Ethnic, racial diversity needs to be considered for vision screening algorithms
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KIAWAH ISLAND, S.C. — In a study presented at Kiawah Eye, instrument-based screening for amblyopia risk factors and refractive error showed different sensitivity levels depending on ethnicity or eye coloration.
“The goal for this study was to compare predictive ability of the Spot screening procedure to detect amblyopia risk factors for myopia and hyperopia with variations of patients in terms of different skin and ocular pigment,” Charles Pophal, MD, said.
The Welch Allyn Spot Vision Screener (Hillrom/Baxter) is a photorefraction device that is used to determine if a child may need a referral for refractive correction, he said. The device uses technology to capture reflected infrared light from the retina through the pupil. Images are analyzed and correlated with refractive error using calibration curves. However, these curves are obtained typically from white subjects with lighter pigment.
The study included participants aged between 6 months and 13 years divided into three pigmentation groups, with 273 African American participants in the darker pigment group, 303 Hispanic participants in the medium pigment group and 464 white participants in the lighter pigment group.
The area under the curve for detecting targeted vision disorders showed excellent accuracy with no significant differences between the groups.
“However, when breaking it up into sensitivity, we did see that the myopic group, the lighter pigment eyes performed slightly better in terms of sensitivity than the medium and darker eyes. This was flipped when comparing hyperopic sensitivity between the groups, with the darker eyes performing better than the lighter and the medium eyes,” Pophal said.
These findings suggest that diversity of retinal and choroidal pigmentation likely contributes to the variation of results.
“These results support consideration of ethnic and racial diversity for future technological advances,” Pophal said. “We spoke with members who work on creating the Spot, and they are in the process of creating neural network algorithms to replace the traditional population average approach, which can hopefully replace some of the more Caucasian networks that we have currently.”
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Pophal C, et al. Effectiveness of the Spot Vision Screener with variations in ocular pigments. Presented at: Kiawah Eye; May 30-June 1, 2024; Kiawah Island, South Carolina.
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