Hunter Stephen C, He Jody, Han Michael, Suh Donny W
University of California Riverside School of Medicine, Riverside, CA, USA.
Department of Ophthalmology, Jamaica Hospital, New York City, NY, USA.
Clin Ophthalmol. 2022 Dec 20;16:4249-4255. doi: 10.2147/OPTH.S382899. eCollection 2022.
To introduce the University of California Irvine (UCI) EyeMobile for Children preschool vision screening program and describe the ophthalmic examination results of children who failed screening with the PlusoptiX S12C photoscreener during one school year.
Children aged 30-72 months were screened with the PlusoptiX using ROC mode 3 during the 2019-2020 school year. Children who failed screening were referred for comprehensive eye examination on the EyeMobile mobile clinic. Presence of amblyopia risk factors (ARFs), amblyopia, and refractive error was determined via retrospective review of records. Amblyopia was defined as unilateral if there was ≥ 2-line interocular difference in the best-corrected visual acuity (BCVA) and as bilateral if BCVA was < 20/50 for children < 4 years old and < 20/40 for children ≥ 4 years old. ARFs were defined using 2021 American Association for Pediatric Ophthalmology and Strabismus (AAPOS) instrument-based screening guidelines.
5226 children were screened during the study period. Of the 546 children who failed screening, 350 (64%) obtained consent and were examined. Mean age of examined children was 4.45 years. Amblyopia was found in 8% of examined children, with unilateral amblyopia seen in 79% of amblyopic subjects. Glasses were prescribed to 246 (70.3%) children. Of the 240 children who received cycloplegic examinations, 43% had hyperopia and 30% had myopia. The positive predictive value (PPV) of the PlusoptiX screening for ARFs in children who received cycloplegic examinations was 70.4%.
A significant proportion of Orange County preschoolers with refractive errors and amblyopia have unmet refractive correction needs. The PlusoptiX S12C photoscreener is an adequate screening device for the UCI EyeMobile for Children program, although modification of device referral criteria may lead to increased PPV. Further research is necessary to understand and overcome the barriers to childhood vision care in our community.
介绍加州大学欧文分校（UCI）儿童EyeMobile学前视力筛查项目，并描述在一学年中使用PlusoptiX S12C照片筛查仪筛查未通过的儿童的眼科检查结果。
在2019 - 2020学年，使用PlusoptiX以ROC模式3对30至72个月大的儿童进行筛查。筛查未通过的儿童被转介至EyeMobile移动诊所进行全面眼科检查。通过回顾记录确定弱视危险因素（ARF）、弱视和屈光不正的存在情况。如果最佳矫正视力（BCVA）双眼相差≥2行，则弱视定义为单眼；对于4岁以下儿童，若BCVA < 20/50，4岁及以上儿童若BCVA < 20/40，则弱视定义为双眼。ARF根据2021年美国小儿眼科与斜视协会（AAPOS）基于仪器的筛查指南进行定义。
在研究期间共筛查了5226名儿童。在546名筛查未通过的儿童中，350名（64%）获得同意并接受了检查。接受检查儿童的平均年龄为4.45岁。在接受检查的儿童中，8%被发现患有弱视，其中79%的弱视患者为单眼弱视。246名（70.3%）儿童被开了眼镜处方。在240名接受睫状肌麻痹验光的儿童中，43%有远视，30%有近视。接受睫状肌麻痹验光的儿童中，PlusoptiX筛查ARF的阳性预测值（PPV）为70.4%。
相当一部分橙县患有屈光不正和弱视的学龄前儿童的屈光矫正需求未得到满足。PlusoptiX S12C照片筛查仪对于UCI儿童EyeMobile项目来说是一种足够的筛查设备，尽管修改设备转诊标准可能会提高PPV。有必要进一步研究以了解并克服我们社区儿童视力保健的障碍。
