A technique for standardizing disk foveal angle measurement

Jethani, Jitendra; Dave, Paaraj

doi:10.1016/j.jaapos.2014.08.015

Cited by 9 publications

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References 4 publications

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“…However, in uncooperative patients and young children, this method is commonly used. [ 1 4 5 8 ] An important aspect where literature is lacking is in the variability and agreement in the grading of torsion by indirect ophthalmoscopy. The examiner is the most important variable even when the other factors are kept constant.…”

Section: Discussionmentioning

confidence: 99%

“…Ocular torsion can be measured by various techniques including indirect ophthalmoscopy, slit lamp biomicroscopy, fundus photography and disc foveal angle, retinal vasculature orientation and now recently using infrared imaging. [ 1 2 3 4 5 6 7 8 ] The commonly used objective techniques of assessing ocular torsion include the indirect ophthalmoscopy and fundus photography. There have been studies on the reliability of fundus photography,[ 9 ] reliability of slit lamp biomicroscopy,[ 10 ] and agreement of between double Maddox rod and Spierer's technique.…”

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confidence: 99%

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The subjectivity of objective evaluation of torsion on fundus photographs by practicing strabismologists

Jethani¹,

Dave²

2018

Indian J Ophthalmol

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Purpose:To assess the variability of assessing the ocular torsion on fundus photographs among strabismus surgeons.Methods:This was a prospective, noninterventional, clinical trial involving 16 trained and experienced squint surgeons participated in the study. Two videos were prepared of a total of 10 fundus pictures with or without lines for disc foveal angle. The first video had a 4 s viewing time for each fundus image. The second video had the disc foveal lines drawn and a similar 4 s viewing time for each image. The participants were asked to grade the torsion. The primary outcome measure was to assess the agreement between the raters for ocular torsion measurement. Difference in the response of observers from the standard response was the secondary outcome measure.Results:A 4 s viewing time was given to mimic the exposure time in the clinic while assessing torsion in a patient. Large variability was found among the responses. The kappa test was done for comparing the agreement between various observers which ranged from slight to fair (<0.40). There was no difference in torsion grading in 30.6% and 26.3% responses in the first and second video from the standard response, respectively. When a limit of ±1 grade was taken as acceptable for the responses, 66.2% for the first and 68.7% for the second video respectively were similar to standard response.Conclusion:There is wide variability in assessing ocular torsion by fundus photography. The level of accuracy does increase with marking the line on photographs but still remains unreliable.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

The subjectivity of objective evaluation of torsion on fundus photographs by practicing strabismologists

Jethani¹,

Dave²

2018

Indian J Ophthalmol

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“…Furthermore, pupil dilation is not necessary at the time of assessment of fundus torsion and it is exceptionally accurate as the macular cross-section scan confirms the exact position of the fovea in relation to the optic nerve head. Other methods that have been described so far for the quantitative measurement of fundus torsion, including fundus pictures in combination with computer software1 and use of binocular indirect ophthalmoscope with protractor,2 are more time consuming and subject to human error, respectively. This novel method of fundus torsion assessment will add to our armamentarium of methods that we use for assessing strabismus.…”

Section: Discussionmentioning

confidence: 99%

Use of optical coherence topography for objective assessment of fundus torsion

Sophocleous

2017

BMJ Case Reports

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Objective assessment of fundus torsion is currently performed with indirect ophthalmoscopy or fundus photography. Using the infrared image of the macular scan of the optical coherence tomography one can assess the presence and amount of fundus torsion. In addition, the line scan through the fovea can be used as a reference to confirm the position of the foveal pit in relation to the optic nerve head. Two cases are used to demonstrate how to assess fundus torsion with the use of the optical coherence tomography.

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“…1a and b ]. [ 13 14 ] The surgery was done depending on the SOOA along with the horizontal alignment:…”

Section: Methodsmentioning

confidence: 99%

Effect of bilateral superior oblique split lengthening on torsion

Jethani

Shah

2015

Indian J Ophthalmol

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Introduction:Superior oblique split lengthening (SOSL) is done for weakening of superior oblique. It corrects the superior oblique overaction (SOOA) and A pattern. Its effect on the torsion of the eye is not known. We present our data on the effect of this particular procedure on torsion.Materials and Methods:We did a study of 16 patients (32 eyes) who underwent bilateral SOSL and compared the disc foveal angle (DFA) preoperatively and postoperatively. The split lengthening was done from 4 mm to 7 mm depending upon the overaction of superior oblique.Results:The mean age was 15.3 ± 8.4 years. Mean preoperative DFA in the right eye (RE) was −3.9° and in the left eye (LE) was −2.9°. Mean postoperative DFA in RE was 0.2° and in LE was 0.9°. The mean change in the DFA for RE was 4.1° ± 1.3° and for LE was 3.8° ± 1.2°. All the patients were aligned horizontally within 6 prism diopter and no pattern and no diplopia postoperatively. The A pattern was corrected in all the patient postsurgery. For each mm of surgery, an improvement of 0.8° was seen in the DFA.Conclusion:We report the effect of SOSL on torsion. The SOSL reduces intorsion postsurgery and is, therefore, a valuable procedure in SOOA where both pattern and in torsion needs to be corrected.

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A technique for standardizing disk foveal angle measurement

Cited by 9 publications

References 4 publications

The subjectivity of objective evaluation of torsion on fundus photographs by practicing strabismologists

The subjectivity of objective evaluation of torsion on fundus photographs by practicing strabismologists

Use of optical coherence topography for objective assessment of fundus torsion

Effect of bilateral superior oblique split lengthening on torsion

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