Fulton Jane M, Leighton Rebecca E, Uwacu Tuyishime Didier Fidele, Moore Bruce, Little Julie-Anne
Centre for Optometry and Vision Science, School of Biomedical Sciences, Ulster University, Coleraine, UK.
New England College of Optometry, Boston, Massachusetts, USA.
Ophthalmic Physiol Opt. 2025 Jul 19. doi: 10.1111/opo.13557.
This study evaluated the QuickSee autorefractor for measurement of the accommodative response in a cohort of children without significant ametropia, and compared the findings to those determined using the gold-standard Shin-Nippon device.
Children aged 5-7 years were recruited. QuickSee and Shin-Nippon autorefractors were used to measure refractive status at distance (4 m) and near (50, 33 and 25 cm). Accommodative response was calculated as the difference between distance autorefraction and the value obtained for each accommodative demand. Individual accommodative response slopes were calculated from linear regression for response against demand and averaged to calculate mean slopes for each autorefractor. Inter-instrument agreement between the QuickSee and Shin-Nippon was assessed using the Bland-Altman method and 95% limits of agreement. Differences in measured accommodative responses between devices across accommodative demand were assessed by repeated measures ANOVA.
Forty-nine children with a median (IQR) spherical equivalent refraction of +0.38 (0.50 D) (range -0.63 to +1.50 D) participated. Median (IQR) accommodative responses for the 2, 3 and 4 D demands were 1.63 D (0.69), 2.50 D (0.75) and 3.13 D (0.63), respectively, for QuickSee, and 1.63 D (0.69), 2.50 D (0.56) and 3.25 D (0.63) for the Shin-Nippon. Mean ± SD slopes for accommodative response were 0.75 ± 0.22 and 0.83 ± 0.18 for QuickSee and Shin-Nippon, respectively (p = 0.09). Pearson's correlation showed no significant proportional bias for measures of accommodative response with either autorefractor (p ≥ 0.19). The mean difference in accommodative response measured by the QuickSee and Shin-Nippon did not differ significantly with accommodative demand (F = 1.70, p = 0.19).
The agreement observed here demonstrates that the QuickSee shows promise in measuring accommodative response over a range of demands (2, 3 and 4 D) in a paediatric population without significant ametropia. Further research is required to determine if these findings translate over a wider range of refractive errors, and to evaluate the value of QuickSee accommodative response measures in vision screening.
本研究评估了QuickSee自动验光仪在一组无明显屈光不正儿童中测量调节反应的情况，并将结果与使用金标准的日本新光仪器所测定的结果进行比较。
招募了5至7岁的儿童。使用QuickSee和日本新光自动验光仪测量远距离（4米）和近距离（50、33和25厘米）的屈光状态。调节反应计算为远距离验光结果与每个调节需求所获得的值之间的差值。根据调节反应与调节需求的线性回归计算个体调节反应斜率，并进行平均以计算每个自动验光仪的平均斜率。使用Bland-Altman方法和95%一致性界限评估QuickSee和日本新光之间的仪器间一致性。通过重复测量方差分析评估不同调节需求下各仪器测量的调节反应差异。
49名儿童参与研究，等效球镜度中位数（四分位间距）为+0.38（0.50 D）（范围为-0.63至+1.50 D）。对于2 D、3 D和4 D的调节需求，QuickSee测量的调节反应中位数（四分位间距）分别为1.63 D（0.69）、2.
