Multifaceted Amblyopia Screening with blinq, 2WIN, and PDI Check.

Area of Science:

• Ophthalmology
• Pediatric Vision Screening
• Amblyopia Risk Factors

Background:

• Novel devices like Rebion blinq, Adaptica 2WIN, and PDI Check aim to identify amblyopia risk factors (ARFs) by assessing different visual parameters.
• These devices target binocular foveation, ocular alignment, and dynamic near-vision capabilities, addressing various facets of visual development.

Purpose of the Study:

• To validate and compare the performance of three novel vision screening devices (Rebion blinq, Adaptica 2WIN, PDI Check) in a pediatric ophthalmology clinic.
• To assess the effectiveness of these devices in identifying amblyopia risk factors according to current clinical guidelines.

Main Methods:

• New and returning pediatric patients underwent confirmatory eye exams after being screened with the three devices.
• Validation involved ROC curves, Bland-Altman plots, and ellipsoid grades, with outcomes classified by visual acuity, strabismus, binocularity, and refractive errors per 2021 AAPOS guidelines.
• The Bosque-Hunter rubric was used for blinq assessment.

Main Results:

• A cohort of 202 ethnically diverse students (aged 4-19) showed a high prevalence (58%) of ARFs.
• PDI Check and blinq demonstrated strong correlations with linear logMAR visual acuity, intereye differences, and stereo color vision.
• Sensitivity and specificity varied by device and screening criteria; for example, blinq showed high sensitivity (87%) for refractive error plus strabismus but low specificity (32%).

Conclusions:

• Each device possesses distinct advantages and limitations for screening older children with a high prevalence of ARFs, including those previously treated.
• Comprehensive validation methods are crucial, extending beyond refraction to encompass a broader range of visual functions as recommended by the 2021 AAPOS guidelines.