From the Guidelines
The Spot Vision Screener's diagnostic performance in detecting amblyopia risk factors or poor visual acuity (VA) is significantly influenced by age, with varying sensitivity and specificity across different age groups. When examining the impact of age on the diagnostic performance of the Spot Vision Screener, it's crucial to consider the developmental stages of children's visual systems and their ability to cooperate during screening.
- In younger children, particularly those under 3 years of age, the device may have lower sensitivity but higher specificity, as noted in the context of vision screening technologies 1.
- As children grow older, from 3 to 6 years, the sensitivity of the Spot Vision Screener generally improves, maintaining good specificity, which makes it a more reliable tool for detecting potential vision problems in this age group. The age-related variation in the Spot Vision Screener's performance is attributed to the ongoing development of children's visual systems and the natural changes in refractive errors during early childhood, which can affect the accuracy of measurements.
- The algorithms used by the Spot Vision Screener are calibrated to account for these developmental differences across various age groups. For optimal diagnostic outcomes, screening protocols should take into account these age-dependent performance characteristics of the Spot Vision Screener.
- This might involve implementing more frequent screenings for very young children to compensate for the lower sensitivity in this age group, as suggested by the principles outlined in instrument-based pediatric vision screening policy statements 1. Understanding and adjusting for these age-related performance differences are essential for clinicians to interpret screening results accurately and to determine when additional comprehensive eye examinations are necessary.
From the Research
Age and Diagnostic Performance of the Spot Vision Screener
The diagnostic performance of the Spot Vision Screener in detecting amblyopia risk factors or poor visual acuity (VA) can be affected by the age of the subject.
- Studies have shown that the Spot Vision Screener has good sensitivity and specificity in detecting amblyopia risk factors in children, especially at preschool ages 2.
- A study published in 2017 found that the Spot Vision Screener had an overall sensitivity of 89.8% and a specificity of 70.4% in detecting amblyopia risk factors in children aged 6 months to 3 years 3.
- Another study published in 2019 found that the overall sensitivity for the Spot Vision Screener was 87.7% and the specificity was 78.0% in detecting amblyopia risk factors in children, with higher sensitivity and specificity in preschool children (under 7 years old) 2.
- The sensitivity and specificity of the Spot Vision Screener can vary depending on the referral criteria used, with some studies showing improved specificity with minimal impact on sensitivity when using updated referral criteria 4, 5.
- A study published in 2020 found that the Spot Vision Screener had a sensitivity of 86.08% and a specificity of 90.15% in detecting amblyogenic risk factors in children aged 24 to 96 months, with areas under the curve of 0.906 for hyperopia, 0.887 for spherical equivalent, and 0.914 for astigmatism 5.
- The performance of the Spot Vision Screener can also be affected by the age of the child, with some studies showing that it is more accurate in older children 3, 6.
Factors Affecting Diagnostic Performance
Several factors can affect the diagnostic performance of the Spot Vision Screener, including:
- Age of the subject: The Spot Vision Screener has been shown to have better sensitivity and specificity in older children 3, 6.
- Referral criteria: The sensitivity and specificity of the Spot Vision Screener can vary depending on the referral criteria used 4, 5.
- Type of amblyopia risk factor: The Spot Vision Screener has been shown to have higher sensitivity and specificity for certain types of amblyopia risk factors, such as astigmatism and spherical equivalent 5.