Gole Glen A, Schluter Philip J, Hall Julie, Colville Deborah
Community Child Health Service, Royal Children's Hospital, Brisbane, Queensland, Australia.
Clin Exp Ophthalmol. 2003 Aug;31(4):341-7. doi: 10.1046/j.1442-9071.2003.00668.x.
This study aimed to determine the accuracy (and usability) of the Retinomax, a hand-held autorefractor, compared to measurements taken from hand-held retinoscopy (HHR) in a sample of normal 1-year-old children. The study was a method comparison set at four Community Child Health Clinics. Infants (n = 2079) of approximately 1 year of age were identified from birth/immunization records and their caregivers were contacted by mail. A total of 327 infants ranging in age from 46 weeks to 81 weeks (mean 61 weeks) participated in the study. The children underwent a full ophthalmic examination. Under cycloplegia, refraction was measured in each eye by streak retinoscopy (HHR) and then re-measured using the Retinomax autorefractor. Sphere, cylinder, axis of cylinder and spherical equivalent measurements were recorded for HHR and Retinomax instruments, and compared. Across the range of refractive errors measured, there was generally close agreement between the two examination methods, although the Retinomax consistently read around 0.3 D less hyperopic than HHR. Significantly more girls (72 infants, 47.7%), struggled during examination with the Retinomax than boys (52 infants, 29.5%) (P < 0.001). Agreement deteriorated between the two instruments if the patient struggled during the examination (P < 0.001). In general, the Retinomax would appear to be a useful screening instrument in early childhood. However, patient cooperation affects the accuracy of results and is an important consideration in determining whether this screening instrument should be adopted for measuring refractive errors in early infancy.
本研究旨在确定与手持视网膜检影法（HHR）测量结果相比，手持自动验光仪Retinomax在正常1岁儿童样本中的准确性（和可用性）。该研究是在四个社区儿童健康诊所进行的方法比较研究。从出生/免疫记录中识别出约1岁的婴儿（n = 2079），并通过邮件联系其照顾者。共有327名年龄在46周至81周（平均61周）的婴儿参与了研究。这些儿童接受了全面的眼科检查。在睫状肌麻痹下，通过带状视网膜检影法（HHR）测量每只眼睛的屈光度数，然后使用Retinomax自动验光仪重新测量。记录HHR和Retinomax仪器的球镜、柱镜、柱镜轴和等效球镜测量值，并进行比较。在所测量的屈光不正范围内，两种检查方法总体上一致性较好，尽管Retinomax测量的远视度数始终比HHR低约0.3D。在检查过程中，使用Retinomax时遇到困难的女孩（72名婴儿，47.7%）明显多于男孩（52名婴儿，29.5%）（P < 0.001）。如果患者在检查过程中不配合，两种仪器之间的一致性会变差（P < 0.001）。总体而言，Retinomax似乎是幼儿期一种有用的筛查工具。然而，患者的配合会影响结果的准确性，在确定是否应采用这种筛查工具来测量婴儿早期的屈光不正时，这是一个重要的考虑因素。
