Optom Vis Sci. 2005 May;82(5):432-438. doi: 10.1097/01.OPX.0000162660.14378.30.
To compare the sensitivity of 11 preschool vision screening tests administered by licensed eye care professionals for the detection of the 4 Vision in Preschoolers (VIP)-targeted vision disorders when specificity is 94%.
This study consisted of a sample (n = 2588) of 3- to 5-year-old children enrolled in Head Start programs, 57% of whom had failed an initial Head Start vision screening. Screening results from 11 tests were compared with results from a standardized comprehensive eye examination that was used to classify children with respect to the four VIP-targeted vision disorders: amblyopia, strabismus, significant refractive error, and unexplained reduced visual acuity (VA). With overall specificity set to 94%, we calculated the sensitivity for the detection of each targeted vision disorder.
With the overall specificity set to 94%, the most accurate tests for detection of amblyopia were noncycloplegic retinoscopy (NCR) (88% sensitivity), the SureSight Vision Screener (80%), and the Retinomax Autorefractor (78%). For detection of strabismus, the most accurate tests were the MTI Photoscreener (65%), the cover-uncover test (60%), the Stereo Smile II stereoacuity test (58%), the SureSight Vision Screener (54%), and the Retinomax Autorefractor (54% in year 1, 53% in year 2). The most accurate tests for detection of significant refractive error were NCR (74%), the Retinomax Autorefractor (66%), the SureSight Vision Screener (63%), and the Lea Symbols VA test (58%). For detection of reduced VA, the most accurate tests were the Lea Symbols Distance VA test (48%), the Retinomax Autorefractor (39%), and NCR (38%).
Similar to the previously reported results at 90% specificity, the screening tests vary widely in sensitivity with specificity set at 94%. The rankings of the sensitivities for detection of the 4 VIP-targeted vision disorders are similar to those with specificity set to 90%.
比较由持牌眼保健专业人员进行的11种学龄前视力筛查测试在特异性为94%时，对学龄前儿童视力问题（VIP）中4种目标视力障碍的检测敏感性。
本研究样本包括2588名3至5岁参加“启智计划”的儿童，其中57%的儿童在最初的“启智计划”视力筛查中未通过。将11项测试的筛查结果与标准化综合眼科检查结果进行比较，该检查用于对儿童的4种VIP目标视力障碍进行分类：弱视、斜视、显著屈光不正和不明原因的视力下降（VA）。将总体特异性设定为94%，我们计算了每种目标视力障碍的检测敏感性。
将总体特异性设定为94%时，检测弱视最准确的测试是非散瞳视网膜检影法（NCR）（敏感性88%）、SureSight视力筛查仪（80%）和Retinomax自动验光仪（78%）。对于斜视检测，最准确的测试是MTI照片筛查仪（65%）、遮盖-去遮盖试验（60%）、Stereo Smile II立体视锐度测试（58%）、SureSight视力筛查仪（54%）和Retinomax自动验光仪（第1年为54%，第2年为53%）。检测显著屈光不正最准确的测试是NCR（74%）、Retinomax自动验光仪（66%）、SureSight视力筛查仪（63%）和Lea符号视力测试（58%）。对于视力下降检测，最准确的测试是Lea符号远距离视力测试（48%）、Retinomax自动验光仪（39%）和NCR（38%）。
与之前报道的特异性为90%时的结果相似，当特异性设定为94%时，筛查测试的敏感性差异很大。检测4种VIP目标视力障碍的敏感性排名与特异性设定为90%时相似。
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