The positive predictive value of photoscreening devices for amblyogenic conditions

D'Souza, Haley; Kun, Adrian; Martinson, Stacy R.; Bejarano, Laura; McCole, Shannon

doi:10.1016/j.jaapos.2021.06.008

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…By analyzing eccentric photorefraction red-reflex images, the app does not require patients to respond, and it therefore can be used to examine preverbal children. The app has been tested in clinical trials by comparing it with its counterparts among dedicated screening devices, such as iScreening [26]. It is reported by the company that developed GoCheck Kids that 4 million children have been screened [27].…”

Section: Discussionmentioning

confidence: 99%

Using Smartphones to Enhance Vision Screening in Rural Areas: Pilot Study

Wang,

Kempen,

Luo

2024

JMIR Form Res

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Background While it is treatable, uncorrected refractive error is the number one cause of visual impairment worldwide. This eye condition alone, or together with ocular misalignment, can also cause amblyopia, which is also treatable if detected early but still occurs in about 4% of the population. Mass vision screening is the first and most critical step to address these issues, but due to limited resources, vision screening in many rural areas remains a major challenge. Objective We aimed to pilot-test the feasibility of using smartphone apps to enhance vision screening in areas where access to eye care is limited. Methods A vision screening program was piggybacked on a charity summer camp program in a rural county in Sichuan, China. A total of 73 fourth and fifth graders were tested for visual acuity using a standard eye chart and were then tested for refractive error and heterophoria using 2 smartphone apps (a refraction app and a strabismus app, respectively) by nonprofessional personnel. Results A total of 5 of 73 (6.8%, 95% CI 2.3%-15.3%) students were found to have visual acuity worse than 20/20 (logarithm of minimal angle of resolution [logMAR] 0) in at least one eye. Among the 5 students, 3 primarily had refractive error according to the refraction app. The other 2 students had manifest strabismus (one with 72–prism diopter [PD] esotropia and one with 33-PD exotropia) according to the strabismus app. Students without manifest strabismus were also measured for phoria using the strabismus app in cover/uncover mode. The median phoria was 0.0-PD (IQR 2.9-PD esophoria to 2.2-PD exophoria). Conclusions The results from this vision screening study are consistent with findings from other population-based vision screening studies in which conventional tools were used by ophthalmic professionals. The smartphone apps are promising and have the potential to be used in mass vision screenings for identifying risk factors for amblyopia and for myopia control. The smartphone apps may have significant implications for the future of low-cost vision care, particularly in resource-constrained and geographically remote areas.

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Section: Discussionmentioning

confidence: 99%

Using Smartphones to Enhance Vision Screening in Rural Areas: Pilot Study

Wang,

Kempen,

Luo

2024

JMIR Form Res

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“…9 Screening employing infrared light, referred to as photo-screening, on the other hand, have gained popularity and shown to be useful in detection of refractive errors, amblyopia and congenital cataracts. [10][11][12] This study aimed to establish the utility of infrared re ex assessment in early detection of retinoblastoma.…”

Section: Discussionmentioning

confidence: 99%

“…8 Red re ex is the most commonly used screening methods for intraocular pathology with its scope for detection of intraocular tumors being limited greatly by pupillary dilatation and expertise of examiner. 9 Infrared spectrum of light has been utilized widely for photorefraction, amblyopia and congenital cataract screening in children, [10][11][12] but has not been explored for detection of intraocular tumors. Longer wavelengths of light cause delayed and lesser pupillary constriction, 13 thus offering a larger pupillary area for assessment.…”

Section: Introductionmentioning

confidence: 99%

Photo-screening for Retinoblastoma: A Proof-of-Concept Study

Vempuluru

Jonnadula

Kaliki

2022

Preprint

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Purpose: The potential of Infrared (IR) photo-screening for detection of retinoblastoma has not been assessed. This study aimed to assess the IR reflex formed across the pupil in eyes with retinoblastoma (RB), vis-à-vis eyes with no intraocular tumor.Methods: Central gaze IR-reflex assessment in eyes with and without RB.Results: Of 30 eyes from 21 subjects, 20 eyes had RB and 10 eyes had no tumors. Image frames were extracted from IR video recordings of 30 eyes, of which 71 central gaze images were eligible for measurement of pixel intensity (0 to 255). Of these, 49 images had RB and 22 images had no tumor. The mean pixel intensity (MPI) within the pupil, in images of eyes with RB was 115 (median, 92; range, 38 to 254), in images of eyes with no tumor was 73 (median, 68; range, 26 to 125) and the difference was statistically significant (Odds ratio 1.018; 95 % CI: 1.004 – 1.032; p, .010;) on bivariate analysis. Of 57 images from eyes with RB, 35 were captured with un-dilated pupils and 22 with dilated pupils. The MPI in images from un-dilated eyes with RB was 107 (median, 79; range, 38 to 254), in images from dilated eyes with RB was 128 (median, 114; range, 46 to 215). However, the difference was not statistically significant (Odds ratio 1.006; 95 % CI: 0.996– 1.015; p, .248).Conclusion: Technology combining IR imaging and MPI measurement within the pupil can translate into a potential tool for early detection of RB.

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“…The Plusoptix family of photoscreeners (S04, s08, s09, s-12, s-16) has had extensive validation compared with eye chart visual acuity, 6,7 digital flash cameras, [7][8][9] the MTI photoscreener, 9,10 the iScreen, 9,[11][12][13] Suresight, 9,14-16 compared with SPOT, 12,13,[17][18][19][20][21] 2WIN, 17,[21][22][23][24][25][26] GoCheck Kids, 13 blinq, 25,26 with Retinomax 9,23,24,27,28 and table-top autorefractors, 22,29 community screening 30,31 and examination. 28,[32][33][34][35][36][37][38][39][40][41][42][43][44] The refractive accuracy has been compared.…”

Section: Introductionmentioning

confidence: 99%

Comparative Validation of PlusoptiX and AI-Optic Photoscreeners in Children with High Amblyopia Risk Factor Prevalence

Arnold¹

2022

OPTH

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Purpose In 2022, an inexpensive multi-radial infrared photoscreener, the AI Optic was released in a similar format as the 2012 PlusoptiX a-12 but utilizing artificial intelligence (AI) for online, central image interpretation. We studied them because no prior comparative validation concerning amblyopia risk factors and particularly refractive error has been done. Patients and Methods Children from a pediatric ophthalmology practice had AI Optic and PlusoptiX-a12 photoscreen concomitantly during comprehensive examination with precisely measured strabismus and refraction. Validation to AAPOS 2021 and 2013 guidelines was evaluated with receiver operating characteristic (ROC) curves while refractive estimates were compared by the ABCD ellipsoid univariable technique. Results In 200 ethnically diverse children aged 1–18, 148 were 4 years or older, 35% had developmental delays, and 2/3 had amblyopia risk factors (ARF). Area under the ROC curve (AUC) targeting AAPOS 2021 refractive plus strabismus for age ≥4 years was 0.58 for AI Optic and 0.74 for PlusoptiX while for children <4 years, AUC was 0.53 for AI Optic and 0.72 for PlusoptiX. For 134 comparable sphero-cylinder refractions, the ABCD Ellipsoid median (interquartile ranges) for AI Optic right eye 2.53 (1.54, 4.01) and left eye 3.05 (1.83, 5.00) did not approximate actual refraction as well as by PlusoptiX right eye 1.88 (1.12, 2.86) and left eye 2.10 (1.26, 3.04) Mann Whitney z=3.7 right and 4.2 left, p<0.001 each. AI Optic via central “AI” reading gave sphero-cylinder and referral estimates in all but 16 of 200 high risk children whereas Plusoptix had 25 inconclusives. On the other hand, with inconclusives scored as a refer, Plusoptix outperformed AI Optic in terms of ARF validation and refractive estimate. Conclusion Plusoptix provided more valid amblyopia and refractive screening than the cheaper AI Optic. Clinics must weigh cost versus performance, and central data sharing before selecting one of these vision-saving devices.

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The positive predictive value of photoscreening devices for amblyogenic conditions

Cited by 4 publications

References 7 publications

Using Smartphones to Enhance Vision Screening in Rural Areas: Pilot Study

Using Smartphones to Enhance Vision Screening in Rural Areas: Pilot Study

Photo-screening for Retinoblastoma: A Proof-of-Concept Study

Comparative Validation of PlusoptiX and AI-Optic Photoscreeners in Children with High Amblyopia Risk Factor Prevalence

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