Comparison between the plusoptiX and MTI Photoscreeners

Arch Ophthalmol. 2009 Dec;127(12):1591-5. doi: 10.1001/archophthalmol.2009.294.


Objective: Both the Medical Technology and Innovations (MTI) and plusoptiX photoscreeners are used to objectively screen for amblyogenic risk factors in children. The MTI has been extensively studied, but the limited availability of film may render it obsolete. We compared the MTI with the plusoptiX, a newer digital photoscreener, for the ability to detect amblyogenic factors when compared with a comprehensive pediatric ophthalmic examination. We believe our results will help to guide community-based vision screening programs.

Methods: One hundred fifty-one children were examined consecutively in our office. Each patient was screened with the MTI and plusoptiX devices on the same day as part of a comprehensive pediatric ophthalmic examination. Results via MTI were evaluated by an expert masked examiner (R.W.A.), and the plusoptiX results were interpreted by the incorporated software.

Results: Sixty-five percent of patients were found to have amblyopia or amblyogenic risk factors during the pediatric ophthalmic examination conducted via the American Association of Pediatric Ophthalmology and Strabismus referral criteria. We found the MTI photoscreener to have a sensitivity of 83.6%, specificity of 90.5%, false- positive rate of 9.4%, false-negative rate of 16.3%, and positive predictive value of 94.2%. The plusoptiX demonstrated a sensitivity of 98.9%, specificity of 96.1%, false- positive rate of 3.7%, false-negative rate of 1.0%, and positive predictive value of 97.9%.

Conclusion: The MTI and plusoptiX photoscreeners proved to be effective when compared with a comprehensive cycloplegic pediatric ophthalmic examination. The plusoptiX, however, was found to have a higher sensitivity and specificity than the MTI.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Amblyopia / diagnosis*
  • Benchmarking
  • Child
  • Child, Preschool
  • False Positive Reactions
  • Humans
  • Infant
  • Predictive Value of Tests
  • Refractive Errors / diagnosis
  • Reproducibility of Results
  • Risk Factors
  • Sensitivity and Specificity
  • Strabismus / diagnosis
  • Vision Screening / instrumentation*
  • Young Adult