ArticleClinical ophthalmology (Auckland, N.Z.)2022
Instrument Referral Criteria for PlusoptiX, SPOT and 2WIN Targeting 2021 AAPOS Guidelines.
Article in Clinical ophthalmology (Auckland, N.Z.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Undiagnosed visual disorders among first-grade children in Türkiye: a school-based photoscreening cross-sectional study with cost analysis.BMC ophthalmology · 2026Article
- Digital infrared reflex testing and asynchronous teleconsultation for infant eye screening.Scientific reports · 2026Article
- Application of the 2021 AAPOS Guidelines in Clinics with Revision and Validation of SPOT Referral Criteria.Clinical ophthalmology (Auckland, N.Z.) · 2025Article
- Referral rate for refractive amblyopia using automated vision screening in school children in Beirut, Lebanon.PloS one · 2025Article
- Comparison of the PlusoptiX A16 and vision screener V100.Frontiers in ophthalmology · 2024Article
- Pre-Cycloplegic Exam Benefit of Photoscreening and Accommodation-Relaxing Skiascopy.Clinical ophthalmology (Auckland, N.Z.) · 2024Article
- Test-Retest of the Spot Vision Screener among Children with Ophthalmological Diseases including Strabismus.Journal of ophthalmology · 2024Article
- Effectiveness of the Spot Vision Screener using updated 2021 AAPOS guidelines.Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2023Article
- Pediatric Non-Refractive Vision Screening with EyeSwift, PDI Check and Blinq: Non-Refractive Vision Screening with Two Binocular Video Games and Birefringent Scanning.Clinical ophthalmology (Auckland, N.Z.) · 2022Article
- Multifaceted Amblyopia Screening with blinq, 2WIN, and PDI Check.Clinical ophthalmology (Auckland, N.Z.) · 2022Article
- Comparative Validation of PlusoptiX and AI-Optic Photoscreeners in Children with High Amblyopia Risk Factor Prevalence.Clinical ophthalmology (Auckland, N.Z.) · 2022Article
- Instrument referral criteria for PlusoptiX and SureSight based on 2021 AAPOS guidelines: A population-based study.Frontiers in public health · 2022Article
- Improving interpupillary distance accuracy in the plusoptix A12R: A distance-dependent correction.Journal of optometryArticle
Corrections and comments
- Erratum issued
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe American Association for Pediatric Ophthalmology and Strabismus (AAPOS) issued a 2021 update of Uniform Validation Guidelines for instrument-based pediatric vision screeners. With each update it is important for each manufacturer to update the Instrument Referral Criteria (IRC) programed into their devices in order to optimize sensitivity and specificity to detect AAPOS criteria.
methodsDe-identified data comparing photoscreening with simultaneous confirmatory examinations constituted separate cohorts for the development of IRC via receiver operating characteristic (ROC) curves. The refractions of the devices were also compared.
resultsThis study defines three sets of refractive IRC (Sensitive, Medium, and Specific) for three leading infrared photoscreening devices, PlusoptiX A12, Welch-Allyn SPOT, and Adaptica 2WIN for children < 4 and ≥ 4 years in order to better target the 2021 AAPOS guidelines. The cohorts were similar but the SPOT group (n=755, mean age 9) was older with more astigmatism and the 2WIN (n=1362, mean age 7) was younger with more hyperopia and anisometropia compared to the cohort for PlusoptiX A12 (n=616, mean age 8). The age-based, medium magnitude IRC for anisometropia, hyperopia, astigmatism and myopia for SPOT were: <4y: 1.5, 1.75, 3.25, 3.5 and ≥4y: 1.5, 1.75, 2.25, 2.0; for PlusoptiX: <4y: 1.75, 3.0, 3.5, 3.5 and ≥4y: 1.75, 3.0, 2.5, 2.5; and for 2WIN: <4y: 1.75, 2.5, 3.5, 3.5 and ≥4y: 1.5, 2.0, 2.5, 2.0. The mean ABCD ellipsoid spectacle matches differed; SPOT: 1.8±1.3 (better) versus PlusoptiX: 1.9±1.6 and 2WIN: 2.2±1.4 (p<0.001).
conclusionThe 2021 AAPOS exam guidelines foster early specificity before age 4 and sensitivity after age 4. These evidence-based IRC for current SPOT, PlusoptiX, and 2WIN photoscreeners should allow device manufacturers the data necessary to adjust their device IRC to maximize specificity, sensitivity or a medium between the two. This paper provides practical suggestions for better validation. Improved early screening combined with thorough treatment should reduce life-long vision impairment due to amblyopia.
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