Comparison of the iScreen and the MTI photoscreeners for the detection of amblyopia risk factors in children

Abstract

The iScreen and Medical Technology and Innovations, Inc, (MTI) photoscreeners objectively screen for amblyopia risk factors in children. The MTI photoscreener has been extensively validated as a device that objectively screens for amblyopia risk factors in children, but limited availability of the instant film it uses may soon render it obsolete. More recently the iScreen photoscreener has been introduced. This device captures images digitally and transmits them electronically to be interpreted. We compared the newer iScreen's ability to detect amblyopia risk factors in children with the established MTI photoscreener. The medical records of consecutive subjects screened by both the iScreen and MTI photoscreeners on the same day were retrospectively reviewed. The iScreen images were analyzed by the device's central interpretation center; MTI images were analyzed by an expert masked examiner using the delta crescent method. Referrals by both instruments were compared to the results of cycloplegic examination as per the American Association for Pediatric Ophthalmology and Strabismus 2003 referral criteria. A total of 169 children were included in the study. Of these, 107 (63%) were found to have amblyopia risk factors. The iScreen was found to have an accuracy rate of 81%, sensitivity of 87%, and specificity of 76%. The MTI was found to have an accuracy rate of 81%, sensitivity of 81%, and specificity of 81%. The iScreen and MTI performed similarly in detecting amblyopia risk factors when compared to a comprehensive pediatric ophthalmology examination.