自动验光与临床医生验光的可重复性。

The repeatability of automated and clinician refraction.

作者信息

Bullimore M A, Fusaro R E, Adams C W

机构信息

The Ohio State University, College of Optometry, Columbus 43210, USA.

出版信息

Optom Vis Sci. 1998 Aug;75(8):617-22. doi: 10.1097/00006324-199808000-00028.

DOI:10.1097/00006324-199808000-00028

PMID:9734807

Abstract

PURPOSE

Auto-refractors are used as a starting point for clinicians' refractions and in studies of refractive error. We investigated the repeatability of the Hoya AR-570 and clinician refraction.

METHODS

Eighty-six subjects, aged 11 to 60 years, were recruited by mailing inquiries to 500 randomly selected patients who had received recent examinations at the University of California Optometric Eye Center. Contact lens wearers, patients with best corrected visual acuity worse than 20/30 in either eye, and patients with a history of diabetes were excluded. Each subject was examined by two clinicians during one visit. The first clinician obtained five auto-refractor readings for each eye (which were later averaged), performed a balanced subjective refraction (with spherical masking lenses in the phoropter), and repeated the automated refractor measurements. This protocol was then repeated by the second clinician. Clinicians were randomized with regard to testing order and masked to automated refractor results, each other's refractions, and previous spectacle prescriptions.

RESULTS

To quantify repeatability, we used mixed model analyses of variance to estimate the appropriate variance components while accounting for the correlation among, for example, repeated measurements of the same eye. Astigmatic data were analyzed by converting into Fourier form: two cross-cylinders at axis 0 degrees (J0) and axis 45 degrees (J45). For mean spherical equivalent, the average difference between five averaged automated refractor readings, taken by two different optometrists, was +0.02 D (95% limits of agreement = -0.36 to +0.40 D). The average difference between the two optometrists' subjective refractions was -0.12 D (95% limits of agreement = -0.90 to +0.65 D). The 95% limits of agreement for the automated refractor were about half those of the clinician for both astigmatic terms (J0 and J45) and for all comparisons.

CONCLUSIONS

Automated refraction is more repeatable than subjective refraction and therefore more appropriate for studies of myopia progression.

摘要

目的

自动验光仪被用作临床医生验光的起点以及屈光不正研究中使用。我们研究了豪雅AR - 570自动验光仪和临床医生验光的可重复性。

方法

通过邮件向500名在加利福尼亚大学验光眼科中心近期接受检查的随机选择患者发出询问，招募了86名年龄在11至60岁之间的受试者。排除隐形眼镜佩戴者、任何一只眼睛最佳矫正视力低于20/30的患者以及有糖尿病史的患者。每位受试者在一次就诊期间由两名临床医生进行检查。第一位临床医生对每只眼睛获取五次自动验光仪读数（随后进行平均），进行平衡主观验光（在综合验光仪中使用球镜遮盖镜片），并重复自动验光仪测量。然后第二位临床医生重复此方案。临床医生在测试顺序上随机分组，并且对自动验光仪结果、彼此的验光结果以及先前的眼镜处方不知情。

结果

为了量化可重复性，我们使用方差的混合模型分析来估计适当的方差成分，同时考虑例如同一只眼睛重复测量之间的相关性。散光数据通过转换为傅里叶形式进行分析：轴位0度（J0）和轴位45度（J45）的两个交叉圆柱镜。对于平均球镜等效度，两位不同验光师获取的五次平均自动验光仪读数之间的平均差异为+0.02 D（95%一致性界限 = -0.36至+0.40 D）。两位验光师主观验光之间的平均差异为 -0.12 D（95%一致性界限 = -0.90至+0.65 D）。对于散光项（J0和J45）以及所有比较，自动验光仪的95%一致性界限约为临床医生的一半。