Refractive Errors In Children Research Articles

A qualitative analysis on prevalence of refractive errors in children

A qualitative analysis on prevalence of refractive errors in children

Clinical Characteristics of Children with Refrative Amblyopia at Cipto Mangunkusumo National Referral Hospital

Amblyopia, commonly referred to as 'lazy eye’, manifests as a reduction in best corrected visual acuity (BCVA) in the absence of detectable ocular structural abnormalities. Refractive amblyopia specifically denotes a subtype of amblyopia arising from uncorrected refractive errors. A retrospective descriptive analysis was conducted on medical records of all pediatric patients with refractive amblyopia at the Department of Ophthalmology, Cipto Mangunkusumo Kirana National Referral Hospital, Jakarta, Indonesia in 2018 to 2022. A total of 391 eyes of 224 patients were included. Median age was 8 (5-18) years, with majority being older than 7 years of age (58.7%). Leading method of treatment was with spectacles alone (80.4%). Overall amblyopia improvement was mostly observed after six months of treatment. In conclusion, refractive amblyopia at our hospital was highly prevalent among children. Thus, early detection and treatment of refractive errors in children is essential to prevent refractive amblyopia.

Evaluation of cycloplegic and noncycloplegic performance of spot vision screener in detection of amblyopia risk factors using 2021 AAPOS guidelines

PurposeThis research evaluates the effectiveness of the Spot Vision Screener (SVS) before and after cycloplegia to detect amblyogenic refractive errors in children. MethodsChildren ages 3 to 10 years old were screened by the SVS before and after cycloplegia. Sensitivity, specificity, positive and negative predictive value, paired t-test, Bland-Altman plot and receiver operating characteristic area under the curve were evaluated by comparing the results of the SVS (v3.0.05) measurements with the results of the cycloplegic Topcon autorefractometer according to the 2021 guidelines of the American Association for Pediatric Ophthalmology and Strabismus. ResultsBoth eyes of 211 patients aged 3 to 10 years old were included. Regarding the amblyopia risk factors, the noncycloplegic SVS had 65.7 % sensitivity, 94.9 % specificity, 81.2 % positive predictive value and 89.3 % negative predictive value. The SVS's sensitivity increased from 65.7 % to 81.9 % with cycloplegia compared to noncycloplegic SVS results. The sensitivity detection of hyperopia was improved from 4.2 % to 100 % after cycloplegia. Areas under the receiver operator characteristic curve for noncycloplegic SVS and cycloplegic SVS were 0.506 (95 % CI, 0.395 to 0.646, p = 0737) and 0.905 (95 % CI, 0.915 to 0.971, p < 0.001) for hyperopia, respectively. Using the +1.64 D revised cutoff criteria for hyperopia increased sensitivity from 4.2 % to 78 %. ConclusionNoncycloplegic SVS measurements showed relatively high specificity in detecting amblyopia risk factors. The fact that noncycloplegic measurements have a very low sensitivity for hyperopia is an important weakness of the SVS, especially because hyperopia is the most frequently encountered refractive error in very young children. It should be noted that amblyogenic hyperopia may be overlooked by an SVS without cycloplegia.

Higher order aberrations according to spherical, and astigmatic refractive errors in children

ABSTRACT Clinical relevance The results of this study present novel insights into the impact of spherical and astigmatic refractive errors on overall, corneal and internal aberrations and may provide a clear understanding of the emmetropisation process and the development of visual function. Background This study aimed to assess the association between overall, corneal and internal higher-order aberrations and the spherical and astigmatic components (magnitude and angle) of refractive error in a large sample of children. Methods A total of 311 children aged 7 – 8 years old were classified based on spherical equivalent refraction (myopic, emmetropic and hyperopic); magnitude of astigmatism (none, low and moderate); and angle of astigmatism (with-the-rule, against-the-rule and oblique). Refractive error and overall, corneal and internal higher-order aberrations were measured using the OPD-Scan III workstation. Results Regarding spherical equivalent refraction, myopic eyes had greater root mean square (RMS) overall higher-order values, total spherical, tetrafoil and secondary astigmatism aberrations, and internal higher-order, total spherical and tetrafoil aberrations in comparison to emmetropic eyes. The magnitude of astigmatism was positively associated with all overall RMS aberrations and with internal higher order, coma, total coma, total spherical and tetrafoil aberrations. Eyes with with-the-rule astigmatism showed higher RMS values of coma and total coma compared to eyes with against-the-rule and oblique astigmatism. Conclusions Higher-order aberrations are dependent on the spherical as well as astigmatic components of refractive error. These findings enhance the current understanding of the emmetropisation process and visual function development.

Hybrid Contact Lenses in Children: a Case Series

Introduction : Refractive errors in children have experienced a significant increase in recent years. Contact lenses are a therapeutic option when spectacles can no longer provide maximum results. One of the most advanced design than suitable for children is Hybrid Contact Lenses (HCL). HCL feature a Rigid Gas Permeable (RGP) center surrounded by a soft ridge or skirt. This design enable the hard center to provide clear vision while the soft skirt offers the comfort and ease of a soft lens. However, this type of contact lens has not been widely used in Indonesia.&#x0D; Case Illustration : Three patients were prescribed HCL to correct their high refractive errors and amblyopia; 1. 5 years old female: OD: S-14.50 C-3.25x180 6/24 OS: S-12.5 C-3.50x10 6/24; 2. 5 years old female with anisometropia: OD: S-6.00 C-2.50x180 6/12 OS: S-0.75 C-2.000x170 6/6; 3. 8 years old male with pseudophakic eyes: OD: S-9.00 C-2.00x180 6/30 OS: S-8.00 C-2.00x175 6/30. Visual Acuity after 1 month of HCL average from 6/9 to 6/6 both eyes (BE).&#x0D; Discussion : In this study, we can notice several advantages of using HCL. The main outcome are significantly increased visual acuity and reduced amblyopia. HCL also has a higher comfort level compare to RGP Lenses, the soft hydrogel skirt really help the neophyte patient to ease their initial adaptation.&#x0D; Conclusion : Contact lenses are a mainstay of optical correction options for children with special refractive needs. Due to it's design and comfort, HCL is one of the most suitable contact lenses for children. Therefore, socialization and further introduction about this contact lens is needed.

The association between iris color and refractive errors in children

This study aimed to evaluate the association between iris color and refractive errors in children aged 6–12 years. This cross-sectional study was based on data obtained from the first phase of the Shahroud Schoolchildren Eye Cohort Study. The target population was 6 to12 year-old students living in urban and rural areas. Iris colors were classified by comparing eye colors with close-up images of iris colors. Myopia was defined as a spherical equivalent (SE) ≤ − 0.5 diopter and hyperopia was defined as SE ≥ 2 diopter in cycloplegic refraction. The association of iris color with hyperopia and myopia was investigated by fitting two separate multiple logistic regression models adjusted for place of residence, age, sex, and times for outdoor activity and near work. Among the 5394 participates with the mean age of 9.7 year, the prevalence of myopia and hyperopia was 4.8% and 4.7% respectively. The number and proportion (in parentheses) of amber, light blue, light brown, dark brown, gray, green and hazel iris colors were 19(0.4%), 26(0.5%), 645(12.0%), 4517(83.7%), 4(0.1%), 59(1.1%), and 124(2.3%) respectively. Compared to dark brown, the odds ratios and 95% confidence intervals (in parentheses) of myopia were 4.8(1.2–18.7), 0.8(0.1–5.8), 1.0(0.7–1.5), 0.4(0.1–2.7) and 0.6(0.2–1.8) for amber, light blue, light brown, green and hazel iris colors in multiple logistic regression model. No significant association was observed between iris colors and hyperopia. This study shows that amber iris is significantly associated with higher odds of myopia. These children should be further monitored and examined. More studies with higher sample size in all iris colors are recommended.

Lens power, cornea power and association with refractive error in children with moderate to high hyperopia.

This study aimed to profile ocular biometry parameters and predictors of spherical equivalent refraction (SER) among children with moderate to high hyperopia. Individuals <18 years of age with moderate to high hyperopia were enrolled from November 2015 to November 2021. Participants underwent a series of comprehensive ocular examinations, and were classified as having low hyperopia, that is, SER +0.5 to < +2.0 D or moderate to high hyperopia, that is, SER ≥ +2.0 D. A total of 459 and 230 eyes with moderate to high hyperopia and low hyperopia, respectively, were included. Moderate to high hyperopic eyes had a shorter axial length, stronger lens power (24.78 ± 5.47 D vs. 18.74 ± 1.63 D, p < 0.001) and weaker corneal power (42.82 ± 1.75 D vs. 43.31 ± 1.55 D, p < 0.001) than low hyperopic eyes. When comparing values before and after 5 years of age, both lens power and axial length differed significantly in the moderate to high hyperopia group, whereas in the low hyperopia group, they only differed significantly after 9 years of age. Lens power was negatively associated with AL in eyes with axial lengths between 20 and 22 mm. A multiple linear regression model which included axial length (standardised β = -0.80, p < 0.001), corneal power (standardised β = -0.47, p < 0.001) and lens power (standardised β = 0.23, p < 0.001) explained 81.2% of the variance in SER. Differences in lens power and axial length in moderate to high hyperopic eyes became significantly smaller after 5 years of age, at least 4 years earlier than for the low hyperopia. Lens power could offset the axial elongation in participants with axial lengths between 20 and 22 mm, suggesting that children with moderate to high hyperopia might have different ocular growth patterns. Axial length, corneal power and lens power were the main predictors of SER in moderate to high hyperopia.

Effect of spectacle correction on hyperopic children.

Background: Hyperopia is a significant refractive error in children, often leading to vision impairment. This study aimed to investigate whether partial or full spectacle correction is benefit for hyperopia in preschool-aged children. Methods: A retrospective study was conducted on hyperopic children visited to teaching medical center outpatient clinic between October 2011 and October 2018, and were categorized into three groups: full correction, overcorrection, and undercorrection. The study was approved by the institutional ethical committee of Tri-Service General Hospital. Results: Following a minimum of one-year follow-up period, no statistically significant differences were observed in best-corrected visual acuity (BCVA) among children receiving full, over, or under spectacle correction. Notably, the overcorrection group exhibited a significant reduction in spherical equivalent (SE) compared to both the full and under correction groups, indicating a better SE with spectacle overcorrection. Conclusions: Spectacle overcorrection may offer potential benefits for enhancing SE in preschool children with hyperopia. Nevertheless, further investigation through randomized controlled trials is warranted to establish the validity of this approach and its impact on visual outcomes in this hyperopic pediatric population.

Correlation Of Parents' Level Of Knowledge With Actions Against Refractive Directness In Children Aged 5 – 8 Years At State Primary School

Refractive errors are the third most common cause of blindness. Uncorrected refractive errors in children will disrupt their learning process. Good parental knowledge and action regarding disorders will be able to prevent vision problems in children. This study aims to study the correlation between parents' level of knowledge and actions regarding refractive errors in children. The design of this research is cross sectional analytic. The sample for this research was parents of students at SD Negeri 101751 Klambir V grades 1 and 2. The sample size was 61 respondents. The sampling technique used simple random sampling. The instrument used in the research was a questionnaire. The data obtained was tested using Spearman analysis. The results of this study show that there is a significant correlation between the level of parental knowledge and actions regarding refractive errors in children with a value of p &lt; 0.05 (p = 0.000). The close relationship between variables is moderate with a value of r=0.478. The level of parents' knowledge of refractive errors is significantly related to their actions. It is hoped that there will be a promotional program from the health department to provide education or counseling regarding eye health, and visual acuity screening, for early detection of refractive errors in children.

Eye Size and Shape in Relation to Refractive Error in Children: A Magnetic Resonance Imaging Study.

The purpose of this study was to determine the association between eye shape and volume measured with magnetic resonance imaging (MRI) and optical biometry and with spherical equivalent (SE) in children. For this study, there were 3637 10-year-old children from a population-based birth-cohort study that underwent optical biometry (IOL-master 500) and T2-weighted MRI scanning (height, width, and volume). Cycloplegic refractive error was determined by automated refraction. The MRI images of the eyes were segmented using an automated algorithm combining atlas registration with voxel classification. Associations among optical biometry, anthropometry, MRI measurements, and RE were tested using Pearson correlation. Differences between refractive error groups were tested using ANOVA. The mean volume of the posterior segment was 6350 (±680) mm3. Myopic eyes (SE ≤ -0.5 diopters [D]) had 470mm3 (P < 0.001) and 970mm3 (P < 0.001) larger posterior segment volume than emmetropic and hyperopic eyes (SE ≥ +2.0D), respectively. The majority of eyes (77.1%) had an oblate shape, but 47.4% of myopic eyes had a prolate shape versus 3.9% of hyperopic eyes. The correlation between SE and MRI-derived posterior segment length (r -0.51, P < 0.001) was stronger than the correlation with height (r -0.30, P < 0.001) or width of the eye (r -0.10, P < 0.001). In this study, eye shape at 10 years of age was predominantly oblate, even in eyes with myopia. Of all MRI measurements, posterior segment length was most prominently associated with SE. Whether eye shape predicts future myopia development or progression should be investigated in longitudinal studies.

The Role of Corneal Aberrations in the Development and Progression of Pseudophakic Myopia after Congenital Cataract Extraction in Infancy

Relevance. Many studies have shown a relationship between higher order aberrations and refractive errors in children without comorbidities, but these studies have not been conducted in children with pseudophakia. Purpose. Evaluation of corneal aberrations after congenital cataract (CC) extraction with intraocular lens (IOL) implantation in infancy, and their impact on the dynamics of eye growth and myopia progression. Materials. Thirty-two children (the median age 9.35 ± 3.31 years; range 4–15 years) with pseudophakia were divided to: group 1, planned refraction (17 children, 23 eyes) and group 2, pseudophakic myopia (15 children, 23 eyes). Twelve children (24 eyes; the median age 11.67 ± 2.43 years) with moderate and high myopia without ophthalmic pathology were examined as a comparison group. Keratometry and aberrometry were performed on a Scheimpflug Galilei G2. Results. Total corneal aberrations root mean square (RMS) and higher order aberrations (HOA) were higher in pseudophakic children (2.77 and 1.13 µm in group 1, 2.48 and 1.15 µm in group 2) when compared with children with acquired myopia (1.58 and 0.44 µm; p &lt; 0.05). Oblique astigmatism and negative oblique trefoil were the highest in pseudophakic myopia (0.63 and (-)0.48 µm). There were positive correlations between eye growth in 4 years and HOA (r = 0,699; p &lt; 0,01), eye growth during the total follow-up time and oblique astigmatism (r = 0,393; p &lt; 0,01), and negative correlation between eye growth during the total follow-up time and oblique trefoil (r = -0,322; p &lt; 0,05). Conclusion. Corneal incision with forced corneal suture during surgery in infants leads to an increase in HOA, especially oblique astigmatism, and oblique trefoil. Correlations between corneal aberrations and the dynamics of globe axial length growth indicate the effect of monochromatic aberrations on eye growth already in the early postoperative period.

Comparison of the new self-contained darkroom refractive screener versus table-top autorefractor and cycloplegia retinoscopy in detecting refractive error

PurposeBy comparing the results of the new self-contained darkroom refractive screener (YD-SX-A) versus table-top autorefractor and cycloplegic retinoscopy, to evaluate the performance of the YD-SX-A in detecting refractive error in children and adolescents and then judge whether it can be used in refractive screening.MethodsCross-sectional study. 1000 participants between the ages of 6 and 18 who visited the Optometry Center of the People's Hospital of Guangxi Zhuang Autonomous Region from June to December 2022 were selected. First, participants were instructed to measure their diopter with a table-top autorefractor (Topcon KR8800) and YD-SX-A in a noncycloplegic setting. After cycloplegia, they were retinoscopy by a professional optometrist. The results measured by three methods were collected respectively. To avoid deviation, only the right eye (1000 eyes) data were used in the statistical analysis. The Bland–Altman plots were used to evaluate the agreement of diopters measured by the three methods. The receiver operating characteristic (ROC) curves was used to analysis effectiveness of detecting refractive error of YD-SX-A.ResultsThe average age of participants was 10.77 ± 3.00 years, including 504 boys (50.4%) and 496 girls (49.6%). When YD-SX-A and cycloplegia retinoscopy (CR) were compared in the myopia group, there was no statistical difference in spherical equivalent (SE) (P > 0.05), but there was a statistical difference in diopter spherical (DS) and diopter cylinder (DC) (P < 0.05). Comparing the diopter results of Topcon KR8800 and CR, the difference between each test value in the myopia group was statistically significant (P < 0.05). In the hyperopia group, the comparison between YD-SX-A and CR showed no statistically significant differences in the DC (P > 0.05), but there were significant differences in the SE and DS (P < 0.05). In the astigmatism group, the SE, DS, and DC were statistically different, and the DC of YD-SX-A was lower than that of CR and Topcon KR8800. Bland–Altman plots indicated that YD-SX-A has a moderate agreement with CR and Topcon KR8800. The sensitivity and specificity of YD-SX-A for detecting myopia, hyperopia and astigmatism were 90.17% and 90.32%, 97.78% and 87.88%, 84.08% and 74.26%, respectively.ConclusionThis study has identified that YD-SX-A has shown good performance in both agreement and effectiveness in detecting refractive error when compared with Topcon KR8800 and CR. YD-SX-A could be a useful tool for large-scale population refractive screening.

A Comprehensive Study on the Prevalence and Determinants of Vision Impairment in the Turkish Population

Objective: Vision impairment and eye diseases significantly affect quality of life and present a substantial public health challenge. According to the TUIK and the World Health Organization, a significant portion of the population suffers from preventable or unaddressed visual impairments. Understanding the prevalence, causes, and demographic distribution of these impairments can aid in formulating effective public health strategies. To analyze the prevalence, determinants, and demographic characteristics of individuals with vision impairment in Turkey, using data provided by TUIK. This proposal aims to utilize existing data to provide valuable insights into the public health issue of vision impairment in Turkey and to foster improved outcomes through targeted intervention strategies. Methods: Secure access to TUIK health survey data focusing on vision impairment in the population aged 0–65 years. We collected additional variables that may influence vision health, such as socioeconomic status, access to healthcare, educational level, and urban versus rural residence. We conducted a cross-sectional study using TUIK data from 2019 onwards, including demographic variables (age, sex, education, and income), and correlated them with the incidence and type of vision impairment. Results: Visual impairment affects approximately 1039000 individuals in Turkey, with a prevalence rate of 1.4%. There was a pronounced increase in visual impairment with age, peaking at 46.5% in those aged &gt; 75 years. Females exhibited higher rates of impairment in most age groups. The most common causes of visual impairment include uncorrected refractive errors in children and young adults, glaucoma in adults aged 15-50, and age-related macular degeneration and diabetic retinopathy in those aged &gt; 50 years. Conclusion: This study highlights a significant age and sex disparity in the prevalence of visual impairment in Turkey, necessitating age-specific and gender-responsive public health strategies. Prioritizing early screening, access to corrective measures, and managing age-related ocular diseases can address the increasing burden of visual impairment. Interventions should be tailored to mitigate risks and provide equitable healthcare access to improve visual health outcomes in the Turkish population.

Refractive Error among Children Visiting the Department of Paediatric Opthalmology of a Tertiary Eye Care Center.

Refractive error is the inability of eyes to focus clearly on images. Visual impairment due to refractive error has a major impact on children's education and daily activities. The hospital has no documentation of the ocular morbidity related to refractive errors in children. The aim of this study was to find out the prevalence of refractive error in children visiting the Department of Paediatric Ophthalmology of a tertiary care centre. A descriptive cross-sectional study was done in the Outpatient Department of Paediatric Ophthalmology in a tertiary care centre from 8 September 2022 to 7 March 2023 after obtaining ethical approval from the Institutional Review Committee. A convenience sampling method was used. The point estimate was calculated at 95% Confidence Interval. Among 3600 children, the prevalence of refractive error was seen in 668 children (18.56%) (15.61-21.51, 95% Confidence Interval). Refractive error was seen in 363 (54.34%) boys and 305 (45.66%) girls. Myopia was found in 340 (50.90%), astigmatism in 207 (30.99%), and hyperopia in 121 (18.11%). The prevalence of refractive error among children attending a tertiary care centre was found to be higher than studies done in similar settings. Regular screening of refractive error for visual impairment is recommended among school going children. astigmatism; hyperopia; myopia; refractive error; visual impairment.

The Difference of Risk Factors Between Mild and Moderate-Severe Refractive Errors in Pediatric Patients at the Diponegoro National Hospital

Background: Refractive errors are the leading cause of visual impairment and the second leading cause of blindness worldwide. The incidence of refractive errors in children in Indonesia and in the world is quite high. The incidence of refractive errors can be triggered by several risk factors, including genetics, age, gender, close-range activities, use of electronic devices, and outdoor activities. Objective: Knowing the difference in risk factors between mild and moderatesevere refractive errors in pediatric patients at the Diponegoro National Hospital.Methods: This type of research is an analytic observational study with a cross sectional approach. Data were taken using a consecutive sampling technique from questionnaires and medical records of pediatric patients in the 2018-2021 period. The research subjects were 57 people who met the inclusion and exclusion criteria. Data were analyzed by univariate and bivariate analysis using Chi-Square and Mann Whitney analysis. Results: The research subjects were dominated by the age of 16-18 years (63.2%), female gender (68.4%), types of myopia disorders (57.9%), and mild degrees (66.7%). The results of the Chi-Square analysis showed that there was a significant difference in reading distance (p=0.000), reading position (p=0.035), duration of use of electronic devices (p=0.031), and duration of outdoor activities (p=0.042) between mild and moderatesevere degrees. Conclusion: There are significant differences in reading distance, reading position, duration of use of electronic devices, and duration of outdoor activities between mild and moderate-severe refractive errors in pediatric patients at the Diponegoro National Hospital.

The Relationship between Axis Length Difference and Refractive Error in Unilateral Myopic Anisometropic Children Treated with Orthokeratology.

To explore the correlation between the axial length (AL) difference (myopic and nonmyopic eye) and the refractive error in children with unilateral myopia anisometropia (UMA) and to elucidate its clinical application in the process of Ortho-K lenses review following nonstop wearing. This study retrospectively analyzed the data of 70 children with UMA (age, 8-15 years) whose myopic eyes were treated with Ortho-K lenses. The spherical equivalent refractive errors (SERE) of the myopic eye ranged from -0.75 D to -4.25 D, and astigmatism was no less than -1.50 D. In addition, SERE of nonmyopic eyes were no less than -0.50 D. AL, and the refractive data of both eyes were measured at baseline. A multivariate linear regression was used to analyze the relationship between the AL difference and refractive error, and paired t-test was used to analyze the changes in AL in both eyes. Every 1 mm axial length change corresponds to -1.627 D (95% CI: -1.921 D, -1.333 D; P < 0.001) change in refractive error in children. The association between the AL change and the degree of myopia did not change with age (P=0.751). Among the 70 subjects, 51 (72.86%) had myopia in the right eye, and the 95% confidence interval (CI) for myopia occurring in the right eye was 62.4%-83.3%. The paired t-test showed that the average AL growth was significantly slower in myopic eyes treated with Ortho-K lenses than in nonmyopic eyes (t = 9.805, P < 0.001). Every 1 mm AL change would cause an average refractive error increase. Age did not influence the association between AL changes and the degree of myopia. The right eye is more likely to be affected in children with UMA. The Ortho-K lens treatment slowed down the growth of AL in the myopic eye in children with UMA.

Development and Validation of a Screening Tool for The Identification of Refractive Errors Among School Going Children In Tamil Nadu, India

Background: The inability to focus light onto the retina, known as refractive error, is a significant cause of correctable visual impairment. Unfortunately, students' ocular complaints often go unnoticed due to a lack of awareness. To address this issue, a questionnaire with high sensitivity and reasonable specificity was developed for teachers to identify students with refractive error. Methods: A questionnaire with surrogate indicators for refractive error in children was used and the data was analysed using SPSS. Significant markers were scored and a ROC curve determined a suitable cut-off. Sensitivity and specificity were calculated based on this cut-off. Results: The questionnaire was developed using five variables that had a 65% probability of identifying refractive error, including copying errors, copying from peers, eye squeezing, previous use of glasses, and eye deviation. A cut-off score of 5.5 out of 14 achieved 90% sensitivity and 50% specificity in detecting refractive errors. Conclusion: This study created a tool with five markers that demonstrated good internal consistency and content validity, it had an average sensitivity and specificity of 84% and 63%, respectively. The tool is twice as likely to identify someone with refractive error than someone without it.

The Development of Retinal Function and Refractive Error in Children With Retinopathy of Prematurity.

The purpose of this study was to test the hypothesis that retinopathy of prematurity (ROP) prolongs development of rod-mediated thresholds for detection of stimuli at 10degrees but not 30degrees eccentricity. In addition, to evaluate the thresholds at each site for an association with visual acuity (VA) and spherical equivalent (SE). We estimated rod-mediated dark-adapted thresholds (DATs) for the detection of 2degree diameter, 50ms, blue (λ < 510nm) flashes at 10degrees and 30degrees eccentric in former preterm subjects (n = 111), stratified by ROP severity: None (n = 32), Mild (n = 66), and Severe (n = 13). We also tested Term-born (n = 28) controls. To determine the age at half-maximal sensitivity (Agehalf) for each group and eccentricity, we fit DATs to logistic growth curves. We obtained VA and SE for Preterm subjects and evaluated the course of threshold development at 10degrees and 30degrees for significant association with VA and SE predicted at age 10 years. DAT development at 10degrees was significantly delayed in ROP (Mild and Severe); ROP did not significantly alter DAT development at 30degrees. At age 10years, among Preterm subjects, both VA and SE were significantly associated with group (None,Mild, and Severe). SE was predicted by the course of DAT development at 30degrees. VA was not associated with the course of DAT development at 10degrees. At 10degrees, ROP-whether mild or severe-is associated with significant delays in DAT development, evidence that the late-maturing central retina is vulnerable to ROP. The association of 30degree threshold and myopia are evidence that more peripheral retina is important to refractive development.

Comparabilidad del autorrefractómetro portátil Retinomax K-plus 3 en modo rápido versus autorrefractómetro de sobremesa en modo estándar

IntroductionThis study analyzes the comparability of measurements taken by a Retinomax K-plus 3 handheld autorefractometer in quick mode and a Topcon KR-800 on-table autorefractometer in standard mode on the pediatric population, and establishes their correlation. MethodsIt is a retrospective comparative study. Spherical diopter power (SPH), cylindrical diopter power (CYL), angle of cylindrical axis (AX), and spherical equivalent (SE) were measured with the Retinomax in quick mode and with the Topcon in standard mode. Each patient was evaluated in cycloplegic and non-cycloplegic conditions by both autorefractometers. Student's t-test was performed between the two instruments for SPH, CYL, and SE. The Pearson correlation coefficient was calculated and the dispersion was represented using Bland-Altman graphs, also evaluating the subgroup of patients under 4 years of age. A descriptive analysis of the percentages of measures that differed was performed. ResultsIt included 98 eyes of 49 subjects (age range: 3-16 years). The data for HPS without cycloplegia are virtually identical, whereas with cycloplegia there is a hyperopic bias of +0.5 diopters measured with Retinomax. CYL results are very similar with and without cycloplegia. There is a high Pearson correlation for both instruments (>0.91) and a low degree of dispersion in the Bland-Altman plots under cycloplegia. ConclusionThe Retinomax data were consistent with those obtained by Topcon. The Retinomax is a useful instrument for detecting refractive errors in children between 3 and 16 years of age.

Comparability of the Retinomax K-plus 3 handheld autorefractometer in quick mode versus on-table autorefractometer in standard mode

IntroductionThis study analyzes the comparability of measurements taken by a Retinomax K-plus 3 handheld autorefractometer in Quick mode and a Topcon KR-800 on-table autorefractometer in standard mode on the pediatric population, and establishes their correlation. MethodsIt is a retrospective comparative study. Spherical diopter power (SPH), cylindrical diopter power (CYL), angle of cylindrical axis (AX), and spherical equivalent (SE) were measured with the Retinomax in Quick mode and with the Topcon in standard mode. Each patient was evaluated in cycloplegic and non-cycloplegic conditions by both autorefractometers. Student’s t-test was performed between the two instruments for SPH, CYL, and SE. The Pearson correlation coefficient was calculated and the dispersion was represented using Bland-Altman graphs, also evaluating the subgroup of patients under 4 years of age. A descriptive analysis of the percentages of measures that differed was performed. ResultsIt included 98 eyes of 49 subjects (age range: 3–16 years). The data for HPS without cycloplegia are virtually identical, whereas with cycloplegia there is a hyperopic bias of +0.5 diopters measured with Retinomax. CYL results are very similar with and without cycloplegia. There is a high Pearson correlation for both instruments (>0.91) and a low degree of dispersion in the Bland-Altman plots under cycloplegia. ConclusionThe Retinomax data were consistent with those obtained by Topcon. The Retinomax is a useful instrument for detecting refractive errors in children between 3 and 16 years of age.