Application of Hess automatic screen recording system in diagnosis of acquired paralytic strabismus

Xiting YANG; Lijun WANG; Hongsong LI; Dingying LIAO; Jianming WANG; Liang YAO

doi:10.16016/j.1000-5404.202106161

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Application of Hess automatic screen recording system in diagnosis of acquired paralytic strabismus

Clinical Medicine | 更新时间：2026-01-09

- Application of Hess automatic screen recording system in diagnosis of acquired paralytic strabismus
- Journal of Third Military Medical University Vol. 43, Issue 24, Pages: 2688-2697(2021)
- 作者机构：
  
  710004 西安，西安交通大学第二附属医院眼科
- 作者简介：
- 基金信息：
  
  the Key Social Development Project of Major Development Plan of Shaanxi Province in 2018(2018ZDXM-SF-045)
- DOI：10.16016/j.1000-5404.202106161
  CLC： R181.32;R770.42;R777.41
- Received：19 June 2021，
  
  Revised：2021-07-25，
  
  Published：30 December 2021
- 稿件说明：
移动端阅览
Xiting YANG, Lijun WANG, Hongsong LI, et al. Application of Hess automatic screen recording system in diagnosis of acquired paralytic strabismus[J]. Journal of Third Military Medical University, 2021, 43(24): 2688-2697.
DOI：

Xiting YANG, Lijun WANG, Hongsong LI, et al. Application of Hess automatic screen recording system in diagnosis of acquired paralytic strabismus[J]. Journal of Third Military Medical University, 2021, 43(24): 2688-2697. DOI： 10.16016/j.1000-5404.202106161.

摘要

目的

评价Hess屏自动记录软件系统(Hess automatic screen recording system

Hess-01型)诊断后天性麻痹性斜视的准确性及测量值的可重复性，探讨其对后天性麻痹性斜视的临床诊疗价值。

方法

收集2018年12月至2019年12月期间在本院眼科门诊、会诊及住院的70例有复视主诉的患者，分别采用Hess-01和三棱镜交替遮盖法，检查双眼在9个诊断眼位的眼球运动功能；将两种方法的定性及定量诊断结果进行比较，并进行统计分析。

结果

70例患者中，Hess-01检出后天性麻痹性斜视55例，检出率为78.6%；根据三棱镜交替遮盖法结合麻痹性斜视诊断标准，确诊为后天性麻痹性斜视50例，检出率为71.4%，两种方法检出率差异有统计学意义(

0.05)，前者的检出率较高。Hess-01诊断后天性麻痹性斜视的灵敏度、特异度、约登指数分别为100%、75%、0.75，阳性似然比(LR+)为4，阴性似然比(LR-)为0，准确率为92.9%。两种方法分别在健眼和患眼测得的水平方位斜视度存在显著的正相关关系(

0.001)。Hess-01在健眼、患眼的水平和垂直方位所测得的斜视角度的组内相关系数(interclass correlation coefficient

ICC)在0.923~0.997之间，变异系数(co

efficients of variation

CV)在5.0%~20.5%之间。两种方法完成双眼9个诊断眼位斜视度测量所需时间分别为(4.38±0.54)min和(12.35±1.54)min，差异有统计学意义(

=-42.28，

0.05)，Hess-01所需时间更短。

结论

Hess-01能省时简便、直观、准确、灵敏地定性诊断后天性麻痹性斜视，可提供具有较好重复性和可靠性的斜视度数据。

Abstract

Objective

To evaluate the accuracy and repeatability of automated system of Hess screen (Hess-01) in order to investigate its clinical value in the diagnosis of acquired paralytic strabismus.

Methods

Seventy patients with self-reported diplopia admitted in our department from December 2018 to December 2019 were selected to examine the binocular motor functional status and deviations at 9 diagnostic positions of gaze using Hess-01 and alternate prism cover test

respectively. The qualitative and quantitative results of the 2 methods were compared and statistically analyzed.

Results

Out of the 70 patients

Hess-01 identified 55 cases (78.6%) as acquired paralytic strabismus

while alternate prism cover test detected 50 cases (71.4%) according to the diagnostic criteria of acquired paralytic strabismus

and significant difference of detection rate was seen between the 2 methods(

0.05). The sensitivity

specificity and Youden index of Hess-01 were 100%

75% and 0.75

and its positive likelihood ratio (LR+)

negative likelihood ratio (LR-) and accuracy were 4

and 92.9%

respectively. In simple horizontal paralytic strabismus

a notably positive correlation was seen between the deviation degrees measured by the 2 methods

in both affected eyes and healthy eyes (

0.001). The interclass correlation coefficients (ICCs) of Hess-01 ranged from 0.923 to 0.997 in the horizontal and vertical positions of both healthy and afflicted eyes

and the coefficients of variation (CVs) ranged from 5.0% to 20.5%. Moreover

the time required by the 2 me

thods were 4.38±0.54 and 12.35±1.54 min

respectively

and Hess-01 required significantly shorter time (

=-42.28

0.05).

Conclusion

Hess-01 can save time

and simply

intuitively

accurately and qualitatively diagnose acquired paralytic strabismus

and it can provide strabismus data with better repeatability and reliability.

关键词

Keywords

references

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