Effectiveness of the GoCheck Kids Vision Screener in Detecting Amblyopia Risk Factors

Peterseim, Mae Millicent W.; Rhodes, Ryan S.; Patel, Rupa N.; Wilson, M. Edward; Edmondson, Luke E.; Logan, Sarah; Cheeseman, Edward W.; Shortridge, Emily; Trivedi, Rupal H.

doi:10.1016/j.ajo.2017.12.020

Cited by 44 publications

(27 citation statements)

References 14 publications

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“…15 – 17 , 26 , 27 In this study, the GCK app had a sensitivity of 76% and a specificity of 85%. Peterseim et al 28 found a sensitivity of 76% and a specificity of 67% in detecting amblyopia risk factors with the GCK app and a modified Nokia Lumia 1020 cellphone. Differences in how subjects were managed between the two studies, and inclusion of strabismus detection, might account for the differences in specificity.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a smartphone photoscreening app to detect refractive amblyopia risk factors in children aged 1–6 years

Arnold¹,

O’Neil²,

Cooper³

et al. 2018

OPTH

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PurposeTo determine the specificity and sensitivity of a smartphone app (GoCheckKids [GCK] used as a photoscreening tool on the iPhone 7 to detect refractive amblyopia risk factors in children aged 1–6 years.Participants and methodsA prospective, multicenter, 10-month evaluation of children aged 1–6 years old who underwent photoscreening with the GCK app to detect amblyopia risk factors. The first acceptable quality photograph of each study subject was evaluated by trained technicians using GCK’s proprietary automated image processing algorithm to analyze for amblyopia risk factors. Trained graders, masked to the cycloplegic clinical data, remotely reviewed photographs taken with the app and compared results to the gold standard pediatric ophthalmology examinations using the 2013 American Association for Pediatric Ophthalmology & Strabismus amblyopia risk factor guidelines. Primary outcome was the ability of the GCK app to identify amblyopia risk factors compared to the cycloplegic refraction.ResultsThere were 287 patient images analyzed. The overall sensitivity and specificity in detecting amblyopia risk factors were 76% and 85%, respectively using manual grading. The overall automated grading results had a sensitivity and sensitivity in detecting amblyopia risk factors of 65% and 83%, respectively.ConclusionThe GCK smartphone app is a viable photoscreening device for the detection of amblyopia risk factors in children aged 1–6 years.

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Section: Discussionmentioning

confidence: 99%

Evaluation of a smartphone photoscreening app to detect refractive amblyopia risk factors in children aged 1–6 years

Arnold¹,

O’Neil²,

Cooper³

et al. 2018

OPTH

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“…This application has been studied for photoscreening and detecting amblyopia risk factors, but not for checking visual acuity. 30 , 31 , 32 This study was approved by the Institutional Review Board in December 2018 with the goal of exploring a family member checking a child’s visual acuity.…”

Section: Introductionmentioning

confidence: 99%

Teleophthalmology: Evaluation of Phone-based Visual Acuity in a Pediatric Population

Silverstein

Williams

Brown

et al. 2021

American Journal of Ophthalmology

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: Purpose With the recent rise of teleophthalmology due to coronavirus disease, we are in need of accurate and reliable methods of checking visual acuity remotely. We compare the visual acuity as measured by the GoCheck Kids application, HOTV with the amblyopia treatment study (ATS), and our clinic protocol. Design This is a prospective, comparison of visual acuity assessment methods. Methods Established patients (aged 3-18) in the practice of a single pediatric ophthalmologist were eligible. Visual acuity was measured by: 1) GoCheck Kids mobile application (by patient’s family member), 2) HOTV-ATS (by study personnel), and 3) regular clinic protocol (by ophthalmic technician). To assess agreement between measures of acuity, intraclass correlations with 95% confidence intervals were computed. Results Fifty-three children participated. The mean difference between GoCheck Kids and HOTV-ATS acuities (0.094) was significantly different (p<0.001); the intraclass correlation (ICC) was 0.55 (95% CI: 0.40, 0.68). The mean difference between GoCheck Kids and chart acuities (0.010) was not significantly different (p=0.319); ICC: 0.59 (95% CI: 0.45, 0.71). The mean difference between HOTV-ATS and chart acuities (0.084) was significantly different (p<0.001); ICC: 0.66 (95% CI: 0.53, 0.76). The percent of eyes with visual acuity as measured by GoCheck Kids that was within 1 line of the HOTV-ATS and chart acuity was 65.3% and 86.7%, respectively. Conclusions GoCheck Kids as checked by a family member provides a modest correlation of visual acuity compared to the chart screen and a fair correlation of visual acuity compared to HOTV-Amblyopia Treatment Study protocol, though a vast majority are within 1 line.

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“…In another study of the Spot screener in detecting strabismus, this time in a pediatric ophthalmology office, sensitivity of (77 and 93%) were reported [25], but it should be noted that intermittent cases were not considered as positive in that study, which likely inflates the values. A prior study of the GoCheckKids app was similar to this study only in that it was also deployed on a phone, but used the automated Bruckner method, and was conducted in a different age group (ages 6 months-6 years) finding the sensitivity of (74.6%) and specificity of (67.2%) for comparison [26]. The Plusoptix photoscreener is also used for detecting strabismus in children (2-14 years) with the sensitivity (40.7%) and specificity (98.3%) respectively [27].…”

Section: Discussion Of the 1 Case Of Strabismus Missedmentioning

confidence: 98%

A smartphone ocular alignment measurement app in school screening for strabismus

et al. 2021

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Background Strabismus is the leading risk factor for amblyopia, which should be early detected for minimized visual impairment. However, traditional school screening for strabismus can be challenged due to several factors, most notably training, mobility and cost. The purpose of our study is to evaluate the feasibility of using a smartphone application in school vision screening for detection of strabismus. Methods The beta smartphone application, EyeTurn, can measure ocular misalignment by computerized Hirschberg test. The application was used by a school nurse in a routine vision screening for 133 elementary school children. All app measurements were reviewed by an ophthalmologist to assess the rate of successful measurement and were flagged for in-person verification with prism alternating cover test (PACT) using a 2.4Δ threshold (root mean squared error of the app). A receiver operating characteristic (ROC) curve was used to determine the best sensitivity and specificity for an 8Δ threshold (recommended by AAPOS) with the PACT measurement as ground truth. Results The nurse obtained at least one successful app measurement for 93% of children (125/133). 40 were flagged for PACT, of which 6 were confirmed to have strabismus, including 4 exotropia (10△, 10△, 14△ and 18△), 1 constant esotropia (25△) and 1 accommodative esotropia (14△). Based on the ROC curve, the optimum threshold for the app to detect strabismus was determined to be 3.0△, with the best sensitivity (83.0%), specificity (76.5%). With this threshold the app would have missed one child with accommodative esotriopia, whereas conventional screening missed 3 cases of intermittent extropia. Conclusions Results support feasibility of use of the app by personnel without professional training in routine school screenings to improve detection of strabismus.

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Effectiveness of the GoCheck Kids Vision Screener in Detecting Amblyopia Risk Factors

Cited by 44 publications

References 14 publications

Evaluation of a smartphone photoscreening app to detect refractive amblyopia risk factors in children aged 1–6 years

Evaluation of a smartphone photoscreening app to detect refractive amblyopia risk factors in children aged 1–6 years

Teleophthalmology: Evaluation of Phone-based Visual Acuity in a Pediatric Population

A smartphone ocular alignment measurement app in school screening for strabismus

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Effectiveness of the GoCheck Kids Vision Screener in Detecting Amblyopia Risk Factors

Cited by 44 publications

References 14 publications

Evaluation of a smartphone photoscreening app to detect refractive amblyopia risk factors in children aged 1&ndash;6 years

Evaluation of a smartphone photoscreening app to detect refractive amblyopia risk factors in children aged 1&ndash;6 years

Teleophthalmology: Evaluation of Phone-based Visual Acuity in a Pediatric Population

A smartphone ocular alignment measurement app in school screening for strabismus

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Product

Resources

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Evaluation of a smartphone photoscreening app to detect refractive amblyopia risk factors in children aged 1–6 years

Evaluation of a smartphone photoscreening app to detect refractive amblyopia risk factors in children aged 1–6 years