Schworm H D, Kau C, Reindl B, Horstmann S, Dollinger B, Boergen K P
Sektion Strabologie und Kinderophthalmologie, Ludwig Maximilians Universität München.
Klin Monbl Augenheilkd. 1997 Mar;210(3):158-64. doi: 10.1055/s-2008-1035036.
Congenital and early acquired ocular changes impairing the optic input induce amblyopia when left untreated. Amblyopia treatment must start early to be efficient. Therefore it seems necessary to employ screening tests in preverbal childhood.
The reliability of two commercially available photoscreening devices, the "Visiscreen 100" (Vision Research Corp.) and the "MTI-Photoscreener" (Medical Technology Inc.), was tested. 180 children from a kinder-garten and 120 infants from our outpatient clinic were screened. The results were compared to the findings of a full ophthalmologic and orthoptic examination.
The efficacy of the photoscreening depended on the skill of the examiner and on the age of the children tested. The rate of interpretable photographs was 94% in the older group and 63.3% in the infants. The mean sensitivity for detection of amblyogenic factors was 63% in the older and 80% in the infant group. The mean negative predictive value was 90%, and 75%, respectively.
Modern photoscreening techniques can help to detect amblyogenic factors in early childhood. However, in addition to the non-interpretable photographs, about 20% of the affected children are missed. Therefore, photoscreening cannot be recommended for countries with a high number of ophthalmologists, such as Germany. Instead, an ophthalmologic and orthoptic investigation in early childhood would be preferable.
先天性及早期获得性眼部病变若不治疗，损害视输入会导致弱视。弱视治疗必须尽早开始才有效。因此，在儿童学说话前阶段进行筛查测试似乎很有必要。
对两种市售的照片筛查设备“Visiscreen 100”（视觉研究公司）和“MTI照片筛查仪”（医疗技术公司）的可靠性进行了测试。对一所幼儿园的180名儿童和我们门诊的120名婴儿进行了筛查。将结果与全面眼科及视光学检查的结果进行了比较。
照片筛查的效果取决于检查者的技术以及受测儿童的年龄。年龄较大组可解读照片的比例为94%，婴儿组为63.3%。检测致弱视因素的平均敏感度在年龄较大组为63%，婴儿组为80%。平均阴性预测值分别为90%和75%。
现代照片筛查技术有助于在儿童早期检测致弱视因素。然而，除了无法解读的照片外，约20%的患病儿童会被漏诊。因此，对于像德国这样眼科医生数量较多的国家，不推荐进行照片筛查。相反，儿童早期进行眼科及视光学检查会更可取。
