Optometry Research Group, IOBA Eye Institute, School of Optometry, University of Valladolid, Valladolid, Spain; Vision Rehabilitation Lab, Department of Physics and Optometry, University of Minho, Braga, Portugal.
Universidad de Valladolid, Instituto Universitario de Oftalmobiología Aplicada (IOBA); Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
Indian J Ophthalmol. 2018 Sep;66(9):1262-1267. doi: 10.4103/ijo.IJO_266_18.
To determine repeatability and agreement of the ARK-30 handheld autorefractor with retinoscopy under cycloplegic and noncycloplegic conditions in children.
Three consecutive autorefractor measurements (with and without cycloplegia) and retinoscopy were performed and compared in 30 randomized eyes of 30 children (mean age of 6.7 ± 2.7 years with spherical equivalent [SE] refraction from ‒4.01 to +7.38 D) in a cross-section and masked study. Bland-Altman analysis of autorefractor measurements (with and without cycloplegia) and agreement with retinoscopy were calculated with conventional notation (sphere [Sph] and cylinder [Cyl]) and vector notation (SE, J, and Jcoefficients).
ARK-30 measurements without cycloplegia were lower than under cycloplegic conditions (Sph: ‒0.52 ± 2.37 D vs + 0.86 ± 2.60 D, P < 0.01; Cyl: ‒0.83 ± 0.80 D versus ‒0.78 ± 0.77 D, P = 0.37; and SE: ‒0.94 ± 2.19 D vs + 0.47 ± 2.44 D, P < 0.01, respectively) and statistically different (P < 0.03) from retinoscopy (Shp: +0.83 ± 2.66 D; Cyl: ‒0.71 ± 0.87 D; SE: +0.51 ± 2.49 D). Without statistical differences were in Jand Jcoefficients. Cyloplegic autorefraction measures were not found to be statistically significantly different to retinoscopy measures. ARK-30 under cycloplegia shows better repeatability with lower limits of agreement (LoA) in Sph (LoA: ‒0.66 to +0.69 D), and SE (LoA: ‒0.66 to +0.65 D) than without cycloplegia (LoA: ‒1.45 to +1.77 D, and ‒1.38 to +1.74 D, respectively).
Under noncycloplegic conditions, ARK-30 autorefractor has low repeatability and a tendency toward minus over correction in children. However, repeatability and agreement with retinoscopy under cycloplegic conditions allow use of ARK-30 in children to estimate refraction but not to substitute gold standard retinoscopic refraction.
在儿童散瞳和不散瞳条件下，用 ARK-30 手持自动折射仪与视网膜镜比较，确定其重复性和一致性。
在横断面和盲法研究中，对 30 名儿童的 30 只随机眼（平均年龄为 6.7 ± 2.7 岁，等效球镜（SE）屈光度从-4.01 至+7.38D）进行了三次连续的自动折射仪测量（散瞳和不散瞳）和视网膜镜检查，并进行了比较。采用常规符号（球镜[Sph]和柱镜[Cyl]）和向量符号（SE、J 和 J 系数）计算自动折射仪测量值（散瞳和不散瞳）与视网膜镜检查的 Bland-Altman 分析和一致性。
未散瞳的 ARK-30 测量值低于散瞳条件下的测量值（Sph：-0.52 ± 2.37D 与+0.86 ± 2.60D，P<0.01；Cyl：-0.83 ± 0.80D 与-0.78 ± 0.77D，P=0.37；SE：-0.94 ± 2.19D 与+0.47 ± 2.44D，P<0.01，分别），且具有统计学差异（P<0.03），与视网膜镜检查结果（Sph：+0.83 ± 2.66D；Cyl：-0.71 ± 0.87D；SE：+0.51 ± 2.49D）。J 和 J 系数无统计学差异。未发现散瞳后自动折射仪测量值与视网膜镜测量值有统计学差异。在散瞳条件下，ARK-30 具有更好的重复性，Sph 的低限一致性（LoA）为（-0.66 至+0.69D），SE 的 LoA 为（-0.66 至+0.65D），优于不散瞳时的 LoA（-1.45 至+1.77D 和-1.38 至+1.74D，分别）。
在非散瞳条件下，ARK-30 自动折射仪在儿童中重复性低，有负向过矫趋势。然而，在散瞳条件下与视网膜镜的重复性和一致性允许 ARK-30 在儿童中用于估计屈光度，但不能替代金标准视网膜镜屈光度。
