Abstract
BackgroundTo compare the refractive results of hand-held and table-mounted autorefractors.MethodsWe designed this study as an observational, cross-sectional study. We compared the mean spheric and cylinder power, spherical equivalent, Jackson cross-cylinder values, determined the limits of agreement (LoA), and evaluated the reliability of two autorefractors.ResultsWe evaluated 256 eyes of 256 pediatric patients (mean age, 9.12 ± 2.26 years; range, 5–16 years). 49% of the patients were female, and 51% were male. The Nidek HandyRef-K autorefractor measured relatively more astigmatism (P < 0.001) and less hyperopia (P = 0.024). The mean differences and 95% LoA were 0.06 D ± 0.47 D (− 0.82 D to 0.98 D) in spherical power, 0.08 D ± 0.28 D (− 0.47 D to 0.64 D) in cylindrical power, 0.11 D ± 0.47 D (− 0.81 D to 1.01 D) in spherical equivalent, 0.02 D ± 0.36 D (− 0.73 D to 0.69 D) in Jackson cross-cylinder power at 0°, 0.005 D ± 0.54 D (− 1.07 D to 1.06 D) in Jackson cross-cylinder power at 45°. We found the difference within 0.50 D in 244 (95%) eyes for spherical power, in 245 (96%) eyes for cylindrical power, 228 (89%) eyes for spherical equivalent, 224 (87%) eyes for Jackson cross-cylinder power at 0°, 213 (83%) eyes for Jackson cross-cylinder power at 45°. When comparing devices, there were strong correlations for spherical power (Spearman’s rho = 0.99, P < 0.001), cylindrical power (Spearman’s rho = 0.88, P < 0.001), and spherical equivalent (Spearman’s rho = 0.98, P < 0.001).ConclusionTwo autorefractors showed clinically applicable agreement limits; excellent reliability for spherical power and spherical equivalent and good reliability for cylindrical power; high positive percent agreement for spherical and cylindrical power, spherical equivalent, Jackson cross-cylinder power at 0°and 45°. These results showed that both devices might be used interchangeably for screening of refractive error in children.
Highlights
Amblyopia is a unilateral or, rarely, bilateral reduction of best-corrected visual acuity that cannot be attributed directly to the effect of any structural abnormality of the eye or visual pathways [1]
Two hundred seventy patients were enrolled, and 14 of them were excluded from the study due to exclusion criteria (Eight invalid results, five manifest strabismus, one choroidal coloboma)
Sixty-nine (26.9%) of the patients had a type of refractive amblyopia (29 [11.3%] ametropic, 26 [10.2%] anisometropic, 14 [5.5%] meridional amblyopia) when they enrolled in the study
Summary
Amblyopia is a unilateral or, rarely, bilateral reduction of best-corrected visual acuity that cannot be attributed directly to the effect of any structural abnormality of the eye or visual pathways [1]. It is a neurodevelopmental disorder associated with the visual cortex and lateral. Timely identification of refractive errors in children is crucial for preventing refractive amblyopia. Cycloplegic retinoscopy is the gold standard for evaluating refractive errors in children because refractive error can be obtained objectively by completely relaxing accommodation with this method [7, 8] It is time-consuming and requires an experienced clinician. To compare the refractive results of hand-held and table-mounted autorefractors
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