Bušić Mladen, Bjeloš Mirjana, Petrovečki Mladen, Kuzmanović Elabjer Biljana, Bosnar Damir, Ramić Senad, Miletić Daliborka, Andrijašević Lidija, Kondža Krstonijević Edita, Jakovljević Vid, Bišćan Tvrdi Ana, Predović Jurica, Kokot Antonio, Bišćan Filip, Kovačević Ljubić Mirna, Motušić Aras Ranka
Mirjana Bjeloš, University Eye Clinic, University Hospital "Sveti Duh", Sveti Duh 64, Zagreb, Croatia,
Croat Med J. 2016 Feb;57(1):29-41. doi: 10.3325/cmj.2016.57.29.
To present and evaluate a new screening protocol for amblyopia in preschool children.
Zagreb Amblyopia Preschool Screening (ZAPS) study protocol performed screening for amblyopia by near and distance visual acuity (VA) testing of 15 648 children aged 48-54 months attending kindergartens in the City of Zagreb County between September 2011 and June 2014 using Lea Symbols in lines test. If VA in either eye was >0.1 logMAR, the child was re-tested, if failed at re-test, the child was referred to comprehensive eye examination at the Eye Clinic.
78.04% of children passed the screening test. Estimated prevalence of amblyopia was 8.08%. Testability, sensitivity, and specificity of the ZAPS study protocol were 99.19%, 100.00%, and 96.68% respectively.
The ZAPS study used the most discriminative VA test with optotypes in line as they do not underestimate amblyopia. The estimated prevalence of amblyopia was considerably higher than reported elsewhere. To the best of our knowledge, the ZAPS study protocol reached the highest sensitivity and specificity when evaluating diagnostic accuracy of VA tests for screening. The pass level defined at ≤0.1 logMAR for 4-year-old children, using Lea Symbols in lines missed no amblyopia cases, advocating that both near and distance VA testing should be performed when screening for amblyopia.
介绍并评估一种针对学龄前儿童弱视的新筛查方案。
萨格勒布弱视学龄前筛查（ZAPS）研究方案，于2011年9月至2014年6月期间，采用利雅线条视力表，对萨格勒布县市内15648名年龄在48 - 54个月的幼儿园儿童进行了近视力和远视力测试，以筛查弱视。若任一眼睛的视力>0.1 logMAR，则对该儿童进行重新测试，若重新测试仍未通过，则将该儿童转至眼科诊所进行全面眼部检查。
78.04%的儿童通过了筛查测试。弱视的估计患病率为8.08%。ZAPS研究方案的可测试性、敏感性和特异性分别为99.19%、100.00%和96.68%。
ZAPS研究使用了最具鉴别力的视力测试方法，即线条视标，因为它们不会低估弱视情况。弱视的估计患病率明显高于其他地方的报道。据我们所知，ZAPS研究方案在评估视力测试用于筛查的诊断准确性时，达到了最高的敏感性和特异性。对于4岁儿童，使用利雅线条视力表将通过水平定义为≤0.1 logMAR时，没有漏诊任何弱视病例，这表明在筛查弱视时应同时进行近视力和远视力测试。
