Effectiveness of the Spot Vision Screener using updated 2021 AAPOS guidelines.

Autor: Peterseim MMW; Medical University of South Carolina, Charleston, South Carolina. Electronic address: petersem@musc.edu., Trivedi RH; Medical University of South Carolina, Charleston, South Carolina., Monahan SR; Medical University of South Carolina, Charleston, South Carolina., Smith SM; Medical University of South Carolina, Charleston, South Carolina., Bowsher JD; Medical University of South Carolina, Charleston, South Carolina., Alex A; Medical University of South Carolina, Charleston, South Carolina., Wilson ME; Medical University of South Carolina, Charleston, South Carolina., Wolf BJ; Medical University of South Carolina, Charleston, South Carolina.
Jazyk: angličtina
Zdroj: Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus [J AAPOS] 2023 Feb; Vol. 27 (1), pp. 24.e1-24.e7. Date of Electronic Publication: 2023 Jan 13.
DOI: 10.1016/j.jaapos.2022.11.019
Abstrakt: Purpose: To evaluate the Spot Vision Screener according to updated 2021 AAPOS Vision Screening Committee guidelines for instrument-based pediatric vision screen validation.
Methods: As part of an IRB-approved ongoing prospective study, children were screened with the Spot prior to a complete examination.
Results: Spot screening was successful in 1,036 of 1,090 children (95%). Forty-eight percent of participants were referred for further screening using the Spot manufacturer guidelines, and 40% of all children were found to have a 2021 amblyopia risk factor or visually significant refractive error by gold standard examination. The Spot recommendation compared reasonably well to the 2021 criteria, with an overall sensitivity of 0.88 and a specificity of 0.78. Applying updated guidelines to the Spot for hyperopia, anisometropia, and astigmatism yielded moderate-to-poor sensitivity (0.27-0.77) but excellent specificity (>0.9). The area under the curve of the receiver operating characteristic analysis demonstrates overall good prediction performance for the Spot for each diagnosis-myopia, hyperopia, astigmatism, anisometropia (range, 0.87-0.97). Results of our study suggest increasing the instrument referral criterion for astigmatism from 1.5 D (manufacturer thresholds of the screener used in this study) to 2 D in older children. Decreasing the anisometropia cut-off from 1 D to 0.75 D would improve sensitivity from 0.59 to >0.8.
Conclusions: In our study population, the overall predictive ability of the Spot is good, with a sensitivity of 0.88 and a specificity of 0.78. We recommend specific device refractive referral criteria to maximize screening effectiveness using the updated AAPOS guidelines.
(Copyright © 2023. Published by Elsevier Inc.)
Databáze: MEDLINE
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