Comparative Validation of PlusoptiX and AI-Optic Photoscreeners in Children with High Amblyopia Risk Factor Prevalence
Robert W Arnold Alaska Blind Child Discovery, Alaska Children’s EYE & Strabismus, Anchorage, AK, USACorrespondence: Robert W Arnold, Alaska Blind Child Discovery, Alaska Children’s EYE & Strabismus, 3500 Latouche Street #280, Anchorage, AK, USA, Tel +19075611917,...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2022-08-01
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| Series: | Clinical Ophthalmology |
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| Online Access: | https://www.dovepress.com/comparative-validation-of-plusoptix-and-ai-optic-photoscreeners-in-chi-peer-reviewed-fulltext-article-OPTH |
| _version_ | 1818497260065914880 |
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| author | Arnold RW |
| author_facet | Arnold RW |
| author_sort | Arnold RW |
| collection | DOAJ |
| description | Robert W Arnold Alaska Blind Child Discovery, Alaska Children’s EYE & Strabismus, Anchorage, AK, USACorrespondence: Robert W Arnold, Alaska Blind Child Discovery, Alaska Children’s EYE & Strabismus, 3500 Latouche Street #280, Anchorage, AK, USA, Tel +19075611917, Fax +19075635373, Email Eyedoc@Alaska.netPurpose: In 2022, an inexpensive multi-radial infrared photoscreener, the AI Optic was released in a similar format as the 2012 PlusoptiX a-12 but utilizing artificial intelligence (AI) for online, central image interpretation. We studied them because no prior comparative validation concerning amblyopia risk factors and particularly refractive error has been done.Patients and Methods: Children from a pediatric ophthalmology practice had AI Optic and PlusoptiX-a12 photoscreen concomitantly during comprehensive examination with precisely measured strabismus and refraction. Validation to AAPOS 2021 and 2013 guidelines was evaluated with receiver operating characteristic (ROC) curves while refractive estimates were compared by the ABCD ellipsoid univariable technique.Results: In 200 ethnically diverse children aged 1– 18, 148 were 4 years or older, 35% had developmental delays, and 2/3 had amblyopia risk factors (ARF). Area under the ROC curve (AUC) targeting AAPOS 2021 refractive plus strabismus for age ≥ 4 years was 0.58 for AI Optic and 0.74 for PlusoptiX while for children < 4 years, AUC was 0.53 for AI Optic and 0.72 for PlusoptiX. For 134 comparable sphero-cylinder refractions, the ABCD Ellipsoid median (interquartile ranges) for AI Optic right eye 2.53 (1.54, 4.01) and left eye 3.05 (1.83, 5.00) did not approximate actual refraction as well as by PlusoptiX right eye 1.88 (1.12, 2.86) and left eye 2.10 (1.26, 3.04) Mann Whitney z=3.7 right and 4.2 left, p< 0.001 each. AI Optic via central “AI” reading gave sphero-cylinder and referral estimates in all but 16 of 200 high risk children whereas Plusoptix had 25 inconclusives. On the other hand, with inconclusives scored as a refer, Plusoptix outperformed AI Optic in terms of ARF validation and refractive estimate.Conclusion: Plusoptix provided more valid amblyopia and refractive screening than the cheaper AI Optic. Clinics must weigh cost versus performance, and central data sharing before selecting one of these vision-saving devices.Keywords: photoscreening, amblyopia, sphero-cylinder refraction, amblyopia risk factor |
| first_indexed | 2024-12-10T18:43:27Z |
| format | Article |
| id | doaj.art-f0fe623bec5447d09baca9ef9ca5b481 |
| institution | Directory Open Access Journal |
| issn | 1177-5483 |
| language | English |
| last_indexed | 2024-12-10T18:43:27Z |
| publishDate | 2022-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Ophthalmology |
| spelling | doaj.art-f0fe623bec5447d09baca9ef9ca5b4812022-12-22T01:37:36ZengDove Medical PressClinical Ophthalmology1177-54832022-08-01Volume 162639265077412Comparative Validation of PlusoptiX and AI-Optic Photoscreeners in Children with High Amblyopia Risk Factor PrevalenceArnold RWRobert W Arnold Alaska Blind Child Discovery, Alaska Children’s EYE & Strabismus, Anchorage, AK, USACorrespondence: Robert W Arnold, Alaska Blind Child Discovery, Alaska Children’s EYE & Strabismus, 3500 Latouche Street #280, Anchorage, AK, USA, Tel +19075611917, Fax +19075635373, Email Eyedoc@Alaska.netPurpose: In 2022, an inexpensive multi-radial infrared photoscreener, the AI Optic was released in a similar format as the 2012 PlusoptiX a-12 but utilizing artificial intelligence (AI) for online, central image interpretation. We studied them because no prior comparative validation concerning amblyopia risk factors and particularly refractive error has been done.Patients and Methods: Children from a pediatric ophthalmology practice had AI Optic and PlusoptiX-a12 photoscreen concomitantly during comprehensive examination with precisely measured strabismus and refraction. Validation to AAPOS 2021 and 2013 guidelines was evaluated with receiver operating characteristic (ROC) curves while refractive estimates were compared by the ABCD ellipsoid univariable technique.Results: In 200 ethnically diverse children aged 1– 18, 148 were 4 years or older, 35% had developmental delays, and 2/3 had amblyopia risk factors (ARF). Area under the ROC curve (AUC) targeting AAPOS 2021 refractive plus strabismus for age ≥ 4 years was 0.58 for AI Optic and 0.74 for PlusoptiX while for children < 4 years, AUC was 0.53 for AI Optic and 0.72 for PlusoptiX. For 134 comparable sphero-cylinder refractions, the ABCD Ellipsoid median (interquartile ranges) for AI Optic right eye 2.53 (1.54, 4.01) and left eye 3.05 (1.83, 5.00) did not approximate actual refraction as well as by PlusoptiX right eye 1.88 (1.12, 2.86) and left eye 2.10 (1.26, 3.04) Mann Whitney z=3.7 right and 4.2 left, p< 0.001 each. AI Optic via central “AI” reading gave sphero-cylinder and referral estimates in all but 16 of 200 high risk children whereas Plusoptix had 25 inconclusives. On the other hand, with inconclusives scored as a refer, Plusoptix outperformed AI Optic in terms of ARF validation and refractive estimate.Conclusion: Plusoptix provided more valid amblyopia and refractive screening than the cheaper AI Optic. Clinics must weigh cost versus performance, and central data sharing before selecting one of these vision-saving devices.Keywords: photoscreening, amblyopia, sphero-cylinder refraction, amblyopia risk factorhttps://www.dovepress.com/comparative-validation-of-plusoptix-and-ai-optic-photoscreeners-in-chi-peer-reviewed-fulltext-article-OPTHphotoscreeningamblyopiasphero-cylinder refractionamblyopia risk factor |
| spellingShingle | Arnold RW Comparative Validation of PlusoptiX and AI-Optic Photoscreeners in Children with High Amblyopia Risk Factor Prevalence Clinical Ophthalmology photoscreening amblyopia sphero-cylinder refraction amblyopia risk factor |
| title | Comparative Validation of PlusoptiX and AI-Optic Photoscreeners in Children with High Amblyopia Risk Factor Prevalence |
| title_full | Comparative Validation of PlusoptiX and AI-Optic Photoscreeners in Children with High Amblyopia Risk Factor Prevalence |
| title_fullStr | Comparative Validation of PlusoptiX and AI-Optic Photoscreeners in Children with High Amblyopia Risk Factor Prevalence |
| title_full_unstemmed | Comparative Validation of PlusoptiX and AI-Optic Photoscreeners in Children with High Amblyopia Risk Factor Prevalence |
| title_short | Comparative Validation of PlusoptiX and AI-Optic Photoscreeners in Children with High Amblyopia Risk Factor Prevalence |
| title_sort | comparative validation of plusoptix and ai optic photoscreeners in children with high amblyopia risk factor prevalence |
| topic | photoscreening amblyopia sphero-cylinder refraction amblyopia risk factor |
| url | https://www.dovepress.com/comparative-validation-of-plusoptix-and-ai-optic-photoscreeners-in-chi-peer-reviewed-fulltext-article-OPTH |
| work_keys_str_mv | AT arnoldrw comparativevalidationofplusoptixandaiopticphotoscreenersinchildrenwithhighamblyopiariskfactorprevalence |