An office-based fix-and-follow grading system assessing visual function in preverbal children

BMC Ophthalmology

Hyeshin Jeon¹  Hee-young Choi¹  Jae Ho Jung² 

[1] Department of Ophthalmology, School of Medicine, Pusan National University, 1-10 Ami-dong Seo-gu, 49241, Busan, South Korea;Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea;Department of Ophthalmology, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South Korea;

关键词: Fix-and-follow;    Saccade;    Visual development;    Visual screening;   

DOI  :  10.1186/s12886-021-02187-9

来源: Springer

【 摘 要 】

BackgroundAssessing visual function in infants is usually challenging. Fix-and-Follow is a simple and popular method for assessing early development of visual perception in infants, currently however, there is no formal reproducible method for grading the capacity of fix-and-follow. This study was to develop and validate a new fix-and-follow grading system for assessing visual function development in preverbal children.MethodsIn this cross-sectional study, the fix-and-follow grades was evaluated in 21 consecutive preverbal children. Fixation was categorised as grade 1 if there was no response to the target and grade 2 if there was a response but only for < 3 s. Grades of 3 and 4 were assigned based capacities to (1) fix on a moving target for ≥3 s, and (2) shift fixation from one target to another. If only one of these two criteria was met, grade 3 was assigned. If both were met, grade 4 was assigned. Following was evaluated using smooth pursuit movement, where grade 1 indicated no movement, grade 2 partial movement, and grade 3 complete movement. Two ophthalmologists independently applied the grading method in all patients. Then one of two examiners repeated the examinations to investigate the intra-observer agreement of the grading system.ResultsIntra-observer agreement was excellent (Kappa coefficient = 0.823) and inter-observer agreement was good (Kappa coefficient = 0.625). All patients who exhibited abnormal ocular movement had score discrepancy between a new fix-and-following grading examination.ConclusionsThe new fix-and-follow grading scale can be applied easily in preverbal children in an office setting, and it proved reliable and reproducible.

【 授权许可】

CC BY