The accuracy of the plusoptiX A08 photoscreener in detecting risk factors for amblyopia in central Iowa

Purpose: To evaluate the accuracy of the plusoptiX A08 photoscreener in detecting risk factors for amblyopia in children aged 0-5 years in central Iowa. Methods: The medical records of consecutive patients seen at 1 practice during a 2-month period were retrospectively reviewed. All patients were screened with the plusoptiX A08 photoscreener and received a comprehensive pediatric ophthalmology examination. Photoscreening results, according to our age-based criteria, were compared with the comprehensive examination findings. Patients were considered to have amblyopia or amblyogenic risk factors in the comprehensive examination based on the American Association for Pediatric Ophthalmology and Strabismus referral criteria guidelines. Results: A total of 290 children were examined during the study period. Of these, 190 (66%) patients were found to have amblyopia or amblyogenic risk factors during the pediatric ophthalmology examination on the basis of American Association for Pediatric Ophthalmology and Strabismus guidelines. The plusoptiX A08 offered an overall testability rate of 98%, sensitivity of 87%, specificity of 88%, positive predictive value of 93%, and negative predictive value of 78%. The sensitivity for detection of strabismus ≤20^Δ was 52%. Conclusions: The plusoptiX showed a high sensitivity for the detection of refractive amblyogenic risk factors and had a high successful testability rate in infants; however, it had low sensitivity for detecting strabismus ≤20^Δ. We postulate that sensitivity for detecting amblyogenic risk factors can be improved by combining the use of this instrument with a cover or stereo test.