Comparison of the PlusoptiX Screening Test with Cycloplegic Retinoscopy to Detect Significant Refractive Errors

Abstract

<em><strong>Introduction</strong><em> Severe refractive errors are risk factors for amblyopia. The most accurate way to detect them is with a complete visual and ocular examination including cycloplegic retinoscopy. <em><strong>Objective:</strong></em> To compare the PlusoptiX Screening Test with cycloplegic retinoscopy to assess significant refractive errors between the ages of 4 and 18. <em><strong>Methods</strong><em> PlusoptiX was used in a sample of 220 children from several schools in Cartagena. For statistical analysis, the paired difference test was used with the SAS 9.4 software with ≈ 0.05, in order to compare median values (Wilcoxon) and cumulative distribution (Kolmogorov-Smirnov) between the two techniques. Nominal values were also generated between the ranges considered as clinically important of ±0.50 and ± 1.00 D. In addition, sensitivity and specificity of the PlusoptiX instrument were calculated in order to discover significant refractive errors compared with cycloplegic retinoscopy. <em><strong>Results</strong><em> In the assessed children, hypermetropia > +3.50 D was detected at 4.5% myopia > –3.00 at 0.04 % astigmatism > -1.50 D at 15.9%, anisometropia > 1.50D at 3.2 % with cycloplegic retinoscopy. Concordance between PlusoptiX and retinoscopy was ±0.50 at 34.7-41% in sphere values and ±0.50 at 57.7-61.3% in cylinder values. The best sensitivity was 72%, with a specificity of 61%. <em><strong>Conclusions</strong><em> PlusoptiX yielded different results from cycloplegic retinoscopy and can be used to facilitate screening however, attention to its low sensitivity and specificity is required.