Barcelona Institute for Global Health, University of Barcelona, Barcelona, Spain.
BMC Pediatr. 2021 Sep 8;21(Suppl 1):306. doi: 10.1186/s12887-021-02606-2.
We looked at existing recommendations and supporting evidence on the effectiveness of screening for visual disorders in newborns and small infants, and in children between six months and five years of age.We conducted a literature search up to the 5th of August 2019 by using key terms and manual search in selected sources. We summarized the recommendations and the strength of the recommendations when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported on the accuracy of screening tests for detecting visual alterations; the efficacy of treatment for improving visual acuity, school performance, and quality of life; and potential harms derived from vision screening and treating visual alterations.Although there is little evidence supporting its validity and effectiveness, examining all newborns for congenital cataract and retinoblastoma through the red reflex examination is widely accepted due to the severity of both diseases and the good outcomes reached by early detection and treatment.Overall, there is a moderate certainty of evidence that visual screening in children between three and five years provides a moderate net benefit, as assessed by the US Preventive Services Task Force: vision screening tests are accurate for detecting amblyopia and its risk factors, and their treatment is associated with visual improvement. There is uncertain evidence on whether vision screening in children under three years of age provides net benefits. Among populations with a low prevalence of vision abnormalities, screening the youngest is associated with an increased rate of false positives, leading to unnecessary additional assessment.
我们研究了现有的关于新生儿和小婴儿以及 6 个月至 5 岁儿童视觉障碍筛查的有效性的建议和支持证据。我们使用关键词和选定来源中的手动搜索，在 2019 年 8 月 5 日之前进行了文献检索。我们根据作者报告的时间和方式，总结了建议和建议的强度。我们根据筛查测试检测视觉改变的准确性、治疗提高视力、学业成绩和生活质量的效果以及视力筛查和治疗视觉改变可能产生的潜在危害，总结了系统评价的主要结果。虽然几乎没有证据支持其有效性和有效性，但由于这两种疾病的严重性以及早期发现和治疗所带来的良好结果，广泛接受对所有新生儿进行红反射检查以检查先天性白内障和视网膜母细胞瘤。总的来说，有中等确定性的证据表明，美国预防服务工作组评估的 3 至 5 岁儿童的视觉筛查提供了中度净收益：视觉筛查测试对检测弱视及其危险因素具有准确性，其治疗与视力改善相关。关于 3 岁以下儿童的视力筛查是否提供净收益，证据不确定。在视力异常患病率较低的人群中，对最小的儿童进行筛查与假阳性率的增加有关，导致不必要的额外评估。
