Does the Accuracy and Repeatability of Refractive Error Estimates Depend on the Measurement Principle of Autorefractors?

Padhy, Debananda; Nayak, Suryasmita; Rath, Suryasnata; Das, Taraprasad

doi:10.1167/tvst.10.1.2

Cited by 24 publications

(20 citation statements)

References 57 publications

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“…On the other hand, the screening methods were also varied, such as the difference of refractive equipment. Indeed, there were studies reporting the different equipment could lead to varied results under noncycloplegic refraction [ 32 , 33 ]. We did not investigate the living conditions of students during the pandemic.…”

Section: Discussionmentioning

confidence: 99%

The change of myopic prevalence in children and adolescents before and after COVID-19 pandemic in Suqian, China

et al. 2022

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Purpose The aim of this study was to investigate the change of myopic prevalence in students with different demographic characteristics before and after the COVID-19 pandemic in Suqian, China. Methods A retrospective, cross-sectional study was conducted. Student data from 52 schools in 2019 and 2020 were collected from the electronic medical records database through cluster sampling. Ophthalmic examinations were conducted on students from September to December in 2019 and 2020. Measurements of uncorrected visual acuity (UCVA) and noncycloplegic autorefraction were included to obtain the spherical equivalent refraction (SER) and prevalence of myopia. The difference in the rate of myopia and SER of students ages 6 to 18 with various demographic characteristics was compared between the two years. Results Records from 118,479 students in 2019 and the 121,881 students in 2020 were obtained. In 2019 and 2020, the prevalence of overall myopia increased from 43.1% to 48.9% (5.8 percentage point), and a substantial shift in myopic rate occurred in grades 4 to 6 (6.9 percentage point). The change in the prevalence of myopia in girls (5.9 percentage point) was approximately equal to that in boys (5.8 percentage point) and it was more common in rural students (5.9 percentage point) than in urban students (5.1 percentage point). The prevalence of low myopia increased more in children, and the prevalence of moderate myopia increased more in adolescents. The mean spherical equivalent refraction (SER) (-1.34±2.03 D) was lower in 2020 than in 2019 (-1.16±1.92 D), while SER decreased mainly at ages 7 to 15. The SER presented myopic status at the age of 9 (-0.55±1.26 D in 2019, -0.71±1.42 D in 2020), and attained moderate myopia at the age of 15 (-3.06±2.41 D in 2019, -3.22±2.40 D in 2020). Conclusions After the COVID-19 pandemic, myopia increased in this population with variable rates of increase in different demographic groups. The change of myopia in children was comparatively greater than that in adolescents. Therefore, we should take measures to prevent and control the development of myopia after the COVID-19 pandemic, especially for younger students.

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Section: Discussionmentioning

confidence: 99%

The change of myopic prevalence in children and adolescents before and after COVID-19 pandemic in Suqian, China

et al. 2022

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“…The data described in the main experiment of the study were all from high-resolution images (640 × 480 pixels) of each eye obtained with a 75-mm lens. In practice, commercial photorefractors obtain images of both eyes simultaneously to estimate their refractive state 3–5 . To do this, the field of view of the infrared camera is expanded, thus compromising the spatial resolution of each eye's image representation.…”

Section: Resultsmentioning

confidence: 99%

“…In practice, commercial photorefractors obtain images of both eyes simultaneously to estimate their refractive state. [3][4][5] To do this, the field of view of the infrared camera is expanded, thus compromising the spatial resolution of each eye's image representation. Should the proposed technology translate into commercial use for identification of eyes with corneal distortions, it should be able to produce results like Figs.…”

Section: Impact Of Image Resolution On the Photorefraction Luminance ...mentioning

confidence: 99%

“…Astigmatism is measured by estimating this luminance gradient across multiple axes by changing the position of the LED array, relative to the camera aperture. Commercial photorefractors implementing this technology estimate the spherocylindrical refractive error of both eyes simultaneously from a remote distance in a few seconds (e.g., Spot Vision Screener [Welch Allyn, Skaneateles Falls, NY] and plusoptiX S16 [Plusoptix GmbH, Nuremberg, Germany]) 3–5 . Additional information such as binocular gaze position and pupil diameter is also obtained in sync with refractive error in these devices.…”

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confidence: 99%

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The Value of Eccentric Infrared Photorefraction in Evaluating Keratoconus

2022

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SIGNIFICANCE: Nonlinearity in the luminance profile of eccentric, infrared photorefraction may be used to differentiate corneal diseases such as keratoconus that distort the cornea, relative to regular refractive errors.PURPOSE: This study aimed to determine the profile of eccentric, infrared photorefraction in keratoconus as a prototypical disease model for distorted corneas and identify a parameter in this profile for differentiating such disease conditions from healthy controls.METHODS: Photorefraction reflex of 75 eyes with forme fruste to advanced keratoconic cases and that of 75 eyes of controls with regular refractive errors (spherical equivalent, +0.50 to −11.75 D; astigmatism, −0.50 to −4.50 D across 0 to 180°axes) were obtained over their natural pupils under unaided viewing using a custom-designed photorefractor placed at 1 m from the subject. The test was repeated in 10 controls with 4 and 6 D of trial-lensinduced myopia and myopic astigmatism at 0, 90, 45, and 135°. Linear regression was performed on the luminance profile across the pupil, and the departure of the data from linearity was estimated using the average residual error of the fit (Res avg ).RESULTS: Photorefraction profiles varied linearly across the pupil in controls, with slopes increasing with refractive error (r = 0.87; P < .001) and Res avg remaining invariant of refractive error (r = −0.29; P > .4). Corresponding profiles in keratoconus significantly departed from linearity, with Res avg progressively increasing with disease severity (r = 0.66; P < .001). Res avg of 0.03 gray-scale units/pixel distinguished keratoconus from controls with sensitivity increasing from 66.7 to 100% for mild to advanced keratoconus and specificity remaining ≥97.1% across disease severity. Induced myopia and myopic astigmatism produced predictable changes in luminance profile slopes but with no change in Res avg values.CONCLUSIONS: Unlike regular myopia and astigmatism, the photorefraction reflex is significantly nonlinear in keratoconus because of the distorted cornea. Measures of nonlinearity in luminance profile may be incorporated in commercial photorefractors for differentiating such disease conditions from regular refractive errors.

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“…20 Four separate experienced retinoscopists in 117 patients 5-60 years old were recently compared to three different autorefractive methods: the rotary prisms Topcon RM 8900, the multiradial eccentric infrared photoscreening in the SPOT and the wavefront aberrometry in the E-see. 21 Nine subjects had inconclusive SPOT and were excluded. Bland-Altman analysis showed similar inter-equipment M and J0 bias that was not age dependent.…”

Section: Discussionmentioning

confidence: 99%

Ellipsoid Spectacle Comparison of Plusoptix, Retinomax and 2WIN Autorefractors

Arnold¹,

Martin²,

Beveridge³

et al. 2021

OPTH

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Background: Handheld devices can automatically give an estimate of refraction. The established method for refraction comparison using spherical equivalent (M) and J0, J45 vector transformations by Bland-Altman analysis is too complex for non-eye doctors involved with vision screening and remote vision clinics. Therefore, a simpler comparison technique was developed. Methods: Based on the spectacle limit to resolve grade A 1 logMAR, B 3 logMAR and C 6 logMAR blur, J0, J45, and M are combined into the Alaska Blind Child Discovery (ABCD) composite ellipsoid GRADE system. Pediatric eye patients had confirmatory examination after dry refraction with three portable autorefractors: Plusoptix, 2WIN and Retinomax. The refractions were then compared using both Bland-Altman and ABCD composite. Performance to detect AAPOS amblyopia risk factors was also assessed. Results: A total of 202 children, mean age seven years, 28% high spectacle need and 43% AAPOS 2013 amblyopia risk factors showed high correlation with cycloplegic refraction (intraclass correlation 0.49 to 0.90) for sphere, J0 and J45 spectacle components. Plusoptix had more (10%) inconclusives due to patients out-of-range. The Retinomax was unable to screen some younger children and was less reliable for sphere but gave more precise astigmatism estimates. The proportion of autorefractions expected to give GRADE A/B highneed patients acuity improvement to 20/40 would be 41% for Plusoptix, 39% for 2WIN and 65% for Retinomax. Sensitivity/specificity for amblyopia risk factor detection was 80%/83% for Plusoptix, 72%/88% for 2WIN and 84%/73% for Retinomax. Conclusion:The simplified spectacle comparison resembled Bland-Altman and could assist lay vision screeners and non-eye doctors attempting remote spectacle donation worldwide.

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Does the Accuracy and Repeatability of Refractive Error Estimates Depend on the Measurement Principle of Autorefractors?

Cited by 24 publications

References 57 publications

The change of myopic prevalence in children and adolescents before and after COVID-19 pandemic in Suqian, China

The change of myopic prevalence in children and adolescents before and after COVID-19 pandemic in Suqian, China

The Value of Eccentric Infrared Photorefraction in Evaluating Keratoconus

Ellipsoid Spectacle Comparison of Plusoptix, Retinomax and 2WIN Autorefractors

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