Toxoplasmosis is a common infection whose worldwide prevalence is estimated at 30%, with large disparities across the world. Among infected subjects, the prevalence of ocular toxoplasmosis (OT) is, however, limited to about 2% in Europe and 17% in South America. In France, it is estimated that about 1 000 000 patients present either active OT or subsequent chorioretinal scars. Toxoplasmagondii is the first cause of posterior uveitis worldwide, responsible for retinochoroiditis, at times associated with anterior uveitis. To date, there is no consensus yet on how to diagnose OT, which is often based only on clinical presentation. Nevertheless, OT-associated symptoms are often atypical and misleading. Over the last 20 years, tremendous progress has been made in biological tools, enabling parasitologists to confirm the diagnosis in most suspected cases of OT. Using anterior chamber puncture, a safe and fast procedure, ophthalmologists sample aqueous humour for analysis using multiple techniques in order to reach high specificity and sensitivity in OT diagnosis. In this article, we present the different techniques available for the biological diagnosis of OT, along with their characteristics, and propose a diagnostic algorithm designed to select the best of these techniques if clinical examination is not sufficient to ascertain the diagnosis.
Background Amblyopia is a major public health problem. Its screening and management require reliable methods of assessing visual acuity. Many tests are available, some of which are used as a reference and the advent of new technologies sees many others whose validity is not proven. The objective of our study was to develop a tablet-based visual acuity test adapted to the pediatric population: the eMOVA test (electronic Measurement Of Visual Acuity). Methods We did a study comparing the eMOVA test with the Rossano-Weiss test. All children aged 3 to 8 attending the ophthalmic and pediatric consultation between September 2016 and June 2017 were included. The results in terms of visual acuity were compared as well as the duration of each test, its comprehension, its acceptability and the attention of the child during the test. Results The eMOVA test overestimated visual acuity by 0.06 logMAR. This difference, statistically significant, was not clinically relevant. The duration of the eMOVA test was longer than the reference test, but it was less painful and more appreciated by children and their parents. Conclusion The e-MOVA test appears as a reliable method of assessing visual acuity that could be used both in consultation and on a larger scale in the context of screening as well as for the care of the most difficult children.
Background Amblyopia is a major public health problem. Its screening and management require reliable methods of assessing visual acuity. Many tests are available, some of which are used as a reference and the advent of new technologies sees many others whose validity is not proven. The objective of our study was to develop a tablet-based visual acuity test adapted to the pediatric population: the eMOVA test (electronic Measurement Of Visual Acuity). Methods We did a study comparing the eMOVA test with the Rossano-Weiss test. All children aged 3 to 8 attending the ophthalmic and pediatric consultation between September 2016 and June 2017 were included. The results in terms of visual acuity were compared as well as the duration of each test, its comprehension, its acceptability and the attention of the child during the test. Results The eMOVA test overestimated visual acuity by 0.06 logMAR. This difference, statistically significant, was not clinically relevant. The duration of the eMOVA test was longer than the reference test, but it was less painful and more appreciated by children and their parents. Conclusion The e-MOVA test appears as a reliable method of assessing visual acuity that could be used both in consultation and on a larger scale in the context of screening as well as for the care of the most difficult children.
Background Amblyopia is a major public health concern. Its screening and management require reliable methods of visual acuity assessment. New technologies offer nowadays many tests available on different app stores for smartphone or tablet but most of them often lack of scientific validation for a medical use. The aim of our study was to attempt validating a tablet-based near visual acuity test adapted to the pediatric population: the eMOVA test (electronic Measurement Of Visual Acuity) by comparing visual acuity measured with more conventional test. Methods A cohort of 100 children aged 3 to 8 attending the ophthalmic-pediatric for eye examination between September 2016 and June 2017 were included in the study. Near visual acuity was assessed on participants using both the eMOVA test and a Standard test (Rossano-Weiss test). Duration of each test, its comprehension, its acceptability and the attention of the child during the test was also investigated. Results The eMOVA test overestimated near visual acuity by 0.06 logMAR. This difference, statistically significant, was not clinically relevant. The duration of the eMOVA test was longer than the reference test, but less discomfort and preferred by children and their parents compared to standard tests. Conclusion The eMOVA test appears as a reliable test to assess near visual acuity in children. By its portability and efficiency, this application proved to be a relevant tool to be used for children eye examination in daily routine at the hospital.
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