To determine the sensitivity and specificity of using a computer photoscreener and non cycloplegic retinoscopy in the detection of amblyopiogenic factors in nine to fifty months old infants and children Methods Th...To determine the sensitivity and specificity of using a computer photoscreener and non cycloplegic retinoscopy in the detection of amblyopiogenic factors in nine to fifty months old infants and children Methods Three hundred children, nine to fifty months old, were screened with the computer photoscreener and non cycloplegic retinoscopy With a blinded standardized clinical assessment as the standard, an overall comparison of the sensitivity of and specificity results obtained with the two techniques was made Photoscreen images on the computer monitor screen were reviewed and analyzed immediately by two independent observers for indicators of amblyopiogenic risk factors Simultaneously, the results were compared to the findings of a full ophthalmologic examination Results The computer photoscreener revealed a sensitivity of 94 6% and specificity of 90 1%, and the non cycloplegic retinocopy revealed a sensitivity of 85 7% and specificity of 81 0% for the detection of amblyopiogenic risk factors, including hyperopia (+2 75 D or more), myopia (-1 50 D or more), astigmatism (1 75 D or more), anisometropia (2 00 D or more), ocular misalignment (5 degrees or more), and media opacity (1 5?mm or more) Conclusions The computer photoscreener offers an opportunity to identify problems that limit vision, and could provide a feasible and sufficiently reliable screening technique in infants and preschool children to be screened successfully for amblyopiogenic risk factors展开更多
Objective: To assess current practices, attitudes, and perceived barriers toward pediatric vision screening. Patients and Methods: A link to a 9-question survey was electronically distributed to a national sample of 6...Objective: To assess current practices, attitudes, and perceived barriers toward pediatric vision screening. Patients and Methods: A link to a 9-question survey was electronically distributed to a national sample of 6000 pediatricians through Medical Marketing Services Inc. Data were collected using Survey Monkey. Results: Email open rate was 11%;37% of those who opened the email responded (225 respondents). Over ninety percent of respondents perform some type of vision screening at least yearly, although age at which screening began varied, with two thirds of respondents instituting formal vision screening after three years. Fifty eight percent of respondents were either extremely unsatisfied, unsatisfied or only somewhat satisfied with their current screening method. Preferred methods of screening and confidence of pediatricians in their ability to detect pathology varied for children under versus over age three. The least frequently used methods for all age groups were autorefraction and photoscreening. The most commonly reported barriers to screening were inadequate training (48%), time required for exam (42%), and inadequate reimbursement (32%). Conclusions: Perceived barriers to vision screening in the pediatrician office have been previously identified, and photoscreening and autorefraction have been identified as a possible means to circumvent them. In spite of the addition of new procedural codes, pediatricians continue to report similar barriers to screening.展开更多
Purpose: To compare the accuracy of plusoptiX A08 photoscreener (PPS) and iScreen 3000 photoscreener (IPS) in objectively screening for amblyopic risk factors in children age 5 months to 13 years old. Methods: Cross-s...Purpose: To compare the accuracy of plusoptiX A08 photoscreener (PPS) and iScreen 3000 photoscreener (IPS) in objectively screening for amblyopic risk factors in children age 5 months to 13 years old. Methods: Cross-sectional study of 148 children who received photoscreenings via PPS and IPS and a comprehensive pediatric ophthalmic examination in our office. Patients were considered to have amblyogenic risk factors based on the AAPOS referral criteria guidelines. Results: 45 percent of patients undergoing a pediatric ophthalmology examination were found to have amblyopia or amblyogenic risk factors. In this study, PPS demonstrated an overall sensitivity of 75.4%, specificity of 68.0%, positive predictive value (PPV) of 67.1%, and negative predictive value (NPV) of 76.1%. However, IPS photoscreener had an overall sensitivity of 66.2%, specificity of 87.6%, PPV of 81.8%, and NPV of 75.5%. Discussion: The accuracy of PPS and IPS was compared in different age groups. The sensitivity and specificity were analyzed according to varied amblyogenic risk factors. The statistic results of this study were compared to those of previous studies, including Vision in Preschoolers (VIP) Study and the Iowa PhotoScreening Program. Conclusion: PPS and IPS proved to be useful tools in the objective vision screening in children. PPS was found to have a higher sensitivity, and IPS showed a higher specificity and PPV in detecting amblyopic risk factors. In conclusion, one device may be more beneficial over the other, depending on the patient population and office settings.展开更多
Background:Accurate refractive assessment in children and young adults is critical to prevent amblyopia and strabismus,conditions that may arise from uncorrected hyperopia.Although non-cycloplegic autorefractors and p...Background:Accurate refractive assessment in children and young adults is critical to prevent amblyopia and strabismus,conditions that may arise from uncorrected hyperopia.Although non-cycloplegic autorefractors and photoscreeners are increasingly used for vision screening due to their practicality and high testability,residual accommodation often introduces systematic measurement bias.The debate regarding the necessity of cycloplegia has intensified,particularly in large-scale epidemiological studies and screening programs,highlighting the need for an evidence-based synthesis.Methods:This systematic review and meta-analysis,conducted according to PRISMA and AMSTAR-2 standards and registered in PROSPERO(CRD420251134665),synthesized data from 54 comparative studies,with 24 included in quantitative analyses.Results:Compared with cycloplegic reference methods,non-cycloplegic autorefractors and photoscreeners consistently underestimated refractive error,showing pooled mean differences of-0.65 D(95%CI:-0.84 to-0.45;95%PI:-1.50 to+0.20 D)and-0.78 D(95%CI:-1.12 to-0.44;95%PI:-1.70 to+0.10 D),respectively.These prediction intervals illustrate the wide variability expected across future studies and populations.The bias was most pronounced in younger children and hyperopic eyes,reflecting the impact of accommodative tone.Despite device-specific differences,no method fully corrected this systematic error.Testability exceeded 95%across most devices,reinforcing their feasibility for population-level screening.However,the certainty of evidence was rated as low due to heterogeneity and observational design limitations.Conclusions:Non-cycloplegic methods systematically underestimate hyperopia and therefore cannot replace cycloplegia for definitive diagnosis or spectacle prescription in pediatric populations.Cycloplegic assessment remains essential to detect amblyogenic refractive errors accurately.Non-cycloplegic methods may be integrated into large-scale screening programs for initial case detection,but positive or borderline cases must undergo cycloplegic confirmation to ensure safe and effective clinical management.展开更多
基金This work was supported in part by the 863 Hi tech Plan of China(No Z19-01-04 02).
文摘To determine the sensitivity and specificity of using a computer photoscreener and non cycloplegic retinoscopy in the detection of amblyopiogenic factors in nine to fifty months old infants and children Methods Three hundred children, nine to fifty months old, were screened with the computer photoscreener and non cycloplegic retinoscopy With a blinded standardized clinical assessment as the standard, an overall comparison of the sensitivity of and specificity results obtained with the two techniques was made Photoscreen images on the computer monitor screen were reviewed and analyzed immediately by two independent observers for indicators of amblyopiogenic risk factors Simultaneously, the results were compared to the findings of a full ophthalmologic examination Results The computer photoscreener revealed a sensitivity of 94 6% and specificity of 90 1%, and the non cycloplegic retinocopy revealed a sensitivity of 85 7% and specificity of 81 0% for the detection of amblyopiogenic risk factors, including hyperopia (+2 75 D or more), myopia (-1 50 D or more), astigmatism (1 75 D or more), anisometropia (2 00 D or more), ocular misalignment (5 degrees or more), and media opacity (1 5?mm or more) Conclusions The computer photoscreener offers an opportunity to identify problems that limit vision, and could provide a feasible and sufficiently reliable screening technique in infants and preschool children to be screened successfully for amblyopiogenic risk factors
文摘Objective: To assess current practices, attitudes, and perceived barriers toward pediatric vision screening. Patients and Methods: A link to a 9-question survey was electronically distributed to a national sample of 6000 pediatricians through Medical Marketing Services Inc. Data were collected using Survey Monkey. Results: Email open rate was 11%;37% of those who opened the email responded (225 respondents). Over ninety percent of respondents perform some type of vision screening at least yearly, although age at which screening began varied, with two thirds of respondents instituting formal vision screening after three years. Fifty eight percent of respondents were either extremely unsatisfied, unsatisfied or only somewhat satisfied with their current screening method. Preferred methods of screening and confidence of pediatricians in their ability to detect pathology varied for children under versus over age three. The least frequently used methods for all age groups were autorefraction and photoscreening. The most commonly reported barriers to screening were inadequate training (48%), time required for exam (42%), and inadequate reimbursement (32%). Conclusions: Perceived barriers to vision screening in the pediatrician office have been previously identified, and photoscreening and autorefraction have been identified as a possible means to circumvent them. In spite of the addition of new procedural codes, pediatricians continue to report similar barriers to screening.
文摘Purpose: To compare the accuracy of plusoptiX A08 photoscreener (PPS) and iScreen 3000 photoscreener (IPS) in objectively screening for amblyopic risk factors in children age 5 months to 13 years old. Methods: Cross-sectional study of 148 children who received photoscreenings via PPS and IPS and a comprehensive pediatric ophthalmic examination in our office. Patients were considered to have amblyogenic risk factors based on the AAPOS referral criteria guidelines. Results: 45 percent of patients undergoing a pediatric ophthalmology examination were found to have amblyopia or amblyogenic risk factors. In this study, PPS demonstrated an overall sensitivity of 75.4%, specificity of 68.0%, positive predictive value (PPV) of 67.1%, and negative predictive value (NPV) of 76.1%. However, IPS photoscreener had an overall sensitivity of 66.2%, specificity of 87.6%, PPV of 81.8%, and NPV of 75.5%. Discussion: The accuracy of PPS and IPS was compared in different age groups. The sensitivity and specificity were analyzed according to varied amblyogenic risk factors. The statistic results of this study were compared to those of previous studies, including Vision in Preschoolers (VIP) Study and the Iowa PhotoScreening Program. Conclusion: PPS and IPS proved to be useful tools in the objective vision screening in children. PPS was found to have a higher sensitivity, and IPS showed a higher specificity and PPV in detecting amblyopic risk factors. In conclusion, one device may be more beneficial over the other, depending on the patient population and office settings.
基金This systematic review and meta-analysis was registered in PROSPERO(registration number:[CRD420251134665])。
文摘Background:Accurate refractive assessment in children and young adults is critical to prevent amblyopia and strabismus,conditions that may arise from uncorrected hyperopia.Although non-cycloplegic autorefractors and photoscreeners are increasingly used for vision screening due to their practicality and high testability,residual accommodation often introduces systematic measurement bias.The debate regarding the necessity of cycloplegia has intensified,particularly in large-scale epidemiological studies and screening programs,highlighting the need for an evidence-based synthesis.Methods:This systematic review and meta-analysis,conducted according to PRISMA and AMSTAR-2 standards and registered in PROSPERO(CRD420251134665),synthesized data from 54 comparative studies,with 24 included in quantitative analyses.Results:Compared with cycloplegic reference methods,non-cycloplegic autorefractors and photoscreeners consistently underestimated refractive error,showing pooled mean differences of-0.65 D(95%CI:-0.84 to-0.45;95%PI:-1.50 to+0.20 D)and-0.78 D(95%CI:-1.12 to-0.44;95%PI:-1.70 to+0.10 D),respectively.These prediction intervals illustrate the wide variability expected across future studies and populations.The bias was most pronounced in younger children and hyperopic eyes,reflecting the impact of accommodative tone.Despite device-specific differences,no method fully corrected this systematic error.Testability exceeded 95%across most devices,reinforcing their feasibility for population-level screening.However,the certainty of evidence was rated as low due to heterogeneity and observational design limitations.Conclusions:Non-cycloplegic methods systematically underestimate hyperopia and therefore cannot replace cycloplegia for definitive diagnosis or spectacle prescription in pediatric populations.Cycloplegic assessment remains essential to detect amblyogenic refractive errors accurately.Non-cycloplegic methods may be integrated into large-scale screening programs for initial case detection,but positive or borderline cases must undergo cycloplegic confirmation to ensure safe and effective clinical management.
