Instrument-based screening for amblyopia risk factors in a primary care setting in children aged 18 to 30 months

Muga, Mònica Vilà-de; Esso, Diego Van; Alarcon, Silvia; Wolley-Dod, Charlotte; Llop, Dolors; Callés, Anna; Ribas, Dàlia; Vilaró, Emma; Carreras, Montserrat; Gomez, Ronyt; Baez, Paula; Murias, Rut

doi:10.1007/s00431-020-03904-0

Cited by 4 publications

(9 citation statements)

References 20 publications

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“…Four studies [26][27][28]30 reported the motifs of referral. Astigmatism was the most common reason in 3 studies 26,27,30 while anisometropia was the main cause of referral in the other study. 28…”

Section: Screening Devices and Referral Resultsmentioning

confidence: 99%

“…We included 13 primary cross-sectional studies [18][19][20][21][22][23][24][25][26][27][28][29][30] published between 2001 and 2021. The number of children enrolled spanned between 404 and 42,149.…”

Section: Resultsmentioning

confidence: 99%

“…PlusOptix 20,24,26,28,29 and SPOT 21,22,25,27,30 was the most used device, followed by MTI 18,23,28 and Retinomax. 19 One study 28 used an MTI in the first years of screening that was subsequently replaced by PlusOptix for the remaining period.…”

Section: Screening Devices and Referral Resultsmentioning

confidence: 99%

“…The proportion of untestable children or in whom a result was inconclusive spanned between 0.3% and 31% and the calculated rate (Figure 2b) was 8% (95%CI: 3-15%; I 2 99.73%). Five studies 20,21,25,27,30 did not report this rate and could not be included in this quantitative analysis.…”

Section: Quantitative Analysismentioning

confidence: 99%

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Photoscreening for amblyopia risk factors assessment in young children: A systematic review with meta-analysis

Ferreira

Vieira

Maia

et al. 2022

European Journal of Ophthalmology

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Purpose Amblyopia is a leading cause of preventable and treatable vision loss in the pediatric population. Instrument-based screening of amblyopia-risk factors is being widely adopted but the audit of its results is still lacking. We sought to review the existing evidence regarding the outcomes of photoscreening applied to children under the age of three years. Methods A three-database search (Pubmed, ISI Web of Science, and Scopus) was performed from inception to March 2021. A meta-analysis of proportions was conducted to summarize the referral rate, untestable rate and positive predictive value (PPV). Results Thirteen studies were selected among 705 original abstracts. The quantitative analysis included twelve studies enrolling 64,041 children. Of these, 13% (95%CI: 7–19%) were referred for further confirmation of the screening result. Astigmatism was the most common diagnosis both after screening and after ophthalmologic assessment of referred children. The pooled untestable rate and PPV were 8% (95%CI: 3–15%) and 56% (95%CI: 40–71%), respectively. Conclusion There is no global consensus on the optimal age, frequency or what magnitude of refractive error must be considered an amblyopia-risk factor. Optimization of referral criteria is therefore warranted.

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Section: Screening Devices and Referral Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Screening Devices and Referral Resultsmentioning

confidence: 99%

Section: Quantitative Analysismentioning

confidence: 99%

See 2 more Smart Citations

Photoscreening for amblyopia risk factors assessment in young children: A systematic review with meta-analysis

Ferreira

Vieira

Maia

et al. 2022

European Journal of Ophthalmology

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“…Current screening methods based on a visual acuity chart may have limited accuracy due to children's poor cooperation and examiners' lack of experience ( 3 , 5 ). Instrument-based screening uses autorefraction or photorefraction, which identifies the presence and magnitude of refractive error instead of measuring visual acuity.…”

Section: Introductionmentioning

confidence: 99%

Instrument referral criteria for PlusoptiX and SureSight based on 2021 AAPOS guidelines: A population-based study

Yan

Qian

et al. 2022

Front. Public Health

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ObjectiveThe study aims to assess two refractive instrument-based methods of vision screening (SureSight and PlusoptiX) to detect refractive amblyopia risk factors (ARFs) and significant refractive errors in Chinese preschool children and to develop referral criteria according to the 2021 AAPOS guidelines.MethodsEye examinations were conducted in children aged 61 to 72 months (n = 1,173) using a PlusoptiX photoscreener, SureSight autorefractor, and cycloplegic retinoscopy (CR). The Vision Screening Committee of AAPOS's preschool vision screening guidelines from 2021 were adopted for comparison. Paired t-test analysis and Bland–Altman plots were used to assess the differences and agreement between the PlusoptiX photoscreener, SureSight autorefractor, and CR. In addition, the validity of the cut-off values of the several ARFs measured with the SureSight and PlusoptiX was estimated using receiver operating characteristic (ROC) curves and compared to the age-based 2021 AAPOS examination failure levels.ResultsA total of 1,173 children were tested with comprehensive eye examinations. When the referral numbers based on the 2013 (43/3.67%) and 2021 (42/3.58%) AAPOS guidelines were compared, significant differences between the values of astigmatism (72.09 vs. 52.38%) and anisometropia (11.63 vs. 38.10%) were found. The 95% limits of agreement (LOA) of the spherical value and the cylindrical value between PlusoptiX and CR were 95.08 and 96.29%. It was 93.87 and 98.10% between SureSight and CR. Considering refractive failure levels, the ROC curves obtained the optimal cut-off points. However, the PlusoptiX and the SureSight showed lower efficiency in hyperopia (Youden index, 0.60 vs. 0.83) and myopia (Youden index, 078 vs. 0.93), respectively. After adjusting the above cut-off points, the optimized NES (Nanjing Eye Study) referral criteria for myopia, hyperopia, astigmatism, and anisometropia were –0.75, 1.25, –1.0, and 0.5 with PlusoptiX and –1.25, 2.75, –1.5, and 0.75 with SureSight.ConclusionsSureSight and PlusoptiX showed a good correlation with CR and could effectively detect refractive ARFs and visually significant refractive errors. There were obvious advantages in detecting hyperopia using SureSight and myopia using PlusoptiX. We proposed instrumental referral criteria for age-based preschool children based on AAPOS 2021 guidelines.

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Characteristics of refractive development in children aged 4 months to 8 years in urban China: A retrospective screening analysis

Yan,

Xia,

Zhang

et al. 2024

Ophthalmic Physiologic Optic

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PurposeTo conduct a large retrospective study of screening refractive error in young children.MethodsThis retrospective study included children aged from 4 months to 8 years in Daxing District, Beijing, who underwent refractive examinations without cycloplegia. It included a cross‐sectional assessment of refractive error screening for all children, and a longitudinal component for a subgroup with data available for two to five visits.ResultsA total of 14,987 children were included in the cross‐sectional study. In the group <1 year of age, the percentage of children with a spherical equivalent (SE) >+2.00 D or with cylinder <−1.50 D was 15.25% and 33.24%, respectively. These were significantly higher than for the 1‐ to 4‐year‐old group (SE 8.1% higher, cylinder 13.2% higher) (χ2 = 53.57, p < 0.001; χ2 = 790.39, p < 0.001). Furthermore, 34.83% of children in the 0‐year‐old group had amblyopia risk factors (ARFs). In the 4‐year‐old group, boys had a significantly longer axial length (AL) than girls (differences in the right and left eyes were 0.53 and 0.56 mm, respectively; z = 5.48 p < 0.001, z = 5.80, p < 0.001). AL increased with age, while the AL difference between boys and girls remained stable at 4–8 years of age. The percentage of children aged 5–8 years with myopia in 2020–2021 was significantly higher than that in 2018–2019 (H = 12.44, p = 0.006). In the longitudinal study of 4406 children (up to 12‐month follow‐up), annual changes in SE were −0.27, −0.06, 0.19 and 0.13 D between 0 and 3 years, and −0.38, −0.58, −0.70 and −0.75 D between 5 and 8 years.ConclusionsChildren's refractive error varied significantly from ages 4 months to 1 year, with a high proportion having ARFs. Children aged 5–8 years showed a trend towards myopia. The prevalence of myopia in the cross‐sectional analysis in 2020–2021 was greater than in 2018–2019. Screening refraction changed minimally over a 12‐month period for children aged 1–3 years, but became more myopic for children aged 5–8 years.

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Instrument-based screening for amblyopia risk factors in a primary care setting in children aged 18 to 30 months

Cited by 4 publications

References 20 publications

Photoscreening for amblyopia risk factors assessment in young children: A systematic review with meta-analysis

Photoscreening for amblyopia risk factors assessment in young children: A systematic review with meta-analysis

Instrument referral criteria for PlusoptiX and SureSight based on 2021 AAPOS guidelines: A population-based study

Characteristics of refractive development in children aged 4 months to 8 years in urban China: A retrospective screening analysis

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