Department of Ophthalmology, Faculty of Medicine, Yamagata University, 2-2-2 Iidanishi, Yamagata, Yamagata, 990-9585, Japan.
Suzuki Eye Clinic, Sagae, Japan.
Jpn J Ophthalmol. 2021 Jul;65(4):537-545. doi: 10.1007/s10384-021-00823-x. Epub 2021 Mar 1.
The purpose of this study was to compare the efficiency of conventional screening and of the Spot™ Vision Screener (SVS)-based screening in detecting potential cases of amblyopia during the Visual examination in Three-Year-Old Health Screening Program (VTYOS), that need to be referred for comprehensive examination.
Population-based cross-sectional study METHODS: This study introduced the SVS-based test to the VTYOS (which includes primary, secondary, and comprehensive examinations) of Sagae, Yamagata Prefecture, Japan. Children aged 3 years 6 months scheduled to undergo the secondary examination were subjected to both the SVS-based (evaluation of refractive error and eye alignment) and conventional screening test (questionnaire and visual acuity evaluation). Success rates, proportion of children who needed a comprehensive examination, rates of actual comprehensive examinations, and positive predictive value were determined and compared between conventional screening and SVS-based screening.
There were 294 participants; the rate of success of SVS-based screening (99.7%) was higher than conventional screening (89.5%, p < 0.01). The proportion of participants found to need a comprehensive examination according to SVS-based findings (7.5%) was lower than that according to conventional screening-based findings (23.5%, p < 0.01). The positive predictive value of the SVS-based screening test (75.0%) was higher than that of the conventional screening test (31.6%, p < 0.01). SVS-based screening detected 2 cases of amblyopia in 225 cases that passed conventional screening.
The VTYOS should ideally add SVS-based screening to conventional screening.
本研究旨在比较传统筛查和基于 Spot™ Vision Screener（SVS）的筛查在检测三岁儿童健康筛查计划（VTYOS）中潜在弱视病例方面的效率，这些病例需要进行全面检查。
基于人群的横断面研究
本研究将基于 SVS 的测试引入日本山形县酒田市的 VTYOS（包括初级、二级和全面检查）。年龄在 3 岁 6 个月、计划接受二级检查的儿童同时接受基于 SVS（评估屈光不正和眼位）和传统筛查测试（问卷调查和视力评估）。确定并比较了传统筛查和基于 SVS 的筛查在成功率、需要全面检查的儿童比例、实际全面检查率和阳性预测值方面的差异。
共有 294 名参与者；基于 SVS 的筛查成功率（99.7%）高于传统筛查（89.5%，p<0.01）。根据 SVS 检查结果发现需要进行全面检查的参与者比例（7.5%）低于根据传统筛查结果发现的比例（23.5%，p<0.01）。基于 SVS 的筛查测试的阳性预测值（75.0%）高于传统筛查测试的阳性预测值（31.6%，p<0.01）。SVS 筛查在 225 例通过传统筛查的病例中发现了 2 例弱视。
VTYOS 理想情况下应在传统筛查的基础上增加基于 SVS 的筛查。
