Evaluation of the SPOT™ Photoscreener’s Efficacy for Detecting Amblyopia Risk Factors Compared to Optometrists’ Examinations in 305 South Dakota Children

Purpose: This study sought to further validate the efficacy of the SPOTTM photoscreener version (v) 3.0.0500 as a screening device for amblyopia risk factors (ARF). Methods: This was a cross-sectional study from five different western South Dakota outpatient clinics. Data from 610 eyes of 305 children aged 6 months to 13.5 years collected between July 2018 to September 2018 were analyzed, using both the out-of-box referral criteria and the 2013 American Association for Pediatric Ophthalmology and Strabismus (AAPOS) referral criteria. Optometrist (eye care provider or ECP) cycloplegia practice patterns were deferred to each clinics’ specific protocols. Power vector and Bland-Altman plot analyses were performed. Results: The average age of the 305 children in the study population is 99.6 months (~8.3 years), with a total of 42% of these subjects receiving no dilating drops prior to testing. From these cases, the SPOTTM v3.0.0500 photoscreener evaluation parameters for detecting ARFs using the out-of-box referral criteria yielded an overall sensitivity (SN) of 95.2%, specificity (SP) of 91.9%, positive predictive value (PPV) of 81.6%, and negative predictive value (NPV) of 98.1%; the SPOTTM v3.0.0500 photoscreener evaluation parameters for detecting ARFs using the 2013 AAPOS referral criteria yielded an overall SN of 96.3%, SP of 92.4%, PPV of 82.1%, and NPV of 98.6%. Conclusions: With SN and NPV values exceeding 95%, this study supports the efficacy of the SPOTTM v3.0.0500 photoscreener as a pediatric screening device to detect ARFs. Power vector analyses help to provide further objective comparisons of refractive measurements between photoscreening devices and refractive examinations