Department of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology, Giridhar Eye Institute, Kochi, Kerala, India.
Department of Optometry, Giridhar Eye Institute, Kochi, Kerala, India.
Indian J Ophthalmol. 2022 Jan;70(1):228-232. doi: 10.4103/ijo.IJO_672_21.
To analyze whether photoscreening can effectively detect amblyogenic risk factors in children with neurodevelopmental disability.
A prospective study of 52 children attending a special school for children with neurodevelopmental disability from December 2017 to May 2018. All were initially tested with a photoscreening device: Welch Allyn® Spot® Vision Screener: model VS100 (Spot®) and further evaluated at a later date by a pediatric ophthalmologist, with a complete ocular evaluation including squint assessment, cycloplegic retinoscopy, and dilated fundus examination. The key parameters studied were demographic features, type of neurodevelopmental disability, refraction, ocular alignment, media clarity, any other ocular morbidity, and time taken for examination. The presence of amblyogenic risk factors (ARF) was analyzed as per the 2013 guidelines of the American Association for Pediatric Ophthalmology and Strabismus.
The mean age was 10.5 years (range: 1-17.5 years). Males (73.1%) outnumbered females (26.9%). The most common neurodevelopmental disability was cerebral palsy. Simple myopic astigmatism was the most common type of refractive error. Presence of ARF in our study was 73.1%. The sensitivity and specificity of photoscreening in detecting ARF were 96.5% and 63.61%, respectively, with a positive predictive value of 80% and negative predictive value of 92.31%. The predictive ability of photoscreening was 79.9% as per the area under curve. The average time taken for photoscreening was less than 60 s.
Photoscreening can detect ARF with high sensitivity and reasonable specificity and is a handy, useful, and time-saving tool in screening children with neurodevelopmental disability.
分析在患有神经发育障碍的儿童中，眼底照相筛查是否能有效发现弱视危险因素。
2017 年 12 月至 2018 年 5 月，对一所特殊学校的 52 名神经发育障碍儿童进行了前瞻性研究。所有儿童均先用 Welch Allyn® Spot® Vision Screener 型视力筛查仪（Spot®）进行初筛，随后由儿科眼科医生进行进一步评估，检查项目包括斜视评估、睫状肌麻痹检影验光和散瞳眼底检查。研究的关键参数包括人口统计学特征、神经发育障碍类型、屈光不正、眼球运动、晶状体透明度、任何其他眼部疾病以及检查时间。弱视危险因素（ARF）的存在根据美国儿科学会眼科和斜视分会 2013 年的指南进行分析。
平均年龄为 10.5 岁（范围：1-17.5 岁），男童（73.1%）多于女童（26.9%）。最常见的神经发育障碍是脑瘫。最常见的屈光不正类型是单纯近视散光。在我们的研究中，ARF 的检出率为 73.1%。眼底照相筛查发现 ARF 的灵敏度和特异性分别为 96.5%和 63.61%，阳性预测值为 80%，阴性预测值为 92.31%。根据曲线下面积，眼底照相筛查的预测能力为 79.9%。眼底照相筛查的平均用时少于 60 秒。
眼底照相筛查具有较高的灵敏度和合理的特异性，是筛查神经发育障碍儿童弱视危险因素的一种方便、有用且节省时间的工具。
