Performance of Two Photoscreeners Enhanced by Protective Cases

Samuel Joseph Martin,1 Hser Eh Htoo,2 Nay Hser,2 Robert W Arnold1 1Alaska Blind Child Discovery, Anchorage, AK, USA; 2Jungle School of Medicine Kawthoolei, Karen State, Burma (Myanmar)Correspondence: Robert W ArnoldAlaska Blind Child Discovery, Anchorage, AK, USATel +1 907561-1917Email eyedoc@alaska...

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Autores principales:	Martin SJ, Htoo HE, Hser N, Arnold RW
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	pediatric vision screening amblyopia instrument-based screening validation Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/f54358733ecc4ef38aa1245ae13072c1
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spelling	oai:doaj.org-article:f54358733ecc4ef38aa1245ae13072c12021-12-02T09:27:53ZPerformance of Two Photoscreeners Enhanced by Protective Cases1177-5483https://doaj.org/article/f54358733ecc4ef38aa1245ae13072c12020-05-01T00:00:00Zhttps://www.dovepress.com/performance-of-two-photoscreeners-enhanced-by-protective-cases-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Samuel Joseph Martin,1 Hser Eh Htoo,2 Nay Hser,2 Robert W Arnold1 1Alaska Blind Child Discovery, Anchorage, AK, USA; 2Jungle School of Medicine Kawthoolei, Karen State, Burma (Myanmar)Correspondence: Robert W ArnoldAlaska Blind Child Discovery, Anchorage, AK, USATel +1 907561-1917Email eyedoc@alaska.netBackground: Photoscreeners provide valid, cost-effective early detection of amblyopia risk factors; however, they require proper illumination, flash intensity, pupil dilation and patient cooperation. The Kaleidos case for the 2WIN infrared photoscreener fixes focal distance, decreases luminance and provides electric power. GoCheck Kids (GCK) has developed a flash-concentrating case for the Apple iPhone 7 Plus smartphone to reduce exposure time.Methods: In remote Burmese and urban Alaskan clinics, Kaleidos and GCK were used before a confirmatory eye examination using 2013 AAPOS uniform guidelines validation, including some older patients. 2WIN refraction was compared to a cycloplegic examination using J0 and J45 vector transformation.Results: In total, 48 Burmese patients and 114 Alaskan patients aged 8± 6 years were evaluated utilizing 2013 amblyopia risk factor guidelines. Kaleidos, with 13 Burmese inconclusives, had a sensitivity of 84%, specificity of 65% and positive predictive value (PPV) of 63%. GCK, with only six inconclusives, had a sensitivity of 63%, specificity of 83% and PPV of 73%, with sensitivity improving to 74% with central expert interpretation. Kaleidos closely matched cycloplegic refraction, with intraclass correlations of 0.47 for J0 vector and 0.57 for J45 vector. The protective cases provided clearer images and better pupil dilation than similar devices without cases.Conclusion: Both devices detected amblyopia risk factors well. GCK gave fewer inconclusive results even with the Asian eyelid configuration, while Kaleidos matched sphere and cylinder refraction. The specialized housing enhanced the performance of the 2WIN and GCK photoscreeners, improving the speed and reliability of amblyopia screening and refraction, even in populous and luminous locations.Clinical Trials Registry: NCT04068129.Keywords: pediatric vision screening, amblyopia, instrument-based screening, validation  Martin SJHtoo HEHser NArnold RWDove Medical Pressarticlepediatric vision screeningamblyopiainstrument-based screeningvalidationOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 1427-1435 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	pediatric vision screening amblyopia instrument-based screening validation Ophthalmology RE1-994
spellingShingle	pediatric vision screening amblyopia instrument-based screening validation Ophthalmology RE1-994 Martin SJ Htoo HE Hser N Arnold RW Performance of Two Photoscreeners Enhanced by Protective Cases
description	Samuel Joseph Martin,1 Hser Eh Htoo,2 Nay Hser,2 Robert W Arnold1 1Alaska Blind Child Discovery, Anchorage, AK, USA; 2Jungle School of Medicine Kawthoolei, Karen State, Burma (Myanmar)Correspondence: Robert W ArnoldAlaska Blind Child Discovery, Anchorage, AK, USATel +1 907561-1917Email eyedoc@alaska.netBackground: Photoscreeners provide valid, cost-effective early detection of amblyopia risk factors; however, they require proper illumination, flash intensity, pupil dilation and patient cooperation. The Kaleidos case for the 2WIN infrared photoscreener fixes focal distance, decreases luminance and provides electric power. GoCheck Kids (GCK) has developed a flash-concentrating case for the Apple iPhone 7 Plus smartphone to reduce exposure time.Methods: In remote Burmese and urban Alaskan clinics, Kaleidos and GCK were used before a confirmatory eye examination using 2013 AAPOS uniform guidelines validation, including some older patients. 2WIN refraction was compared to a cycloplegic examination using J0 and J45 vector transformation.Results: In total, 48 Burmese patients and 114 Alaskan patients aged 8± 6 years were evaluated utilizing 2013 amblyopia risk factor guidelines. Kaleidos, with 13 Burmese inconclusives, had a sensitivity of 84%, specificity of 65% and positive predictive value (PPV) of 63%. GCK, with only six inconclusives, had a sensitivity of 63%, specificity of 83% and PPV of 73%, with sensitivity improving to 74% with central expert interpretation. Kaleidos closely matched cycloplegic refraction, with intraclass correlations of 0.47 for J0 vector and 0.57 for J45 vector. The protective cases provided clearer images and better pupil dilation than similar devices without cases.Conclusion: Both devices detected amblyopia risk factors well. GCK gave fewer inconclusive results even with the Asian eyelid configuration, while Kaleidos matched sphere and cylinder refraction. The specialized housing enhanced the performance of the 2WIN and GCK photoscreeners, improving the speed and reliability of amblyopia screening and refraction, even in populous and luminous locations.Clinical Trials Registry: NCT04068129.Keywords: pediatric vision screening, amblyopia, instrument-based screening, validation
format	article
author	Martin SJ Htoo HE Hser N Arnold RW
author_facet	Martin SJ Htoo HE Hser N Arnold RW
author_sort	Martin SJ
title	Performance of Two Photoscreeners Enhanced by Protective Cases
title_short	Performance of Two Photoscreeners Enhanced by Protective Cases
title_full	Performance of Two Photoscreeners Enhanced by Protective Cases
title_fullStr	Performance of Two Photoscreeners Enhanced by Protective Cases
title_full_unstemmed	Performance of Two Photoscreeners Enhanced by Protective Cases
title_sort	performance of two photoscreeners enhanced by protective cases
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/f54358733ecc4ef38aa1245ae13072c1
work_keys_str_mv	AT martinsj performanceoftwophotoscreenersenhancedbyprotectivecases AT htoohe performanceoftwophotoscreenersenhancedbyprotectivecases AT hsern performanceoftwophotoscreenersenhancedbyprotectivecases AT arnoldrw performanceoftwophotoscreenersenhancedbyprotectivecases
_version_	1718398159762227200

Performance of Two Photoscreeners Enhanced by Protective Cases

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