The Effect of Developmentally-at-Risk Status on the Reliability of the iScreen® Photorefractive Device in Young Children

INTRODUCTION AND PURPOSE: We evaluated the impact of developmentally-at-risk status on the results of photorefractive screening with iScreen®. PATIENTS AND METHODS: We sequentially recruited 169 children (aged 2-5 years) to participate in a blinded, prospective study of a photoscreening device. The principle investigator examined the children after photoscreening. Using established standards for amblyogenic factors, the principle investigator and photoscreen interpreters separately made a determination of "normal" or "needs referral" for each child. Sensitivity, specificity, positive predictive value, and negative predictive value for the photoscreening device were determined. RESULTS: Overall, sensitivity was 85% with a positive predictive value of 98%, and specificity was 87% with a negative predictive value of 47%. Developmentally-at-risk status in 34 children (three refused imaging) did not reduce sensitivity (89%) or specificity (100%) when compared with 130 children (two refused imaging) who did not have developmentally-at-risk factors (sensitivity = 84% and specificity = 80%). CONCLUSION: The efficacy of photorefractive screening in young children with developmentally-at-risk status is comparable to results found in normal children.