Comparison of the SPOT and SW800 photoscreener in detecting amblyopia risk factors in Chinese children between 4 to 6 years of age

Abstract

Purpose : To evaluate the effectiveness of SPOT photoscreener and SW800 vision screener in detecting amblyopia risk factors meeting 2013 the American Association of Pediatric Ophthalmology and Strabismus (AAPOS) criteria in Chinese children between 4 to 6 years of age.

Methods : One hundred and thirteen children (226 eyes), aged between 4 to 6 years old, underwent complete ophthalmologic examination, cycloplegic retinoscopy refraction, and photoscreen using both SPOT photoscreener and SW800 vision screener. The agreement of the results obtained with each photoscreener and retinoscopy were evaluated by paired t-test as well as Person correlation test. The sensitivity and specificity of detecting amblyopia risk factors were calculated based on the AAPOS 2013 guidelines. The overall effectiveness of detecting amblyopia risk factors by using either of the photoscreener was analyzed with Receiver Operating Characteristic (ROC) curves.

Results : Results showed a strong linear agreement between SPOT and retinoscopy (P<0.01) in aspects of spherical equivalent (SE, R²=0.90), Diopter Sphere (DS, R²=0.93), Diopter Cylinder (DC, R²=0.70) and Horizontal Deviation (Hdev, R²=0.82), with overall -0.17D myopic shift of SE. Significant correlation also was shown between SW800 and retinoscopy (P<0.01) in aspects of SE (R²=0.81), DS (R²=0.87), DC (R²=0.67) and Hdev (R²=0.63), with overall -0.12D myopic shift of SE. Based on the criteria specified by the AAPOS 2013 guidelines, the sensitivity and specificity (in respective order) in detecting hyperopia were 91.62% and 80.85% for SPOT and 94.97% and 70.21% for SW800; in detecting myopia were 91.28% and 87.10% for SPOT and 96.92% and 70.96% for SW800; in detecting astigmatism were 93.57% and 88.37% for SPOT and 89.29% and 86.04% for SW800; in detecting anisometropia were 92.05% and 66.67% for SPOT and 83.33% and 88.64% for SW800; and in detection of strabismus was 96.22% and 71.43% for SPOT and 94.31% and 74.14% for SW800.

Conclusions : The refractive and strabismus values measured by SPOT photoscreener and SW800 vision screener showed a strong agreement with the results from cycloplegic retinoscopy refraction, with a mild overall myopic shift of less than -0.2D. The performance in detecting individual amblyopia risk factors was satisfactory for Chinese children between 4 to 6 years of age.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.