscopes to examine the optic disc in 9 subjects. An EOU score was provided after every examination (a higher score indicating that the ophthalmoscope is easier to use). A consultant ophthalmologist provided the reference standard VCDR. Results. 288 examinations were performed. The number of examinations that yielded an estimation of the VCDR was significantly higher for the Arclight ophthalmoscope (125/144, 85%) compared to the Heine ophthalmoscope (88/144, 61%) (p < 0.001). The mean difference from the reference standard VCDR was similar for both instruments, with a mean of -0.078 (95% CI: -0.10 to -0.056) for the Arclight and -0.072 (95% CI: -0.097 to -0.046) for Heine (p = 0.69). The overall EOU score was significantly higher for the Arclight ophthalmoscope (p < 0.001). Conclusion. The Arclight ophthalmoscope performs as well as, and is easier to use than, a standard direct ophthalmoscope, suggesting it is a reliable, low-cost alternative.

No MeSH data available.