Cordonnier M, De Maertelaer V
Department of Ophthalmology, Hôpital Erasme, Brussels, Belgium.
Strabismus. 2004 Dec;12(4):261-74. doi: 10.1080/09273970490886594.
To compare the results of manifest refraction obtained with two different hand-held autorefractors (Sure-Sight, Welch Allyn Co. and Retinomax 1, Nikon Inc.) and with the Topcon RMA 6000 on-table autorefractor in order to estimate any potential bias between these refractometers and to compare the diagnostic performances of these two hand-held autorefractors as screening devices.
Ninety-eight children were refracted under manifest conditions with the three above-mentioned refractometers and under cycloplegic conditions with the Topcon on-table autorefractor, or by means of retinoscopy. The agreement between the manifest measurements obtained with the three different autorefractors was studied using the method of Bland and Altman. The validity of several thresholds of manifest refractive anomalies as measured with the Sure-Sight and with the Retinomax was estimated by receiver operating characteristic (ROC) curves using cycloplegic measures as reference. results There is a spherical positive bias of 1 D between the Sure-Sight and the Retinomax and better agreement between the Topcon and the Retinomax. The surface area indexes of the ROC curves and the diagnostic performances in term of sensitivity and specificity are better with the Retinomax in cases of hyperopia, astigmatism and anisometropia. For myopia, the Sure-Sight has better performance.
The results suggest that either device may be sufficient for assessing refractive errors in children in a screening setting. However, because of a bias between both refractometers in measuring the sphere, distinctive referral criteria must be chosen for the detection of hyperopia and myopia. The diagnostic performance is slightly in favor of the Retinomax.
比较两种不同手持自动验光仪（Sure-Sight，Welch Allyn公司；Retinomax 1，尼康公司）与Topcon RMA 6000台式自动验光仪进行显然验光的结果，以评估这些验光仪之间可能存在的偏差，并比较这两种手持自动验光仪作为筛查设备的诊断性能。
98名儿童在显然验光条件下分别使用上述三种验光仪进行验光，在睫状肌麻痹条件下使用Topcon台式自动验光仪或通过检影验光。使用Bland和Altman方法研究三种不同自动验光仪进行的显然验光测量结果之间的一致性。以睫状肌麻痹测量结果为参考，通过受试者工作特征（ROC）曲线评估Sure-Sight和Retinomax测量的几种显然屈光不正阈值的有效性。结果Sure-Sight和Retinomax之间存在1 D的球镜正偏差，Topcon和Retinomax之间的一致性更好。在远视、散光和屈光参差病例中，Retinomax的ROC曲线表面积指数以及敏感度和特异度方面的诊断性能更好。对于近视，Sure-Sight表现更佳。
结果表明，在筛查环境中评估儿童屈光不正时，两种设备可能都足够。然而，由于两种验光仪在测量球镜时存在偏差，在检测远视和近视时必须选择不同的转诊标准。诊断性能略倾向于Retinomax。
