Testability and test–retest reliability of SpotChecks Contrast Sensitivity Test in children with unilateral amblyopia
Year: 2026
Type: article
Abstract: PURPOSE: To report testability and test-retest reliability of the SpotChecks contrast sensitivity (CS) test in amblyopic and nonamblyopic eyes of children with unilateral amblyopia. METHODS: Children aged 3-12 years with unilateral amblyopia due to strabismus and/or anisometropia were recruited as part of a randomized trial. SpotChecks was administered twice in the left eye at 8 weeks post-randomization. This single-use paper test has a measurable CS threshold range of 0.90 to 2.09 logCS (24 lines, 1 line = 0.05 logCS). Testability was defined as the completion of a pre-test. Bland-Altman analysis was used to evaluate test-retest reliability. RESULTS: In children aged 3-6 years, 81% (117/145) passed the pre-test: 17 of 34 (50%) 3-year-olds, 39 of 46 (85%) 4-year-olds, 33 of 37 (89%) 5-year-olds, and 28 of 28 (100%) 6-year-olds. Fifty-four of 117 (46%) who passed the pre-test had matching test pairs for analysis. In children aged 7-12 years, all 45 passed the pre-test. Twenty-two of 45 (49%) who passed the pre-test had matching test pairs for analysis. Among 76 test-retest pairs (40 amblyopic and 36 nonamblyopic eyes), the mean difference (95% CI) was 0.01 (-0.02 to 0.03) logCS and the half-width of the 95% limits of agreement was ±0.20 (0.16-0.24) logCS. Results were similar between amblyopic and nonamblyopic eyes, as well as within age cohorts. CONCLUSIONS: Children aged 6-12 years were more likely to be testable. Regardless of age, half of all test-retest pairs were completed incorrectly, possibly due to examiner or participant-related factors. A greater than 4-line (0.20 logCS) change on the SpotChecks contrast sensitivity test is required to detect a change in contrast sensitivity function beyond measurement error in children 3-12 years of age with unilateral amblyopia. TRIAL REGISTRATION: Clinicaltrials.Gov, registered 14 July 2022, NCT05462821.
Source: Optometry and Vision Science
DOI: 10.1002/ovs2.70058
Authors: Vivian M. Manh, Rui Wu, Michael E. Gray, Nathan L. Cheung, Susan A. Cotter, John W. Erickson, Jennifer H. Fisher, Jennifer A. Galvin, Kammi B. Gunton, Benjamin G. Jastrzembski, Aparna Raghuram, Allegra P. Burgher, Katherine O. Whitfield, Wesley T. Beaulieu, Raymond T. Kraker, Katherine K. Weise, Stacy L. Pineles, Jonathan M. Holmes, the Pediatric Eye Disease Investigator Group
Institutions: Seattle Children's Hospital, Jaeb Center for Health Research, Cincinnati Children's Hospital Medical Center, Duke University, Marshall B. Ketchum University, Nemours Children's Clinic, University of California, Berkeley, Yale University, Wills Eye Hospital, University of California, Davis, Boston Children's Hospital, Corewell Health, University of North Carolina at Chapel Hill, University of Alabama at Birmingham, University of California, Los Angeles, University of Arizona
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7162088125