PURPOSE
To evaluate the use of the Spot Vision Screener (Spot; Welch Allyn, Skaneateles Falls, New York, USA) for detection of amblyopia risk factors in children aged 6 months to 3 years, as defined by the 2013 guidelines of the American Association for Pediatric Ophthalmology and Strabismus.
DESIGN
Reliability analysis.
METHODS
In this study, children seen from June 1, 2012, to April 30, 2016 were tested with the Spot during a routine visit. Enrolled children underwent a comprehensive eye examination including cycloplegic refraction and sensorimotor testing within 6 months of the testing date by a pediatric ophthalmologist masked to the Spot results.
RESULTS
A total of 184 children were included. The Spot successfully obtained readings in 89.7% of patients. Compared with the ophthalmologist’s examination, the Spot had an overall sensitivity of 89.8% and a specificity of 70.4%.
CONCLUSION
The Spot achieved good sensitivity and specificity for detection of amblyopia risk factors in this young cohort, particularly in the older subgroup. Our data offer support for automated vision screening in young children.
In this preliminary study, the Plus Lens test and the Spot Vision Screener demonstrated moderate sensitivity with good specificity in detecting high hyperopia. [J Pediatr Ophthalmol Strabismus. 2017;54(3):163-167.].
Purpose:
To determine the accuracy of the Spot Vision Screener (Welch Allyn, Skaneateles Falls, NY) in children 6 years and older and recommend device thresholds to improve its accuracy for the detection of refractive error.
Methods:
The Spot Vision Screener results were compared with three gold standard conditions of increasingly narrow refractive error criterion. The sensitivity, specificity, positive predictive value, and negative predictive value of the Spot Vision Screener in detecting each gold standard criterion were calculated. The most accurate threshold setting for each parameter was identified by calculating the area under the curve receiver operating characteristic.
Results:
The Spot Vision Screener was able to successfully evaluate 313 of 330 children (95%). The sensitivity of the Spot Vision Screener to detect American Association for Pediatric Ophthalmology and Strabismus guidelines for amblyopia risk factors was 89.5% and the specificity was 76.7%. The sensitivity decreased to 80% and the specificity increased to 75.3% with narrower refractive criteria. The sensitivity in detecting refractive criteria improved with the proposed optimized device thresholds. Estimates for the general population indicate that the positive predictive value is reasonable at 52.3% to 61.8%, depending on the stringency of the criteria, with excellent negative predictive values.
Conclusions:
In school-aged children, the primary screening focus shifts from preventing amblyopia to detecting visual disturbances, including refractive error, that may interfere with academic performance. In this age group, the Spot Vision Screener was an acceptable method of detecting significant refractive error with improved sensitivity with threshold optimization.
[
J Pediatr Ophthalmol Strabismus
. 2020;57(3):146–153.]
Vascular endothelial growth factors (VEGFs) are key mediator of retinal and choroidal neovascularization as well as retinal vascular leakage leading to macular edema. As such, VEGF plays an important role in mediating visually significant complications associated with common retinal disorders such as diabetic retinopathy, retinal vein occlusion, and age-related macular degeneration. Various drugs that inhibit vascular endothelial growth factors (anti-VEGF therapies) have been developed to minimize vision loss associated with these disorders. These drugs are injected into the vitreous cavity in a clinic setting at regular intervals. This article provides an overview of the various anti-VEGF drugs used in ophthalmology and the common retinal conditions that benefit from this therapy.
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