Loayza Alex, Lewis Alston, Chamberlin Sheila, Trivedi Rupal, Wolf Bethany, Peterseim M Millicent
J Pediatr Ophthalmol Strabismus. 2025 Mar-Apr;62(2):122-127. doi: 10.3928/01913913-20241105-03. Epub 2024 Dec 2.
To evaluate the ability of the monocular QuickSee Free (QSF) portable autorefractor (PlenOptika) to detect and measure refractive error relative to gold standard cycloplegic retinoscopy in a population of school-aged children in a low-resource setting in The Gambia.
A total of 101 children, aged between 3 and 17 years (10.2 ± 3.45 years) underwent visual acuity screening, autorefraction by the QSF, and complete ophthalmic examination including cycloplegic retinoscopy. The agreement of the results was evaluated by Bland-Altman plots. The sensitivity and specificity of detecting myopia, anisometropia, and astigmatism were calculated based on the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) 2021 guidelines. The overall accuracy of detecting refractive error was analyzed with receiver operating characteristic curves.
Spherical equivalent (SE), sphere, and cylinder of the QSF all displayed moderate interclass correlation with cycloplegic retinoscopy with cylinder correlating the highest with physician measurements followed by SE, then sphere. The average bias for the QSF was slightly negative for sphere and spherical equivalents, indicating that on average the QSF tended to underestimate these measures relative to physicians. Based on AAPOS 2021 guidelines, the sensitivity and specificity (in respective order) were 62% and 93% for detecting myopia, 57% and 86% for detecting anisometropia, and 78% and 95% for detecting astigmatism. The area under the receiver operating characteristic curve was greater than 0.75 for all three conditions, suggesting the QSF has good predictive ability to detect myopia, anisometropia, and astigmatism.
The QSF displayed moderate agreement with physician reported refractions and it also tended to underestimate spherical equivalents and sphere. The device exhibited high predictability in detecting refractive error in the low-resource setting. .
评估单眼QuickSee Free（QSF）便携式自动验光仪（PlenOptika）在冈比亚资源匮乏地区学龄儿童群体中检测和测量屈光不正的能力，相对于金标准睫状肌麻痹验光。
共有101名年龄在3至17岁（10.2±3.45岁）的儿童接受了视力筛查、QSF自动验光，以及包括睫状肌麻痹验光在内的全面眼科检查。结果的一致性通过Bland-Altman图进行评估。根据美国小儿眼科与斜视协会（AAPOS）2021年指南计算检测近视、屈光参差和散光的敏感性和特异性。使用受试者工作特征曲线分析检测屈光不正的总体准确性。
QSF的等效球镜（SE）、球镜和柱镜与睫状肌麻痹验光均显示出中等程度的组内相关性，其中柱镜与医生测量值的相关性最高，其次是SE，然后是球镜。QSF的球镜和等效球镜的平均偏差略为负值，表明平均而言，相对于医生，QSF往往低估这些测量值。根据AAPOS 2021年指南，检测近视的敏感性和特异性（按相应顺序）分别为62%和93%，检测屈光参差为57%和86%，检测散光为78%和95%。在所有三种情况下，受试者工作特征曲线下面积均大于0.75，表明QSF在检测近视、屈光参差和散光方面具有良好的预测能力。
QSF与医生报告的验光结果显示出中等程度的一致性，并且也倾向于低估等效球镜和球镜。该设备在资源匮乏地区检测屈光不正方面表现出较高的可预测性。
