Abstract
Purpose: To compare the accuracy of plusoptiX A08 photoscreener (PPS) and iScreen 3000 photoscreener (IPS) in objectively screening for amblyopic risk factors in children age 5 months to 13 years old. Methods: Cross-sectional study of 148 children who received photoscreenings via PPS and IPS and a comprehensive pediatric ophthalmic examination in our office. Patients were considered to have amblyogenic risk factors based on the AAPOS referral criteria guidelines. Results: 45 percent of patients undergoing a pediatric ophthalmology examination were found to have amblyopia or amblyogenic risk factors. In this study, PPS demonstrated an overall sensitivity of 75.4%, specificity of 68.0%, positive predictive value (PPV) of 67.1%, and negative predictive value (NPV) of 76.1%. However, IPS photoscreener had an overall sensitivity of 66.2%, specificity of 87.6%, PPV of 81.8%, and NPV of 75.5%. Discussion: The accuracy of PPS and IPS was compared in different age groups. The sensitivity and specificity were analyzed according to varied amblyogenic risk factors. The statistic results of this study were compared to those of previous studies, including Vision in Preschoolers (VIP) Study and the Iowa PhotoScreening Program. Conclusion: PPS and IPS proved to be useful tools in the objective vision screening in children. PPS was found to have a higher sensitivity, and IPS showed a higher specificity and PPV in detecting amblyopic risk factors. In conclusion, one device may be more beneficial over the other, depending on the patient population and office settings.
Highlights
Amblyopia is a major cause of visual problems in the developed world [1,2,3] and the leading cause of blindness in the 20 to 70 year age group [4], affecting 2% to 5% of the population [5]
plusoptiX A08 photoscreener (PPS) demonstrated an overall sensitivity of 75.4%, specificity of 68.0%, positive predictive value (PPV) of 67.1%, and negative predictive value (NPV) of 76.1%
PPS and iScreen photoscreener (IPS) proved to be useful tools in the objective vision screening in children
Summary
Amblyopia is a major cause of visual problems in the developed world [1,2,3] and the leading cause of blindness in the 20 to 70 year age group [4], affecting 2% to 5% of the population [5]. Several studies, including the Prospective Amblyopia Treatment Study, have demonstrated that amblyopia treatment is highly effective when detected and treated in young children [6,7,8,9,10,11,12]. Traditional vision screening methods have a relative low compliance due to high over-referral rates, low sensitivity and low specificity [16]. Newer screening methods, including photoscreeners and autorefractors, have been proposed as potential replacements or supplements to traditional screening methods [17,18,19,20,21,22,23,24,25]. Potential advantages are reduced testing time, increased objectivity of screening, and enhance testability rates in younger children, who may be poorly cooperative with traditional tests. Potential disadvantages are the high initial costs associated with the instruments, and the need with some photoscreeners for external interpretation of screening results [15]
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