McCurry T Christopher, Lawrence Linda M, Wilson M Edward, Mayo Liliana
Medical University of South Carolina, College of Medicine, Charleston, South Carolina 29203, USA.
J AAPOS. 2013 Aug;17(4):374-7. doi: 10.1016/j.jaapos.2013.05.006. Epub 2013 Aug 6.
Children with autism and related disorders reportedly have an increased prevalence (40%) of ocular disorders, and comprehensive eye examinations by a pediatric ophthalmologist are recommended. Examinations can be very time consuming, expensive, and stressful for the child. A photoscreener such as the plusoptiX S08 may be a cost-effective, time-saving, and less invasive method for testing patients with autism. The purpose of this study was to determine the efficacy of photoscreening with the plusoptiX S08 in detecting amblyopia risk factors in children with autism.
Photoscreening and complete ophthalmologic examinations were performed on 43 children with autism. Prevalence, sensitivity, specificity, positive predictive value, and negative predictive value were calculated using ophthalmologic examination as the gold standard.
The gold standard examination used American Association for Pediatric Ophthalmology and Strabismus Vision Screening Committee guidelines for the definition of amblyopia risk factors. The plusoptiX S08 referred 29 (67%) of 43 children. On examination, 16 patients (37%) had amblyopia risk factors. The plusoptiX S08 had a sensitivity of 94% (95% CI, 0.68-0.99). The specificity was 48% (95% CI, 0.29-0.68), the positive predictive value was 52% (95% CI, 0.33-0.70), and the negative predictive value was 93% (95% CI, 0.64-0.99).
The plusoptiX S08 is sensitive but less specific at detecting treatable ocular conditions in children with autism. The majority of children with autism and amblyopia risk factors were detected on screening; however, about half of all referrals had no amblyopia risk factors. The plusoptiX S08 reduced the need for a full examination in one-third of the children screened.
据报道，患有自闭症及相关疾病的儿童眼部疾病患病率有所增加（40%），因此建议由小儿眼科医生进行全面的眼部检查。此类检查可能非常耗时、昂贵，且会给孩子带来压力。像plusoptiX S08这样的照片筛选仪可能是一种经济高效、节省时间且侵入性较小的方法，用于检测自闭症患者。本研究的目的是确定使用plusoptiX S08进行照片筛选在检测自闭症儿童弱视危险因素方面的有效性。
对43名自闭症儿童进行了照片筛选和全面的眼科检查。以眼科检查作为金标准，计算患病率、敏感性、特异性、阳性预测值和阴性预测值。
金标准检查采用美国小儿眼科与斜视学会视力筛查委员会关于弱视危险因素定义的指南。plusoptiX S08对43名儿童中的29名（67%）进行了转诊。经检查，16名患者（37%）存在弱视危险因素。plusoptiX S08的敏感性为94%（95%置信区间，0.68 - 0.99）。特异性为48%（95%置信区间，0.29 - 0.68），阳性预测值为52%（95%置信区间，0.33 - 0.70），阴性预测值为93%（95%置信区间，0.64 - 0.99）。
plusoptiX S08在检测自闭症儿童可治疗的眼部疾病方面具有敏感性，但特异性较低。大多数患有自闭症且有弱视危险因素的儿童在筛查中被检测出来；然而，所有转诊儿童中约有一半没有弱视危险因素。plusoptiX S08减少了三分之一接受筛查儿童进行全面检查的需求。
