Performance of the Spot Vision Screener in children with Down syndrome and other special needs.


Journal

Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus
ISSN: 1528-3933
Titre abrégé: J AAPOS
Pays: United States
ID NLM: 9710011

Informations de publication

Date de publication:
10 2023
Historique:
received: 29 01 2022
revised: 28 05 2023
accepted: 06 07 2023
medline: 23 10 2023
pubmed: 18 9 2023
entrez: 17 9 2023
Statut: ppublish

Résumé

Amblyopia is a common cause of monocular vision impairment and disproportionally affects developmentally delayed children. Photoscreeners have been suggested as a method to detect amblyopia risk factors (ARFs) in children with developmental disabilities who may not be amenable to traditional vision screening methods. The Spot Vision Screener is a commonly used photoscreener for detecting ARF and has shown excellent sensitivity and accuracy in the general pediatric population. The purpose of this study was to evaluate its accuracy in children with Down syndrome and other special needs. Children with various disabilities or delays were recruited from outpatient clinics at the Children's Hospital of Colorado. Participants had their photograph taken with Spot before and after pupil dilation and cycloplegia. Images were compared to results of a comprehensive clinical eye examination. A total of 100 children participated in the study. Images could not be obtained in 12 children; 5 children did not attend their clinical examination. The overall sensitivity of Spot was 90%, with a positive predictive value of 80% in undilated subjects. The area under the receiver operator curve (AUROC) was 0.68 (95% CI, 0.57-0.79), which did not differ significantly from the AUROC after dilation/cycloplegia (0.68; 95% CI, 0.54-0.81). The Spot Vision Screener could be used by primary care clinics and vision screening programs with a high sensitivity to determine which patients with Down syndrome and special needs should be referred for clinical examination.

Sections du résumé

BACKGROUND
Amblyopia is a common cause of monocular vision impairment and disproportionally affects developmentally delayed children. Photoscreeners have been suggested as a method to detect amblyopia risk factors (ARFs) in children with developmental disabilities who may not be amenable to traditional vision screening methods. The Spot Vision Screener is a commonly used photoscreener for detecting ARF and has shown excellent sensitivity and accuracy in the general pediatric population. The purpose of this study was to evaluate its accuracy in children with Down syndrome and other special needs.
METHODS
Children with various disabilities or delays were recruited from outpatient clinics at the Children's Hospital of Colorado. Participants had their photograph taken with Spot before and after pupil dilation and cycloplegia. Images were compared to results of a comprehensive clinical eye examination.
RESULTS
A total of 100 children participated in the study. Images could not be obtained in 12 children; 5 children did not attend their clinical examination. The overall sensitivity of Spot was 90%, with a positive predictive value of 80% in undilated subjects. The area under the receiver operator curve (AUROC) was 0.68 (95% CI, 0.57-0.79), which did not differ significantly from the AUROC after dilation/cycloplegia (0.68; 95% CI, 0.54-0.81).
CONCLUSIONS
The Spot Vision Screener could be used by primary care clinics and vision screening programs with a high sensitivity to determine which patients with Down syndrome and special needs should be referred for clinical examination.

Identifiants

pubmed: 37717620
pii: S1091-8531(23)00189-1
doi: 10.1016/j.jaapos.2023.07.011
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

274.e1-274.e7

Subventions

Organisme : NCATS NIH HHS
ID : UL1 TR002535
Pays : United States

Informations de copyright

Copyright © 2023 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Auteurs

Lucy I Mudie (LI)

Department of Ophthalmology, University of Colorado, Aurora, Colorado; Center for Research Outcomes in Children's Surgery, Children's Hospital of Colorado, Aurora, Colorado.

Kaci Pickett (K)

Center for Research Outcomes in Children's Surgery, Children's Hospital of Colorado, Aurora, Colorado.

Kaylene Ross (K)

Center for Research Outcomes in Children's Surgery, Children's Hospital of Colorado, Aurora, Colorado.

Emily McCourt (E)

Department of Ophthalmology, University of Colorado, Aurora, Colorado; Center for Research Outcomes in Children's Surgery, Children's Hospital of Colorado, Aurora, Colorado.

Robert Enzenauer (R)

Department of Ophthalmology, University of Colorado, Aurora, Colorado; Center for Research Outcomes in Children's Surgery, Children's Hospital of Colorado, Aurora, Colorado. Electronic address: robert.enzenauer@childrenscolorado.org.

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