Abstract
Purpose :
To investigate whether the accuracy, sensitivity, and specificity of the Welch-Allyn VS100 Spot vision screener (VS100) without cycloplegia is comparable to the gold stand of cycloplegic autorefraction carried out using a Grand-Seiko WAM-5500 (WAM) open field autorefractor in children with myopia.
Methods :
Refractive error was assessed in the right eyes of a cohort of children (n=52), 56% female, with myopia (MSE=-3.89±1.99D) aged 10.20±2.69years, using the VS100 pre-cycloplegia and the WAM post-cycloplegia.
Measurements were compared for spherical (S), cylindrical (C), mean spherical equivalent (MSE), and vector values J0 and J45 between the VS100 and WAM using paired t-tests, Bland-Altman plots, and Pearson correlation. AAPOS (2013) referral criteria for amblyopia risk factors were used to assess the sensitivity and specificity.
Results :
Paired t-tests revealed there were no significant differences between non-cycloplegic VS100 and cycloplegic WAM for both the S (p .304) and J45 (p .234).
Both mean MSE and C were statistically more positive, MSE by 0.16 (95%CI 0.05 to 0.26)D, t(51) = 2.994, p .002 and C by 0.17 (95%CI 0.00 to 0.35)D, t(51) = 2.01, p .0.050 when measured with the VS100 than WAM. Whereas J0 was found to be -0.35 (95%CI -0.44 to -0.44)D, t(51) = -7.416, p <.001 more negative.
Strong positive correlations between VS100 and WAM for S(r(50) = 0.982, p <.001), MSE (r(50) = 0.983, p <.001), weaker positive correlations were found in the vector components J0 (r(50) = 0.407, p .003) and J45 (r(50) = 0.478, p <.001). No significant correlation was found for C(r(50) = 0.165, p .242).
VS100 achieved a sensitivity of 100.0%, specificity of 95.1% with a positive predictive value of 84.6% and a negative predictive value of 100.0% for S using the AAPOS (2013) guidelines.
Conclusions :
The VS100 compared well to cycloplegic WAM demonstrating no significant difference in measuring S, with small but clinically negligible differences in both MSE and C as well as achieving strong positive correlations measuring S and MSE. Sensitivity and specificity was high against AAPOS (2013) criteria.
This demonstrates the feasibility for using the VS100 for screening children with myopia in a more rapid, less invasive manner and removing the need for cycloplegia in comparison with the gold standard of cycloplegic WAM.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.