Asare Afua Oteng, Malvankar-Mehta Monali S, Makar Inas
Lawson Health Research Institute, London, Ont; Ivey Eye Institute/Department of Ophthalmology, St. Joseph's Hospital, London, Ont; University of Toronto, Toronto, Ont.
Lawson Health Research Institute, London, Ont; Ivey Eye Institute/Department of Ophthalmology, St. Joseph's Hospital, London, Ont; Department of Epidemiology and Biostatistics, London, Ont.
Can J Ophthalmol. 2017 Oct;52(5):480-485. doi: 10.1016/j.jcjo.2017.02.002. Epub 2017 Mar 17.
Amblyopia is the leading cause of monocular vision impairment in children. Early intervention is critical to prevent permanent vision impairment. Preschool vision screening programs in Canada are limited. This study reports the initial results of a community-wide vision screening program for preschoolers using the Plusoptix S12C Photoscreener (Plusoptix Inc, Nuremburg, Germany).
Cross-sectional.
For this study, 1443 children aged 18-59 months were recruited and screened in various community settings in London, Ontario.
Participants were screened with the Plusoptix S12C device from September 2015 to May 2016. Data were analyzed for percentage of children referred for amblyogenic risk factors using the Arnold 2012 referral criteria. Referral, inconclusive results, follow-up rate, and positive predictive value were reported.
Data from 1321 children were analyzed. Mean age of children meeting the inclusion criteria was 34.1 ± 9.6 (18-58) months. One hundred and nineteen children were referred to an optometrist for a comprehensive eye exam; 39 (3.0%) were inconclusive screens. The referral rate for children detected with amblyogenic risk factors was 6.1%. Forty (50.0%) children were documented as complying with the follow-up examination. The positive predictive value was 81.8%.
Our community-wide vision screening program identified in a timely, manner, 80 preschoolers with amblyogenic risk factors previously unknown to be present. Results identified children with amblyogenic risk factors that may have gone undetected. This program could serve as a model for consideration by policy makers.
弱视是儿童单眼视力损害的主要原因。早期干预对于预防永久性视力损害至关重要。加拿大的学龄前视力筛查项目有限。本研究报告了一项使用Plusoptix S12C照片筛查仪(德国纽伦堡Plusoptix公司)对学龄前儿童进行社区范围视力筛查项目的初步结果。
横断面研究。
在本研究中,招募了1443名年龄在18至59个月的儿童,并在安大略省伦敦市的不同社区环境中进行筛查。
2015年9月至2016年5月期间,使用Plusoptix S12C设备对参与者进行筛查。根据阿诺德2012年的转诊标准,分析有弱视危险因素而被转诊儿童的百分比。报告转诊情况、结果不确定情况、随访率和阳性预测值。
对1321名儿童的数据进行了分析。符合纳入标准的儿童平均年龄为34.1±9.6(18 - 58)个月。119名儿童被转诊至验光师处进行全面眼科检查;39例(3.0%)筛查结果不确定。检测出有弱视危险因素儿童的转诊率为6.1%。记录显示40名(50.0%)儿童接受了随访检查。阳性预测值为81.8%。
我们的社区范围视力筛查项目及时发现了80名此前未知存在弱视危险因素的学龄前儿童。结果确定了可能未被发现的有弱视危险因素的儿童。该项目可作为政策制定者考虑的一个范例。