Person:
Antona Peñalba, Beatriz

First Name

Beatriz

Last Name

Antona Peñalba

URI

https://hdl.handle.net/20.500.14352/79924

Affiliation

Universidad Complutense de Madrid

Faculty / Institute

Óptica y Optometría

Department

Optometría y Visión

Area

Optica

Identifiers

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Now showing 1 - 10 of 25

Intraexaminer repeatability and agreement in stereoacuity measurements made in young adults
(International journal of ophthalmology., 2015) Antona Peñalba, Beatriz; Barrio De Santos, Ana Rosa; Sánchez Pérez, María Isabel; González Díaz-Obregón, Enrique; González Montero, María Guadalupe
AIM: To determine the repeatability and agreement of stereoacuity measurements made using some of the most widely used clinical tests: Frisby, TNO, Randot and Titmus. METHODS: Stereoacuity was measured in two different sessions separated by a time interval of at least 24h but no longer than 1wk in 74 subjects of mean age 20.6y using the four methods. The study participants were divided into two groups: subjects with normal binocular vision and subjects with abnormal binocular vision. RESULTS: Best repeatability was shown by the Frisby and Titmus [coefficient of repeatability (COR): 依13 and 依12s arc respectively] in the subjects with normal binocular vision though a clear ceiling effect was noted. In the subjects with abnormal binocular vision, best repeatability was shown by the Frisby (COR: 依69s arc) and Randot (COR: 依72s arc). In both groups, the TNO test showed poorest agreement with the other tests. CONCLUSION: Therepeatabilityof stereoacuitymeasures was low in subjects with poor binocular vision yet fairly good in subjects with normal binocular vision with the exception of the TNO test. The reduced agreement detected between the tests indicates they cannot be used interchangeably.
Five levels of performance and two subscales identified in the computer-vision symptom scale (CVSS17) by Rasch, factor, and discriminant analysis
(PLoS ONE, 2018) González Pérez, Mariano; Susi García, María Del Rosario; Barrio De Santos, Ana Rosa; Antona Peñalba, Beatriz
Purpose: To quantify the levels of performance (symptom severity) of the computer-vision symptom scale (CVSS17), confirm its bifactorial structure as detected in an exploratory factor analysis, and validate its factors as subscales. Methods: By partial credit model (PCM), we estimated CVSS17 measures and the standard error for every possible raw score, and used these data to determine the number of different performance levels in the CVSS17. In addition, through discriminant analysis, we checked that the scale's two main factors could classify subjects according to these determined levels of performance. Finally, a separate Rasch analysis was performed for each CVSS17 factor to assess their measurement properties when used as isolated scales. Results: We identified 5.8 different levels of performance. Discriminant functions obtained from sample data indicated that the scale's main factors correctly classified 98.4% of the cases. The main factors: Internal symptom factor (ISF) and external symptom factor (ESF) showed good measurement properties and can be considered as subscales. Conclusion: CVSS17 scores defined five different levels of performance. In addition, two main factors (ESF and ISF) were identified and these confirmed by discriminant analysis. These subscales served to assess either the visual or the ocular symptoms attributable to computer use.
Strabometry precision: intra-examiner repeatability and agreement in measuring the magnitude of the angle of latent binocular ocular deviations (heterophorias or latent strabismus)
(Binocular vision & strabology quarterly, Simms-Romano's, 2011) Antona Peñalba, Beatriz; González Díaz-Obregón, Enrique; Barrio De Santos, Ana Rosa; Barra Lázaro, Francisco; Sánchez Pérez, Isabel; Cebrián, José Luis
BACKGROUND AND PURPOSE: This study was designed to compare heterophoria measurements obtained using the methods: prisms cover test (prism alternate cover test), von Graefe technique, Maddox rod test and modified Thorington test. Given the different methodological features of these tests, our working hypothesis was that these tests would not be interchangeable and repeatability would vary. METHODS: Horizontal deviation measurements were made at: far distance (six meters) and near distance (40 centimeters) on two occasions in 61 young subjects of mean age 19.7 years (range 18 -32 years), with essentially normal eyes and vision, who were not familiar with the methods used. Statistical repeatability and agreement were determined using the Bland and Altman method. RESULTS: Repeatability: No difference between the results of the various heterophoria tests was statistically significant. Coefficients of repeatability were always best when the tests were conducted at far, the cover test being the most repeatable. Agreement: Mean differences between absolute values ranged from 1.7 prism diopters to 5.1 prism diopters for measurements at far and from 2.1 prism diopters to 3.4 prism diopters at near. CONCLUSIONS: The alternating prism cover test was the most repeatable test for measuring latent horizontal deviations. Among the subjective tests, the modified Thorington test was the most repeatable. The low level of agreement observed between the different tests makes their interchangeable use in clinical practice not recommended.
Repeatability intraexaminer and agreement in amplitude of accommodation measurements
(Graefe's Archive for Clinical and Experimental Ophthalmology, 2009) Antona Peñalba, Beatriz; Barra Lázaro, Francisco; Barrio De Santos, Ana Rosa; González Díaz-Obregón, Enrique; Sánchez Pérez, Isabel
Background: Clinical measurement of the amplitude of accommodation (AA) provides an indication of maximum accommodative ability. To determine whether there has been a significant change in the AA, it is important to have a good idea of the repeatability of the measurement method used. The aim of the present study was to compare AA measurements made using three different subjective clinical methods: the push-up, push-down, and minus lens techniques. These methods differ in terms of the apparent size of the target, the end point used, or the components of the accommodation response stimulated. Our working hypothesis was that these methods are likely to show different degrees of repeatability such that they should not be used interchangeably. Methods: The AA of the right eye was measured on two separate occasions in 61 visually normal subjects of mean age 19.7 years (range 18 to 32). The repeatability of the tests and agreement between them was estimated by the Bland and Altman method. We determined the mean difference (MD) and the 95% limits of agreement for the repeatability study ( COR) and for the agreement study (COA). Results: The COR for the push-up, push-down, and minus lens techniques were +/- 4.76, +/- 4.00, and +/- 2.52D, respectively. Higher values of AA were obtained using the pushup procedure compared to the push-down and minus lens methods. The push-down method also yielded a larger mean AA than the negative-lens method. MD between the three methods were high in clinical terms, always over 1.75D, and the COA differed substantially by at least +/- 4.50D. The highest agreement interval was observed when we compared AA measurements made using minus lenses and the push-up method (+/- 5.65D). Conclusions: The minus lens method exhibited the best repeatability, least MD (-0.08D) and the smallest COR. Agreement between the three techniques was poor.
Repeatability and agreement in the measurement of horizontal fusional vergences
(Ophthalmic and Physiological Optics, 2008) Antona Peñalba, Beatriz; Barrio De Santos, Ana Rosa; Barra Lázaro, Francisco; González Díaz-Obregón, Enrique; Sánchez Pérez, María Isabel
Purpose: This study was designed to determine the repeatability of fusional vergence rangesmeasured using the rotary prisms in the phoropter and in free space using the prism bar. The level of agreement between the two methods was also investigated.. Methods: In two separate sessions, negative and positive fusional vergence ranges (NFV and PFV, respectively) were measured at distance and near in 61 young adults (mean age 19.74, S.D. 2.5 years) who were unfamiliar with the methods used. Base-in and base-out blur, break and recovery points were sequentially determined. Both sets of measurements were obtained by the same examiner. At each distance, NFV was determined first and then PFV. The repeatability of the tests and agreement between measurements made with the phoropter rotary prisms and the prism bar were estimated by the Bland and Altman method. Results: For both the phoropter rotary prisms and prism bar, NFV measurements showed better repeatability than PFV at both near and distance. Mean differences recorded for the NFV break and recovery points were non-significant (under 0.5D), while those observed for PFV were generally greater than 2D. When agreement between the two tests was assessed, it was found that break points were higher when determined using the phoropter rotary prisms, while recovery points were generally higher for the prism bar method. In clinical terms, according to the expected values of the NFV and PFV, agreement between the two techniques can be described as fair, because although mean differences were never greater than 5.5D, 95% agreement intervals were as wide as ±8.00D for NFV and ±13.19D for PFV. Conclusions: The two methods used to measure fusional vergences showed fairly good inter- session repeatability for measuring NFV but repeatability was reduced for PFV measurements. The level of agreement observed between the two methods was such that their interchangeable use in clinical practice is not recommended.
Repeatability of mesopic visual acuity measurements using high- and low-contrast ETDRS letter charts
(Graefes Archive for Clinical and Experimental Opththalmology, 2015) Barrio De Santos, Ana Rosa; Antona Peñalba, Beatriz; Puell Marín, María Cinta
To determine the repeatability of mesopic high-contrast (HC) and low-contrast (LC) visual acuity (VA) measurements made at distance and near in healthy young individuals. While the repeatability of photopic VA is well-known, there is a lack of information with regard to the repeatability of VA measured under low luminance conditions. In two different sessions 1 week apart, best-corrected monocular VA was determined using HC (96 %) and LC (10 %) ETDRS charts under mesopic luminance conditions (0.75 cd/m(2)) at distance (HCD, LCD) and near (HCN, LCN) in 47 healthy subjects aged 22.9 +/- 6.8 years. Repeatability was estimated by the Bland and Altman method, whereby the mean difference (MD) and the 95 % limits of agreement were determined as the coefficient of repeatability (COR). Mean logMAR VA values were HCD = 0.09, LCD = 0.44, HCN = 0.21, and LCN = 0.57. Mean differences in measurements between sessions 1 and 2 were not significant, and low in clinical terms (a parts per thousand currency sign1 letter). Repeatability was better for the distance measurements at both high and lowcontrast (COR (HCD) +/- 0.11 and COR (LCD) +/- 0.11 logMAR vs COR (HCN) +/- 0.15 and COR (LCN) +/- 0.16 logMAR), and MDs were also slightly closer to zero for the distance measurements. Similar repeatability was observed between HC and LC VA, both at distance and near. In mesopic conditions, ETDRS charts offer repeatable best-corrected monocular VA measurements. The criterion for a significant change in logMAR VA was 1 line at distance and 1.5 lines at near.
The role of clinical diagnosis criteria on the frequency of accommodative insufficiency
(International journal of ophthalmology, 2019) García Montero, María; Antona Peñalba, Beatriz; Barrio de Santos, Ana Rosa; Nieto Zayas, Carmen; Martínez Alberquilla, Irene; Hernández Verdejo, José Luis
AIM: To estimate and compare the frequency of accommodative insufficiency (AI) within the same clinical population sample depending on the type of clinical criteria used for diagnosis. Comparing the frequency within the same population would help to minimize bias due to sampling or methodological variability. METHODS: Retrospective study of 205 medical records of symptomatic subjects free of any organic cause and symptoms persisting despite optical compensation evaluated. Based on the most commonly clinical diagnostics criteria found in the literature, four diagnostics criteria were established for AI (I, II, III and IV) based on subjective accommodative tests: monocular accommodative amplitude two or more diopters below Hofstetter’s minimum value [15-(0.25×age)] (I, II, III, IV); failing monocular accommodative facility with minus lens, establishing the cut-off in 0 cycles per minute (cpm) (I) and in 6 cpm (II, III); failing binocular accommodative facility with minus lens, establishing the cut-off in 0 cpm (I) and in 3 cpm (II). RESULTS: The proportion of AI (95%CI) for criteria I, II, III and IV were 1.95% (0.04%-3.86%), 2.93% (0.31%-4.57%), 6.34% (1.90%-7.85%) and 41.95% (35.14%-48.76%) respectively, with a statistically significant difference shown between these values (χ2=226.7, P<0.001). A pairwise multiple comparison revealed that the proportion of AI detected for criterion IV was significantly greater than the proportion for the rest of the criteria (P-adjusted<0.05 in all cases). CONCLUSION: The prevalence of cases of AI within the same clinical population varies with the clinical diagnostic criteria selected. The variation is statistically significant when considering the monocular accommodative amplitude as the only clinical diagnostic sign.
Intra-examiner repeatability and agreement in accommodative response measurements
(Ophthalmic and Physiological Optics, 2009) Antona Peñalba, Beatriz; Sánchez Pérez, Isabel; Barrio De Santos, Ana Rosa; Barra Lázaro, Francisco; González Díaz-Obregón, Enrique
Purpose: Clinical measurement of the accommodative response (AR) identifies the focusing plane of a subject with respect to the accommodative target. To establish whether a significant change in AR has occurred, it is important to determine the repeatability of this measurement. This study had two aims: First, to determine the intraexaminer repeatability of AR measurements using four clinical methods: Nott retinoscopy, monocular estimate method (MEM) retinoscopy, binocular crossed cylinder test (BCC) and near autorefractometry. Second, to study the level of agreement between AR measurements obtained with the different methods. Methods: The AR of the right eye at one accommodative demand of 2.50 D (40 cm) was measured on two separate occasions in 61 visually normal subjects of mean age 19.7 years (range 18-32 years). The intraexaminer repeatability of the tests, and agreement between them, were estimated by the Bland-Altman method. We determined mean differences (MD) and the 95% limits of agreement [coefficient of repeatability (COR) and coefficient of agreement (COA)]. Results: Nott retinoscopy and BCC offered the best repeatability, showing the lowest MD and narrowest 95% interval of agreement (Nott: -0.10 +/- 0.66 D, BCC: -0.05 +/- 0.75 D). The 95% limits of agreement for the four techniques were similar (COA = +/- 0.92 to +/- 1.00 D) yet clinically significant, according to the expected values of the AR. The two dynamic retinoscopy techniques (Nott and MEM) had a better agreement (COA = +/- 0.64 D) although this COA must be interpreted in the context of the low MEM repeatability (COR = +/- 0.98 D). Conclusions: The best method of assessing AR was Nott retinoscopy. The BCC technique was also repeatable, and both are recommended as suitable methods for clinical use. Despite better agreement between MEM and Nott, agreement among the remaining methods was poor such that their interchangeable use in clinical practice is not recommended.
Repeatability of the Modified Thorington Card Used to Measure Far Heterophoria
(Optometry and Vision Science, 2014) Cebrián, José Luis; Antona Peñalba, Beatriz; Barrio De Santos, Ana Rosa; González Díaz-Obregón, Enrique; Gutiérrez Hernández, Ángel Luis; Sánchez Pérez, María Isabel
Purpose. To determine the interexaminer and intraexaminer repeatability of the modified Thorington test (TH) for distance vision in young adults and to compare these results with those observed for the heterophoria tests most commonly used in clinical practice. Agreement among tests was also assessed. Methods. Distance heterophoria was quantified on two separate occasions by two examiners in 110 subjects aged 18 to 32 years (mean, 19.74 years; SD, 2.5 years) using four different tests: cover test (CT) Von Graefe, Maddox rod, and modified TH. The repeatability of the tests and agreement between them was estimated by the Bland and Altman method whereby the mean difference and the 95% limits of agreement were determined as the coefficient of repeatability (COR) and coefficient of agreement. Results. The Thorington test showed best interexaminer repeatability (COR = +/- 1.43 Delta), followed closely by CT (COR = +/- 1.65 Delta), whereas best intraexaminer repeatability was observed for CT (COR = +/- 1.28 Delta) followed by TH (COR = +/- 1.51 Delta). Among the different combinations of tests, TH and CT showed best agreement indicated by the lowest coefficient of agreement (+/- 2.23 Delta) and a low mean difference (-0.63 Delta) between measurements. Conclusions. Good interexaminer and intraexaminer repeatability was observed for both TH and CT, and agreement between the two tests was also good. Given the simple administration of the TH, we recommend its clinical use to quantify distance horizontal heterophoria.
Spanish Cross-Cultural Adaptation and Rasch Analysis of the Convergence Insufficiency Symptom Survey (CISS)
(Translational Vision Science & Technology, 2020) González Pérez, Mariano; Pérez Garmendia, Carlos; Barrio De Santos, Ana Rosa; García Montero, María; Antona Peñalba, Beatriz
Purpose: To culturally and linguistically adapt the Convergence Insufficiency Symptom Survey (CISS) to Spanish and assess the psychometric performance of the new version through Rasch analysis and classical test theory methods. Methods: The Spanish version of the CISS (CISSVE ) was completed by 449 subjects (9– 30 years old) from the general population. The validity and reliability of CISSVE were assessed through Rasch statistics (precision, targeting, item fit, unidimensionality, and differential item functioning). To test construct validity, we calculated the coefficients of correlation between the CISSVE and the Computer-Vision Symptom Scale (CVSS17) or Warwick–Edinburgh Mental Well-Being Scale (WEMWBS). We determined test–retest reliability in a subset of 229 subjects. We used differential item functioning (DIF) to compare the CISSSVE and the CISS after administering the CISS to 216 English children. Results: After applying exclusion criteria, the responses of 420 participants (mean age, 18.62 years; female, 54.95%) revealed good Rasch model fit, good precision (person separation = 2.33), and suboptimal targeting (–1.37). There was some evidence of multidimensionality, but disattenuated correlations between the Rasch dimension and a possible secondary dimension were high, suggesting they were measuring similar constructs. No item bias according to gender or age was detected. Spearman’s correlation was 0.34 (P < 0.001) for CISSVE –CVSS17 and non-significant for CISSVE –WEMWBS. The limits of agreement for test–retest reliability were 9.67 and –8.71. Rasch analysis results indicated no difference between CISS and CISSVE. Conclusions: According to our results, CISSVE is a valid and reliable tool for measuring the symptoms assessed by CISS in Spanish people 9 to 30 years of age. Translational Relevance: CISSVE can measure convergence insufficiency symptoms in Spanish-speaking subjects.