PDF(Pubmed)
Abstract：
The study aims to assess two refractive instrument-based methods of vision screening (SureSight and PlusoptiX) to detect refractive amblyopia risk factors (ARFs) and significant refractive errors in Chinese preschool children and to develop referral criteria according to the 2021 AAPOS guidelines.
Eye examinations were conducted in children aged 61 to 72 months (n = 1,173) using a PlusoptiX photoscreener, SureSight autorefractor, and cycloplegic retinoscopy (CR). The Vision Screening Committee of AAPOS\'s preschool vision screening guidelines from 2021 were adopted for comparison. Paired t-test analysis and Bland-Altman plots were used to assess the differences and agreement between the PlusoptiX photoscreener, SureSight autorefractor, and CR. In addition, the validity of the cut-off values of the several ARFs measured with the SureSight and PlusoptiX was estimated using receiver operating characteristic (ROC) curves and compared to the age-based 2021 AAPOS examination failure levels.
A total of 1,173 children were tested with comprehensive eye examinations. When the referral numbers based on the 2013 (43/3.67%) and 2021 (42/3.58%) AAPOS guidelines were compared, significant differences between the values of astigmatism (72.09 vs. 52.38%) and anisometropia (11.63 vs. 38.10%) were found. The 95% limits of agreement (LOA) of the spherical value and the cylindrical value between PlusoptiX and CR were 95.08 and 96.29%. It was 93.87 and 98.10% between SureSight and CR. Considering refractive failure levels, the ROC curves obtained the optimal cut-off points. However, the PlusoptiX and the SureSight showed lower efficiency in hyperopia (Youden index, 0.60 vs. 0.83) and myopia (Youden index, 078 vs. 0.93), respectively. After adjusting the above cut-off points, the optimized NES (Nanjing Eye Study) referral criteria for myopia, hyperopia, astigmatism, and anisometropia were -0.75, 1.25, -1.0, and 0.5 with PlusoptiX and -1.25, 2.75, -1.5, and 0.75 with SureSight.
SureSight and PlusoptiX showed a good correlation with CR and could effectively detect refractive ARFs and visually significant refractive errors. There were obvious advantages in detecting hyperopia using SureSight and myopia using PlusoptiX. We proposed instrumental referral criteria for age-based preschool children based on AAPOS 2021 guidelines.
Eye examinations were conducted in children aged 61 to 72 months (n = 1,173) using a PlusoptiX photoscreener, SureSight autorefractor, and cycloplegic retinoscopy (CR). The Vision Screening Committee of AAPOS\'s preschool vision screening guidelines from 2021 were adopted for comparison. Paired t-test analysis and Bland-Altman plots were used to assess the differences and agreement between the PlusoptiX photoscreener, SureSight autorefractor, and CR. In addition, the validity of the cut-off values of the several ARFs measured with the SureSight and PlusoptiX was estimated using receiver operating characteristic (ROC) curves and compared to the age-based 2021 AAPOS examination failure levels.
A total of 1,173 children were tested with comprehensive eye examinations. When the referral numbers based on the 2013 (43/3.67%) and 2021 (42/3.58%) AAPOS guidelines were compared, significant differences between the values of astigmatism (72.09 vs. 52.38%) and anisometropia (11.63 vs. 38.10%) were found. The 95% limits of agreement (LOA) of the spherical value and the cylindrical value between PlusoptiX and CR were 95.08 and 96.29%. It was 93.87 and 98.10% between SureSight and CR. Considering refractive failure levels, the ROC curves obtained the optimal cut-off points. However, the PlusoptiX and the SureSight showed lower efficiency in hyperopia (Youden index, 0.60 vs. 0.83) and myopia (Youden index, 078 vs. 0.93), respectively. After adjusting the above cut-off points, the optimized NES (Nanjing Eye Study) referral criteria for myopia, hyperopia, astigmatism, and anisometropia were -0.75, 1.25, -1.0, and 0.5 with PlusoptiX and -1.25, 2.75, -1.5, and 0.75 with SureSight.
SureSight and PlusoptiX showed a good correlation with CR and could effectively detect refractive ARFs and visually significant refractive errors. There were obvious advantages in detecting hyperopia using SureSight and myopia using PlusoptiX. We proposed instrumental referral criteria for age-based preschool children based on AAPOS 2021 guidelines.
摘要：
该研究旨在评估两种基于屈光器械的视力筛查方法（SureSight和PlusoptiX），以检测中国学龄前儿童的屈光弱视危险因素（ARFs）和明显的屈光不正，并根据2021年AAPOS指南制定转诊标准。
使用PlusoptiX光筛选器对61至72个月（n=1,173）的儿童进行了眼科检查，SureSight自动折射仪,和睫状肌麻痹视网膜镜检查（CR）。采用2021年AAPOS学龄前视力筛查指南的视力筛查委员会进行比较。配对t检验分析和Bland-Altman图用于评估PlusoptiX光筛选器之间的差异和一致性，SureSight自动折射仪,和CR。此外,使用受试者工作特征(ROC)曲线估算了用SureSight和PlusoptiX测得的几种ARF的截止值的有效性,并与基于年龄的2021年AAPOS检查失败水平进行了比较.
共有1,173名儿童接受了全面的眼科检查。当根据2013年（43/3.67%）和2021年（42/3.58%）AAPOS指南的推荐数字进行比较时，散光值之间的显著差异(72.09vs.52.38%）和屈光参差（11.63vs.38.10%）被发现。PlusoptiX和CR之间的球形值和圆柱形值的95％一致性极限（LOA）分别为95.08和96.29％。SureSight和CR之间的比率分别为93.87和98.10％。考虑到屈光失败水平，ROC曲线获得了最佳截止点。然而,PlusoptiX和SureSight在远视中显示出较低的效率(Youden指数，0.60vs.0.83)和近视(尤登指数，078vs.0.93),分别。调整上述截止点后，优化的NES（南京眼科研究）近视转诊标准，远视,散光,PlusoptiX的屈光参差分别为-0.75、1.25、-1.0和0.5，SureSight的屈光参差分别为-1.25、2.75、-1.5和0.75。
SureSight和PlusoptiX与CR表现出良好的相关性，可以有效检测屈光性ARFs和视觉上明显的屈光不正。使用SureSight检测远视和使用PlusoptiX检测近视具有明显的优势。我们根据AAPOS2021指南，为基于年龄的学龄前儿童提出了工具性转诊标准。
使用PlusoptiX光筛选器对61至72个月（n=1,173）的儿童进行了眼科检查，SureSight自动折射仪,和睫状肌麻痹视网膜镜检查（CR）。采用2021年AAPOS学龄前视力筛查指南的视力筛查委员会进行比较。配对t检验分析和Bland-Altman图用于评估PlusoptiX光筛选器之间的差异和一致性，SureSight自动折射仪,和CR。此外,使用受试者工作特征(ROC)曲线估算了用SureSight和PlusoptiX测得的几种ARF的截止值的有效性,并与基于年龄的2021年AAPOS检查失败水平进行了比较.
共有1,173名儿童接受了全面的眼科检查。当根据2013年（43/3.67%）和2021年（42/3.58%）AAPOS指南的推荐数字进行比较时，散光值之间的显著差异(72.09vs.52.38%）和屈光参差（11.63vs.38.10%）被发现。PlusoptiX和CR之间的球形值和圆柱形值的95％一致性极限（LOA）分别为95.08和96.29％。SureSight和CR之间的比率分别为93.87和98.10％。考虑到屈光失败水平，ROC曲线获得了最佳截止点。然而,PlusoptiX和SureSight在远视中显示出较低的效率(Youden指数，0.60vs.0.83)和近视(尤登指数，078vs.0.93),分别。调整上述截止点后，优化的NES（南京眼科研究）近视转诊标准，远视,散光,PlusoptiX的屈光参差分别为-0.75、1.25、-1.0和0.5，SureSight的屈光参差分别为-1.25、2.75、-1.5和0.75。
SureSight和PlusoptiX与CR表现出良好的相关性，可以有效检测屈光性ARFs和视觉上明显的屈光不正。使用SureSight检测远视和使用PlusoptiX检测近视具有明显的优势。我们根据AAPOS2021指南，为基于年龄的学龄前儿童提出了工具性转诊标准。
