Claro (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain.
Clin Exp Optom. 2023 Jan;106(1):20-28. doi: 10.1080/08164622.2021.2003692. Epub 2021 Nov 28.
Clinical Relevance Background: Steady-state accommodation is frequently evaluated with open-field autorefractors; however there is no consensus regarding the optimal test duration. Our results allow us to standardise the procedure followed for the assessment of the steady-state accommodative response in clinical and laboratory settings and may be of great relevance in time-constrained situations.
The present study aims to determine the optimal recording time to assess the magnitude and variability of the accommodative response with a binocular open-field autorefractor.
The steady-state accommodative response of 84 healthy undergraduate students was dynamically measured using the Grand Seiko WAM-5500 autorefractor at 500 cm, 40 cm and 20 cm for 90 s while participants maintained focus on a stationary target. We examined the reliability and level of agreement between four time intervals (the first 10-s, 30-s, 60-s and 90-s) at three accommodative demands (0.2D, 2.5D and 5D).
The magnitude of accommodation showed an excellent level of reliability (intraclass correlation coefficient [ICC]> 0.90) for the comparisons between the 90-s, 60-s and 30-s time intervals at the three viewing distances tested. However, when including the 10-s interval, there was a moderate reduction of the reliability indices and an increase of the mean difference between two time intervals (intra-class correlation [ICC] ranging from 0.89 to 0.97; and ESs ranging from 0.16 to 0.42). For the variability of accommodation, we observed an excellent reliability for the comparisons of the 90-s and 60-s measures at the three accommodative demands (ICC: 0.95-0.96), whereas for the rest of comparisons we observed from moderate to good levels of reliability.
Our data indicate that of 30-s and 60-s are enough to accurately assess the magnitude and variability of the accommodative response with the WAM-5500 autorefractor, respectively.
临床相关性
采用开放式自动折射仪经常评估稳态调节；然而，对于最佳测试持续时间，尚无共识。我们的研究结果可以使我们在临床和实验室环境中评估稳态调节反应的程序标准化，并且在时间受限的情况下可能具有重要意义。
本研究旨在确定使用双目开放式自动折射仪评估调节反应幅度和可变性的最佳记录时间。
使用 Grand Seiko WAM-5500 自动折射仪，在 500cm、40cm 和 20cm 处，在 90 秒内对 84 名健康大学生的稳态调节反应进行动态测量，同时要求参与者保持对固定目标的注视。我们检查了四个时间间隔（前 10 秒、30 秒、60 秒和 90 秒）在三个调节需求（0.2D、2.5D 和 5D）下的可靠性和一致性水平。
在三个测试距离下，90 秒、60 秒和 30 秒时间间隔之间的调节幅度具有极好的可靠性（组内相关系数 [ICC]＞0.90）。然而，当包括 10 秒间隔时，可靠性指数会适度降低，并且两个时间间隔之间的平均差异会增加（组内相关系数 [ICC] 范围为 0.89 至 0.97；效应大小 [ES] 范围为 0.16 至 0.42）。对于调节的可变性，我们观察到在三个调节需求下，90 秒和 60 秒测量值之间的比较具有极好的可靠性（ICC：0.95-0.96），而对于其余的比较，我们观察到从中度到良好的可靠性水平。
我们的数据表明，WAM-5500 自动折射仪分别需要 30 秒和 60 秒即可准确评估调节反应的幅度和可变性。
