Ransbarger Kristiane M, Dunbar Jennifer A, Choi So Eun, Khazaeni Leila M
Department of Ophthalmology, Loma Linda University , Loma Linda, California.
J AAPOS. 2013 Oct;17(5):516-20. doi: 10.1016/j.jaapos.2013.06.013.
To describe the results of vision screenings performed with the Spot photoscreener in the community setting.
Low-income, predominantly Hispanic children in day care and preschool settings were screened by lay operators using the Spot photoscreener. Inclusion criteria were age 6-72 months and availability of a complete photoscreening record. Referral criteria were based on Vision Screening Committee of American Association for Pediatric Ophthalmology and Strabismus guidelines. Data were stratified by age group and analyzed for percentage of children referred for hyperopia, myopia, astigmatism, anisometropia, anisocoria, and ocular misalignment. Vision screening records were compared with comprehensive eye examination records from an optometrist or ophthalmologist to determine positive predictive value.
Vision screening examinations were performed on 8,317 subjects from September 2011 through May 2012. The mean age of the 7,814 subjects (3953 males) meeting inclusion criteria was 44.4 months. The Spot referred 2,393 (30.6%). Of the screened population, the suspected reason for referral was astigmatism in 1,863 (23.8%), ocular misalignment in 879 (11.3%), anisometropia in 90 (1.2%), myopia in 82 (1.1%), hyperopia in 63 (0.8%), and anisocoria in 16 (0.2%). Comprehensive examination reports, including a cycloplegic refraction, were available for 300 referred children (12.5%). The reason for referral was confirmed in 55.7%, with an overall positive predictive value of 65.7%.
The Spot photoscreener yielded a high overall referral rate. Although a high prevalence of astigmatism may be expected in this population, a high referral rate for suspected ocular misalignment led to a very high proportion of false positive referrals, suggesting that the software for this algorithm is in need of refinement.
描述在社区环境中使用Spot视力筛查仪进行视力筛查的结果。
由非专业操作人员使用Spot视力筛查仪对日托和学前班环境中的低收入、以西班牙裔为主的儿童进行筛查。纳入标准为年龄6 - 72个月且有完整的视力筛查记录。转诊标准基于美国小儿眼科与斜视协会视力筛查委员会的指南。数据按年龄组分层，并分析转诊的远视、近视、散光、屈光参差、瞳孔不等大和眼位不正儿童的百分比。将视力筛查记录与验光师或眼科医生的全面眼科检查记录进行比较，以确定阳性预测值。
2011年9月至2012年5月期间对8317名受试者进行了视力筛查检查。符合纳入标准的7814名受试者（3953名男性）的平均年龄为44.4个月。Spot视力筛查仪转诊了2393名（30.6%）。在筛查人群中，转诊的疑似原因是散光1863名（23.8%）、眼位不正879名（11.3%）、屈光参差90名（1.2%）、近视82名（1.1%）远视63名（0.8%）、瞳孔不等大16名（0.2%）。300名转诊儿童（12.5%）有包括睫状肌麻痹验光在内的全面检查报告。转诊原因在55.7%的病例中得到证实，总体阳性预测值为65.7%。
Spot视力筛查仪总体转诊率较高。虽然预计该人群中散光患病率较高，但疑似眼位不正的高转诊率导致假阳性转诊比例非常高，这表明该算法的软件需要改进。
