Cordonnier M, Dramaix M
Ophthalmology Department, Hopital Universitaire Erasme, Université Libre de Bruxelles.
Br J Ophthalmol. 1998 Nov;82(11):1260-4. doi: 10.1136/bjo.82.11.1260.
High hyperopia constitutes the majority of refractive errors in large scale visual screening at preschool ages. The authors aimed to assess the validity of the Retinomax hand held refractor to detect high hyperopia in a refractive screening performed without cycloplegia and carried out on children aged 9-36 months. They considered +1.5 D of manifest hyperopia to be the threshold value and abnormal absolute hyperopia to be above +3.5 D.
Of the 897 children screened without cycloplegia, 220 were refracted with cycloplegia. The validity of several thresholds of manifest hyperopia was estimated by receiver operating characteristic (ROC) curves using cycloplegic measures as a reference. The reproducibility of Retinomax measurements was assessed. Normal and quick mode measurements were compared using the Wilcoxon test.
The manifest threshold of +1.5 D offered the best combination of sensitivity (70.2%), specificity (94.6%), positive predictive value (78.6%), and negative predictive value (91.9%) to disclose abnormal absolute hyperopia. A good agreement was obtained between the various measurements using Retinomax on the same subject. In the results of this survey, there is no evidence that accommodation is minimised in the normal mode of measurement compared with the quick mode.
The Retinomax hand held infrared autorefractor is a suitable instrument to diagnose abnormal hyperopia (manifest hyperopia > +1.5 D) in noncycloplegic refractive screening at preschool ages. It is suggested as the quick mode of measurement as it is more feasible in children (success rate 98.5%).
在学龄前儿童大规模视力筛查中，高度远视是屈光不正的主要类型。作者旨在评估在未使用睫状肌麻痹剂的情况下，对9至36个月大儿童进行屈光筛查时，使用Retinomax手持验光仪检测高度远视的有效性。他们将1.5 D的显性远视视为阈值，将超过3.5 D的绝对远视视为异常。
在897名未使用睫状肌麻痹剂进行筛查的儿童中，220名接受了睫状肌麻痹验光。以睫状肌麻痹验光结果为参考，通过受试者工作特征（ROC）曲线评估了几个显性远视阈值的有效性。评估了Retinomax测量的可重复性。使用Wilcoxon检验比较了正常模式和快速模式的测量结果。
1.5 D的显性阈值在检测异常绝对远视时，灵敏度（70.2%）、特异性（94.6%）、阳性预测值（78.6%）和阴性预测值（91.9%）的组合最佳。在同一受试者上使用Retinomax进行的各种测量之间取得了良好的一致性。在本次调查结果中，没有证据表明与快速模式相比，正常测量模式下的调节作用最小化。
Retinomax手持红外自动验光仪是在学龄前儿童非睫状肌麻痹屈光筛查中诊断异常远视（显性远视>+1.5 D）的合适仪器。建议采用快速测量模式，因为它在儿童中更可行（成功率98.5%）。
