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Abstract
Purpose
To compare the refractive measurements obtained using a photorefractor (PlusoptiX S09, PlusoptiX GmbH, Germany) with those obtained using cycloplegic refraction in children.
Methods
We assessed the refractive status of 268 eyes in 134 children. The values acquired via photorefraction with a PlusoptiX S09 device were compared with those obtained by cycloplegic retinoscopy. Hyperopia (㤗+3.5 D), myopia (㤗-3.0 D), with the rule or against the rule astigmatism (㤗-1.5 D), and oblique astigmatism (㤗-1.0 D) were set as diagnostic criteria for refractive amblyopia risk factors (RARFs). The difference in the detection of RARFs by the two methods was the main outcome measure.
Results
The average spherical refractive power was −0.81 ± 1.68 D for PlusoptiX S09 versus −0.26 ± 2.00 D for cycloplegic retinoscopy (average difference −0.54 ± 0.61 D; p < 0.001). The average spherical equivalent was −1.20 ± 1.62 D for PlusoptiX S09 versus −0.64 ± 1.94 D for cycloplegic retinoscopy (average difference −0.56 ± 0.62 D; p < 0.001). The average cylinder power was −0.79 ± 0.93 D for PlusoptiX S09 versus −0.76 ± 0.94 D for cycloplegic retinoscopy (average difference −0.03 ± 0.33 D; p = 0.135). Even though cycloplegic retinoscopy is considered the gold standard, the sensitivity and specificity for detecting RARFs with the PlusoptiX S09 were 88.0% and 96.3%, respectively.
References
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Figure 1.
Scatter plots showing refractive power obtained via PlusoptiX S09 and cycloplegic refraction. Pearson correlation between PlusoptiX S09 and cycloplegic refraction for spherical power, cylinder power, spherical equivalent (r = 0.960, r = 0.939, r = 0.955, respectively,p < 0.001). (A) Spherical power, (B) cylinder power, (C) spherical equivalent.
Table 1.
Comparison of mean refractive power obtained by PlusoptiX S09 and cycloplegic refraction
| CR | PR* | Mean difference (95% CI of difference) | CR versus PR p-value† | |
|---|---|---|---|---|
| Spherical power (D) | -0.26 ± 2.00 | -0.81 ± 1.68 | -0.54 ± 0.61 | <0.001 |
| (-6.00 ∼ +5.00) | (-6.00 ∼ +5.00) | (-0.62 — −0.47) | ||
| Cylinder power (D) | -0.76 ± 0.94 | -0.79 ± 0.93 | -0.03 ± 0.33 | 0.135 |
| (-5.25—0.00) | (-6.25 — 0.00) | (-0.07 — 0.01) | ||
| Spherical equivalent (D) | -0.64 ± 1.94 | -1.20 ± 1.62 | -0.56 ± 0.62 | <0.001 |
| (-6.75 ∼ +4.50) | (-6.00 ∼ +3.50) | (-0.63∼-0.48) |
Table 2.
Comparison of mean refractive power between two groups according to the discrepancy of refractive power measured by PlusoptiX S09 and cycloplegic refraction
| Group 1* 183 eyes (68.3%) | Group 2† 85 eyes (31.7%) | p-value‡ | ||
|---|---|---|---|---|
| Spherical power (D) | CR | -0.92 ± 1.77 | 1.16 ± 1.70 | <0.001 |
| (-6.00∼5.00) | (-3.25∼5.00) | |||
| Cylinder power (D) | CR | -0.70 ± 0.92 | -0.89 ± 0.98 | 0.152 |
| (-5.25∼0.00) | (-3.50∼0.00) | |||
| Spherical equivalent (D) | CR | -1.28 ± 1.76 | 0.72 ± 1.56 | <0.001 |
| (-6.75∼3.13) | (-3.88∼4.50) |
Table 3.
Accuracy parameters of PlusoptiX S09 for detecting refractive amblyopia risk factors compared to standard cycloplegic refraction
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