Comparison of the GoCheck Kids and Spot Screener photoscreening devices for the detection of amblyopia risk factors using 2021 AAPOS recommendations.

Purpose: To compare the Spot Vision Screener (SPOT) to the GoCheck Kids mobile application (GCK) in the evaluation of amblyopia risk factors (ARFs), according to updated 2021 AAPOS guidelines for instrument-based pediatric vision screening.

Methods: SPOT, GCK using horizontal and vertical images (two-photo mode), and a complete eye examination (CEE) were performed on children ages ≥1 to <7 years referred to a pediatric ophthalmologist from October 2020 to December 2022 for a failed vision screen based on manufacturer guidelines. The primary outcomes were sensitivity, specificity, and positive predictive value (PPV) for each photoscreener.

Results: Of 267 subjects included, 42% had one or more 2021 guideline ARFs after CEE. Overall, for SPOT and GCK, respectively, the sensitivity was 0.765 and 0.748, specificity was 0.769 and 0.755, and PPV was 0.728 and 0.712 (P > 0.05 for all). In participants ≥4 years old, SPOT had higher ARF sensitivity than GCK (0.900 and 0.750, resp.; P = 0.005), while among participants <4 years old, SPOT had lower sensitivity than GCK (0.487 and 0.744 respectively; P = 0.004). There were no statistically significant differences between SPOT and GCK in specificity among the younger (0.750 and 0.676 resp.) or older (0.785 and 0.823, resp.) cohorts, or in strabismus detection. The performance of the SPOT and GCK was evaluated using receiver operating characteristics (ROC) curves. Area under the curve (AUC) ranged from 0.857 to 0.980 for SPOT and 0.809 to 0.931 for GCK.

Conclusions: Overall, SPOT, and GCK had similar values for sensitivity, specificity, and PPV to identify patients with ARFs using the 2021 AAPOS guidelines.