Validation of plusoptiX S04 photoscreener as a vision screening tool in children with intellectual disability

J AAPOS. 2011 Oct;15(5):476-9. doi: 10.1016/j.jaapos.2011.05.023.

Abstract

Purpose: Intellectual disability (ID) is a major public health issue, affecting more than 1% of children worldwide. Pediatric vision screening using standard eye charts may be challenging for children with ID, who may benefit from a quick noninvasive vision screening tool. This study evaluated the accuracy of plusoptiX S04 (Plusoptix Gmbh, Nuremberg, Germany) in detecting amblyopia risk factors in children with ID.

Methods: Children diagnosed with ID according to age-appropriate psychological tests were examined consecutively. Vision screening was performed using the plusoptiX S04 prior to complete ophthalmological examination, including cycloplegic refraction. Pass/refer screening results was compared with findings of ophthalmological examination. Amblyogenic risk factors were defined according to American Association for Pediatric Ophthalmology and Strabismus referral criteria.

Results: A total of 182 infants and children were examined. Only 3% of children were uncooperative for screening. Ophthalmological examination detected amblyogenic risk factors in 32% of patients. The sensitivity of plusoptiX S04 was 95% (95% CI, 85.6%-98.9%), and specificity was 50% (95% CI, 40.8%-59.1%). The positive predictive value was 47% (95% CI, 37.7%-56.4%) and the negative predictive value was 95.4% (95% CI, 87.1%-99.1%).

Conclusions: High sensitivity and negative predictive values suggest that the plusoptiX S04 will detect most children with ID who have amblyogenic risk factors, but one-half of all children referred will have no risk factors.

Publication types

  • Validation Study

MeSH terms

  • Amblyopia / complications
  • Amblyopia / diagnosis*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Humans
  • Infant
  • Intellectual Disability / complications
  • Refractive Errors / diagnosis
  • Reproducibility of Results
  • Risk Factors
  • Sensitivity and Specificity
  • Treatment Outcome
  • Vision Screening / instrumentation*
  • Visual Acuity / physiology*