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G.-S. Ying, M. G. Maguire, V. Dobson, G. E. Quinn, M. T. Kulp, L. A. Cyert, Vision in Preschoolers Study Group; Validity of Noncycloplegic Retinoscopy, Retinomax Autorefractor and SureSight Vision Screener for Detecting VIP-Targeted Eye Conditions. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1704.
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To evaluate, by receiver operating characteristic (ROC) analysis, the ability of non-cycloplegic retinoscopy (NCR), Retinomax Autorefractor (Rmax) and SureSight Vision Screener (SSight) to detect VIP-targeted eye conditions among 3- to 5-year-old Head Start (HS) children.
In the 2-year VIP Phase I (Yr-1 and Yr-2), NCR, Rmax and SSight were administered by VIP-certified pediatric optometrists and ophthalmologists to 2588 HS preschoolers. In VIP Phase II (Yr-3), Rmax and SSight were administered by both nurse and lay screeners to 1452 HS preschoolers.All screened children underwent comprehensive, standardized eye examinations by masked VIP-certified examiners to identify amblyopia, strabismus, significant refractive error, and/or reduced visual acuity. These VIP-targeted conditions were also grouped into 3 hierarchical groups based upon severity.The ability of screening test to identify VIP-targeted eye conditions was summarized by the area under the ROC curve (AUC), calculated from weighted logistic regression models. The predictors in the models included the power of the most positive meridian for hyperopia, the power of the most negative meridian for myopia, cylinder power for astigmatism, and the larger of the intereye difference in spherical power and the intereye difference in cylindrical power for anisometropia. The value from the more severely affected eye was used for the eye-specific measurements.
The three tests had similar AUC. AUC for detecting any VIP-targeted conditions was 0.84 (95% CI: 0.81-0.87) for NCR (Yr-1), 0.83 (0.80-0.86,Yr-1) to 0.88 (0.86-0.90,Yr-3) for Rmax, and 0.86 (0.84-0.89, Yr-2) to 0.88 (0.86-0.90, Yr-3) for SSight. The AUC for detecting the most severe Group 1 conditions was very high for each test, ranging from 0.94 (0.92-0.96) to 0.96 (0.95-0.98). The AUC for detecting the most and moderately severe Group 1&2 conditions ranged from 0.89 (0.87-0.92) to 0.92 (0.90-0.93).
All three screening tests had very similar power for detecting vision disorders in preschoolers. This is consistent with our previously reported results at specificity levels of 90% and 94%.
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