Kinori Michael, Molina Iliana, Hernandez Eric O, Robbins Shira L, Granet David B, Coleman Anne L, Brown Stuart I
a The Goldschleger Eye Institute, Sheba Medical Center, Tel HaShomer, affiliated to the Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.
b Department of Ophthalmology, Shiley Eye Center, School of Medicine , University of California-San Diego , La Jolla , CA , USA.
Curr Eye Res. 2018 May;43(5):654-658. doi: 10.1080/02713683.2018.1437453. Epub 2018 Feb 9.
To compare the performance of the PlusoptiX S12 mobile photoscreener and the Retinomax K+3 Autorefractor as screening devices in preschool children.
Children ranging from 3 to 5 years of age from 11 San Diego County preschools underwent vision screening in their schools where ambient light could not always be controlled using both the Retinomax and the PlusoptiX. Cycloplegic refraction on the consented children was subsequently performed on the UCSD EyeMobile for children on-site at the school locations.
A total of 321 children were screened with the PlusoptiX and Retinomax. The PlusoptiX referred 22% of children, of whom 70% of the referrals were read as "unable". The Retinomax referred 13% and there were no "unables". Similar results occurred in the cycloplegic-refracted 182 consented children-64% of the PlusoptiX referrals were read as "unable" . Only one third of these "unables" required glasses. Both devices referred the four children with amblyopia and one case of strabismus. However, PlusoptiX's 3 false negatives had amblyopia risk factors (ARFs) while the one Retinomax's false negative did not have ARFs. The Retinomax screening had 95% sensitivity and 94% specificity. The PlusoptiX screening had 86% sensitivity and 84% specificity.
In this preschool population and environment, the PlusoptiX referred 63% more than the Retinomax in addition to a lower specificity and sensitivity. Adjusting PlusoptiX referral criteria might not substantially improve the specificity of the PlusoptiX due to the high numbers of "unables".
比较PlusoptiX S12移动验光仪和Retinomax K+3自动验光仪作为学龄前儿童筛查设备的性能。
来自圣地亚哥县11所幼儿园的3至5岁儿童在其学校接受视力筛查，学校环境光无法始终得到控制，使用Retinomax和PlusoptiX两种设备进行检查。随后，在学校现场对同意检查的儿童在加州大学圣地亚哥分校眼科流动车上进行散瞳验光。
共有321名儿童接受了PlusoptiX和Retinomax检查。PlusoptiX转诊了22%的儿童，其中70%的转诊被判定为“无法判定”。Retinomax转诊了13%的儿童，且无“无法判定”情况。在182名同意散瞳验光的儿童中也出现了类似结果——PlusoptiX转诊的儿童中有64%被判定为“无法判定”。这些“无法判定”的儿童中只有三分之一需要配镜。两种设备都转诊了4名弱视儿童和1例斜视儿童。然而，PlusoptiX的3例假阴性儿童有弱视危险因素（ARF），而Retinomax的1例假阴性儿童没有ARF。Retinomax筛查的灵敏度为95%，特异度为94%。PlusoptiX筛查的灵敏度为86%，特异度为84%。
在这个学龄前儿童群体和环境中，PlusoptiX的转诊率比Retinomax高63%，且特异度和灵敏度较低。由于“无法判定”的数量较多，调整PlusoptiX的转诊标准可能无法显著提高其特异度。
