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Results of photorefractometric screening for amblyogenic defects in children aged 20 months
M R Angi1, V Pucci, F Forattini
1Department of Ophthalmology, Padua University, Italy.
Insights
Early refractometric screening for amblyogenic factors in children showed moderate effectiveness. While photorefractometry identified risk factors, the preventive program did not significantly reduce amblyopia prevalence at age four.
Area of Science:
- Ophthalmology
- Pediatric Vision
- Public Health
Background:
- Amblyopia, or
- lazy eye
- is a leading cause of visual impairment in children.
- Early detection and intervention are crucial for effective treatment.
- Refractometric screening offers a potential method for identifying children at risk.
Purpose of the Study:
- To evaluate the effectiveness of a preventive program utilizing refractometric screening for amblyogenic factors in young children.
- To assess the prevalence of amblyopia in screened versus unscreened populations at age four.
Main Methods:
- Non-cycloplegic photorefractometry (PhR) was used for initial screening at 20 months and 4 years.
- Positive screening cases underwent cycloplegic autorefractometry (AR) and received corrective lenses.
- Visual acuity, stereopsis, and AR were assessed in screened and control groups at age four.
Main Results:
- Photorefractometry demonstrated 80% sensitivity, 96% specificity, and 46% positive predictive value for amblyogenic factors.
- Amblyopia prevalence at age four was 1.07% in the screened group versus 2.57% in the control group (P > 0.05).
- The study initiated an investigation into myopia progression with full correction versus under-correction.
Conclusions:
- The refractometric screening program showed good accuracy in identifying amblyogenic factors but did not lead to a statistically significant reduction in amblyopia prevalence at age four.
- Further research is needed to optimize screening protocols and intervention strategies for preventing childhood amblyopia.
Abstract:
This report evaluates the validity of a preventive programme in a population which underwent refractometric screening at the ages of 20 months and 4 years. In 1987, 1,046 children born in 1985 in the territory of the Veneto National Health Unit No. 19 were invited to undergo screening for amblyogenic factors such as meridional hyperopia greater than or equal to +2.50 diopters (D), myopia less than or equal to -2.50 D, anisometropia greater than or equal to 2 D, opacity of the dioptric media and strabismus. The test method was non-cycloplegic photorefractometry (PhR). Seven hundred and ninety-five children were tested (76%); positive cases underwent subsequent cycloplegic autorefractometry (AR) and corrective lenses were prescribed as necessary. In 1989, an eye test was performed on 653 children who had taken part in the previous PhR screening and on 350 similar children who had not: the test included evaluation of visual acuity, stereopsis and AR. An eye with a corrected visual acuity of less than 0.7 was considered amblyopic. PhR demonstrated a sensitivity of 80%, a specificity of 96% and a positive prediction rating of 46% in the identification of amblyogenic factors. The prevalence of amblyopia at 4 years of age in the group which had undergone previous screening was 1.07% vs. 2.57% in the group which had not (P: not significant). The progress of the myopia was studied in a group with full optical correction used continuously (Group A) and in a control group under-corrected by at least 1.5 D (Group B).(ABSTRACT TRUNCATED AT 250 WORDS)