Department of Ophthalmology, Boston Children's Hospital/Harvard Medical School, Boston, Massachusettes (R.N.C., A.R.).
Akron Children's Hospital, Akron, Ohio (M.C., A.G., A.J.D.P., T.L.R.).
Am J Ophthalmol. 2022 Apr;236:221-231. doi: 10.1016/j.ajo.2021.10.019. Epub 2021 Oct 23.
To assess test-retest repeatability of the accommodative response (AR) in children with and without amblyopia and adults using the Grand Seiko autorefractor.
Prospective reliability assessment.
Test-retest of accommodation was obtained while participants viewed 20/150 sized letters at 33 cm using the Grand Seiko autorefractor in children 5 to <11 years with amblyopia (n=24) and without amblyopia (n=36), and adults 18 to <35 years (n=34). Bland-Altman 95% limits of agreement (LOA) and intraclass correlation coefficients (ICCs) were used to assess repeatability and reliability. The AR between the fellow and amblyopic eyes of children with amblyopia and eye 1 and eye 2 of the visually normal participants was assessed using group comparisons.
The 95% LOA of the AR was greatest in the amblyopic eyes (-1.25 diopters [D], 1.62 D) of children with amblyopia. The 95% LOA were similar between the fellow eyes (-0.88 D, 0.74 D) of children with amblyopia and both eyes of the children without amblyopia (eye 1: -0.68 D, 0.71 D; eye 2: -0.59 D, 0.70 D) and the adults (eye 1: 95% LOA = -0.49 D, 0.45 D; eye 2: LOA = -0.66 D, 0.67 D). ICCs revealed the Grand Seiko autorefractor as a reliable instrument for measuring AR.
The Grand Seiko autorefractor was more repeatable and reliable when measuring the AR in children and adults without amblyopia than in the amblyopic eye in children with amblyopia. It is recommended that multiple measures of the AR be obtained in amblyopic eyes to improve the precision of measures.
使用 Grand Seiko 自动折射仪评估弱视儿童和成人的调节反应（AR）的测试-再测试可重复性。
前瞻性可靠性评估。
在 33cm 处使用 Grand Seiko 自动折射仪，让弱视（n=24）和非弱视（n=36）儿童以及 18 至 35 岁成人观看 20/150 大小的字母，对调节反应进行测试-再测试。使用 Bland-Altman 95%一致性界限（LOA）和组内相关系数（ICC）评估可重复性和可靠性。使用组间比较评估弱视儿童的对侧眼和弱视眼之间的 AR，以及正常视力参与者的眼 1 和眼 2 之间的 AR。
弱视儿童的弱视眼的 AR 95% LOA 最大（-1.25 屈光度[D]，1.62 D）。弱视儿童的对侧眼（-0.88 D，0.74 D）与非弱视儿童的双眼（眼 1：-0.68 D，0.71 D；眼 2：-0.59 D，0.70 D）和成人（眼 1：95% LOA = -0.49 D，0.45 D；眼 2：LOA = -0.66 D，0.67 D）的 95% LOA 相似。ICC 显示 Grand Seiko 自动折射仪是测量 AR 的可靠仪器。
与弱视儿童的弱视眼相比，Grand Seiko 自动折射仪在测量无弱视儿童和成人的 AR 时更具可重复性和可靠性。建议在弱视眼中多次测量 AR，以提高测量精度。
