Eficácia do Spot™ Vision Screener na detecção de fatores de risco para ambliopia em crianças pré-escolares de 4 a 6 anos de idade

OBJECTIVE: To compare the efficacy of visual screening using the Snellen chart to that of refractive screening using the Spot ™ Vision Screener for detecting the causal factors for amblyopia in a pre-school-aged population (4–6-year-old children). METHODS : In total, 97 pre-school-aged children enrolled in city and state day care centers underwent visual screening exams [uncorrected monocular visual acuity (VA) cut-off point of ≤0.7 and/or a difference in VA of two or more lines between the two eyes] and refractive screening exams (cut-off points: hypermetropia ≥ +3.00 D, myopia ≥ −0.75 D, and astigmatism ≥ −0.75 D). All children then underwent a complete ophthalmologic exam, and the refractive error was measured using cycloplegic manual retinoscopy. RESULTS: Among the children with refractive errors above the adopted cut-off point, the estimated percentages of those who were not referred for a complete ophthalmologic exam were 46.4% in the case of the visual screening method and 17.9% in the case of the refractive screening method. The visual screening method using the Snellen chart exhibited a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 58.6%, 64.7%, 41.5%, and 78.6%, respectively. The refractive screening method using the Spot ™ Vision Screener exhibited a sensitivity, specificity, PPV, and NPV of 92.8%, 35.2%, 37.1%, and 92.3%, respectively. CONCLUSION: Refractive screening using the SPOT ™ Vision Screener was more effective than visual screening using the Snellen chart for detecting the causal factors for amblyopia in the studied population.