Performance of Spot Photoscreener in Detecting Amblyopia Risk Factors in Chinese Pre-school and School Age Children Attending an Eye Clinic

Abstract

PurposeTo evaluate the effectiveness of Spot photoscreener in detecting amblyopia risk factors meeting 2013 the American Association of Pediatric Ophthalmology and Strabismus (AAPOS) criteria in Chinese preschool and school-age children.MethodsOne hundred and fifty-five children (310 eyes), aged between 4 to 7 years (5.74 ± 1.2 years) underwent complete ophthalmologic examination, photoscreening, and cycloplegic retinoscopy refraction. The agreement of the results obtained with the photoscreening and retinoscopy was evaluated by linear regression and Bland-Altman plots. The sensitivity and specificity of detecting amblyopia risk factors were calculated based on the AAPOS 2013 guidelines. The overall effectiveness of detecting amblyopia risk factors was analyzed with Receiver Operating Characteristic (ROC) curves.ResultThe mean refractive errors measured with the Spot were: spherical equivalent (SE) = 0.70 ± 1.99 D, J0 = 0.87 ± 1.01 D, J45 = 0.09 ± 0.60 D. The mean results from retinoscopy were: SE = 1.19 ± 2.22 D, J0 = 0.77 ± 1.00 D, J45 = -0.02 ± 0.45 D. There was a strong linear agreement between results obtained from those two methods (R2 = 0.88, P<0.01). Bland–Altman plot indicated a moderate agreement of cylinder values between the two methods. Based on the criteria specified by the AAPOS 2013 guidelines, the sensitivity and specificity (in respective order) for detecting hyperopia were 98.31% and 97.14%; for detecting myopia were 78.50% and 88.64%; for detecting astigmatism were 90.91% and 80.37%; for detecting anisometropia were 93.10% and 85.25%; and for detection of strabismus was 77.55% and 88.18%.ConclusionThe refractive values measured from Spot photoscreener showed a moderate agreement with the results from cycloplegic retinoscopy refraction, however there was an overall myopic shift of -0.49D. The performance in detecting individual amblyopia risk factors was satisfactory, but could be further improved by optimizing criteria based on ROC curves.

Compared performance of Spot and SW800 photoscreeners on Chinese children

“…However, paired t-test revealed that both the photoscreeners tend to measure the SE with a mild myopic shift, −0.17 D for Spot and −0.12 D for SW800. Studies from other groups also reported myopic shift of the measurements from photoscreeners such as Spot (−0.49 D),8 PlusOptix A09 (−0.52 to −0.57 D)18 19 and plusoptiX A12C (−0.45 D) 20. This less hyperopic measurement could be expected by the pupil dilation.…”

Evaluation of vision screening of 5–15‐year‐old children in three Tongan schools: comparison of The Auckland Optotypes and Lea symbols

“…Data here are reported at poorer than 0.3 logMAR, 0.5 logMAR and 1.0 logMAR and referrals were made for children having habitual visual acuity worse than 0.3 logMAR, to balance benefits of referrals with the limited eye‐care resources available in Tonga. Standard refractive error thresholds for screening were used for reporting and referral (astigmatism > 1.50 D, hyperopia > 3.50 D, anisometropia > 1.50 D, myopia < −1.50 D), as well as device‐specific adjusted refractive cut‐offs recently recommended (astigmatism > 1.25 D, hyperopia > 2.375 D, anisometropia > 1.125 D, myopia < −2.00 D) …”

Diagnostic test accuracy of Spot and Plusoptix photoscreeners in detecting amblyogenic risk factors in children: a systemic review and meta‐analysis

“…There were two articles without full text and most of them were recorded in the Embase database exclusively. After detailed assessment with eligibility criteria, 21 publications with a total of 5022 subjects were included in the final meta‐analysis . Details of the 21 articles are summarised in Table .…”

“…Studies have made efforts to optimise the referral criteria to increase the test accuracy of the screener for various versions. 37,41,51 However, based on this metaanalysis (Figure 9), it is hard to tell significant differences in the performance across the software versions. Statistical analysis according to the software versions was not done because there are too many versions used across the included studies and very limited sample sizes for each version.…”

“…Also, the screeners’ software versions have different referral criteria. Studies have made efforts to optimise the referral criteria to increase the test accuracy of the screener for various versions . However, based on this meta‐analysis ( Figure ), it is hard to tell significant differences in the performance across the software versions.…”