Abstract
Purpose: This study aims to compare and assess the agreement of the objective amplitude of accommodation (AA) measured using a new-generation closed-field autorefractor with conventional subjective methods. Methods: In total, 84 healthy individuals with an age range of 19 to 50 years participated in this cross-sectional study. AA was measured objectively with a Nidek autorefractor (AR-1a; Nidek Co., Ltd., Tokyo, Japan) and subjectively using push-up (PU) and minus-lens (ML) methods in a random order. Comparison between different methods was performed using repeated-measures analysis of variance and the Bonferroni test for pairwise comparisons. In addition to the Pearson correlation, the Bland and Altman method and the intraclass correlation coefficient were used to determine the agreement between the three techniques. Only the right-eye results were used for analysis. Results: AA measured using the Nidek autorefractor (3.43 ± 1.94 D) was significantly lower than that measured with PU (7.67 ± 2.38 D; p < 0.001) and ML (7.60 ± 2.81 D; p < 0.001) methods. The difference between the subjective methods was not significant statistically (p = 1.0). The correlation for Nidek measurements and PU and ML methods was moderate (r = 0.5502 and r = 0.6832, respectively), while it was strong when comparing subjective methods (r = 0.7821). The limits of agreement for Nidek vs. PU, Nidek vs. ML, and PU vs. ML methods were −8.28 to −0.23 D, −8.19 to −0.15 D, and −3.38 to 3.51 D, respectively. Conclusions: There was a moderate agreement between AA obtained with subjective methods and objective Nidek measurements. The objective AA measurements obtained with a new Nidek autorefractor were significantly lower than subjective measurements.
Highlights
Introduction iationsThe accommodative capacity of the eye decreases with age, and this decline becomes clinically relevant from the age of 40 years, resulting in presbyopia [1]
This study aims to compare AA measurements obtained using a new-generation autorefractor with conventional subjective methods
Subjective measurements overestimate AA compared to objective methods
Summary
This cross-sectional study enrolled volunteers with healthy eyes at Hygeia Clinic, Gdansk, Poland, in October 2020. All participants signed informed consent forms after receiving an explanation of the study’s objectives. The clinical history was collected and both eyes received a complete ophthalmic examination, including assessment of objective refraction refined by the subjective method with the corrected ametropia most plus (CAMP) lens and by accommodative balancing [14]. Subjects with eye diseases, including strabismus, cataract, macular disorders, or inflammation, as well as having undergone intraocular surgery or trauma were excluded. Individuals with a history of systemic diseases, such as diabetes mellitus, anemia, or neurological disorders, and with a history of using ocular and systemic drugs were excluded from this study.
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