PHOTOSCREENING FOR EARLY DETECTION OF AMB LYOGENIC OCULAR CHANGES

Background Congenital and early acquired ocular changes impairing the optic input induce amblyopia when left untreated. Amblyopia treatment must start early to be efficient. Therefore it st ems necessary to emp loy screening tests in preverbal childhood. Patients and methods The r eliability of two commercially available photoscreening devices. the ' 'Visiscreen 100'' (Vision Research Corp.) and the ''MTI-Photoscreener' ' (Medical Technology Inc.), was tested. 180 children from a kindergar ten and 120 infants from our outpatient clinic were screened. The resu lts were compared to the findings of a full ophthalmologic and orthopt ic examination. Results The efficacy of the photoscreening depended on the skill of the examiner and on the age of the children tested. The rate of interpretable photographs was 94% in the older group and 63,3% in the infants. The mean sensitivity for detection of amblyogenic fac tors was 63% in the older and 80% in the infant group. The mean negati ve predictive value was 90% and 75%, respectively. Conclusion Modern p hotoscreening techniques can help to detect amblyogenic factors in ear ly childhood. However, in addition to the non-interpretable photograph s. about 20% of the affected children are missed. Therefore. photoscre ening cannot be recommended Cor countries with a high number of ophtha lmologists, such as Germany, Instead. an ophthalmologic and orthoptic investigation in early childhood would be preferable.