Evaluation of the Spot Vision Screener in young children in Costa Rica.
BACKGROUND
The Spot Vision Screener has demonstrated good sensitivity and specificity in the pediatric ophthalmology clinic setting. We sought to evaluate the updated Spot (version 2.0.16) in a general pediatric population through a collaboration of the Storm Eye Institute of the Medical University of South Carolina, the Clinica Dr Clorito Picado, and National Children's Hospital of Costa Rica. We compared results of screening with the Spot and pediatric ophthalmologic examination and determined sensitivity and specificity of the Spot in detecting amblyogenic risk factors (ARFs) according to the 2013 AAPOS Vision Screening Committee guidelines for automated vision screeners.


METHODS
Children were screened with the Spot followed by a pediatric ophthalmologic examination. Cycloplegic refraction and motility findings were analyzed by age group to determine ARFs.


RESULTS
A total of 219 subjects, averaging 60 months of age (range, 20-119 mo) were included. The prevalence of ARFs in our population was 12.3% (27/219). The most common risk factor was astigmatism, with a prevalence of 8.7% (19/219). The Spot referred 43 children (19.6%). Sensitivity of the Spot was 92.6%; specificity, 90.6%. The positive predictive value was 58.1%; the negative predictive value, 98.9%.


CONCLUSIONS
The Spot demonstrated good sensitivity and specificity in detecting amblyopia risk factors in this general pediatric population.
Department of Ophthalmology, National Children's Hospital of Costa Rica, San Jose, Costa Rica.
Maricela
M
Arana Mendez
Department of Ophthalmology, National Children's Hospital of Costa Rica, San Jose, Costa Rica.
Leslie
L
Arguello
Department of Ophthalmology, National Children's Hospital of Costa Rica, San Jose, Costa Rica.
Joaquin
J
Martinez
Clinica Ophthalmologica, San Jose, Costa Rica.
Marisela
M
Salas Vargas
Clinica Ophthalmologica, San Jose, Costa Rica.
Ana Maria
AM
Alvarado Rodriguez
Miles Center for Pediatric Ophthalmology, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina.
Carrie E
CE
Papa
Miles Center for Pediatric Ophthalmology, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina.
Carolyn M
CM
Peterseim
Department of Pediatrics, Clinica Dr. Clorito Picado, San Jose, Costa Rica.
Mauricio
M
Otárola Víquez
Miles Center for Pediatric Ophthalmology, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina.
Rupal H
RH
Trivedi
Miles Center for Pediatric Ophthalmology, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina. Electronic address: petersem@musc.edu.
Mae Millicent W
MM
Peterseim
D000550:Amblyopia / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003364:Costa Rica / Q000453:epidemiology; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D042262:Retinoscopy; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015351:Vision Screening / Q000295:instrumentation*