The usefulness of the Retinomax autorefractor for childhood screening validated against a Danish preterm cohort examined at the age of 4 years

Abstract

Background and purpose Refractometers have gained a foothold in childhood screening for ophthalmic disorders. Given the results of an ophthalmic follow-up of an extremely preterm Danish cohort, the results of the Retinomax autorefractor were further evaluated. Materials and methods A nationwide cohort of infants born before gestational age 28 weeks (n = 178) and 56 term controls were examined at the age of 4 years. Refraction was given as the cycloplegic Retinomax value. For this study, we analysed the equipment's confidence value on the printout and equipment-induced myopization (as the difference between refraction measured before and after topical cyclopentholate 1%), both items hypothetical with a view to having identified factual ophthalmic deviations. Results Thirty-two of 42 eyes with visual acuity ≤ 0.4 had high Retinomax confidence values (8-9); the Retinomax values were also high in 10 of 12 children with strabismus and lack of stereopsis. Low values (1-6) were recorded in 11 single eyes, 5 of which were normal (false positives). Three children already known to have low vision were unable to cooperate. The overall mean value for equipment-induced myopization was 1.9 D (range, 0-6.87 D). Myopization showed no correlation with visual acuity and corneal curvature, and a weak positive correlation with refractive value disappeared when the myopic outliers were excluded. Conclusions The hand-held Retinomax seemed to be reliable for assessing refraction in 4-year-old children, provided a cycloplegic

As‐indicated versus routine vision screening of preterm children: a 17‐year retrospective regional study

“…The results are in line with a Danish study that found mean visual acuity in extremely preterm children (Fledelius et al. ) to be 0.63 and in full‐term controls 0.8, at 4 years. The frequency of vision impairment in extremely preterm children has been reported as 2.0–3.1% (Leversen et al.…”

“…A high number had astigmatism compared to the studies by Fledelius (Fledelius et al. ) (14.6%, cylinder ≥ −0.75D) and Sandfeld (Sandfeld et al. ) (4.3%, cylinder ≥ −1.0D).…”

“…Autorefraction has been validated for use in this population (Fledelius et al. ). A full ophthalmic examination was performed including slit lamp, ophthalmoscopy and assessment of strabismus.…”

“…However, preterm children have higher risk of refractive error (Holmstrom & Larsson ; Fledelius et al. ) including anisometropia, strabismus and cerebral vision impairment (CVI) (Slidsborg et al. ; Dutton ).…”

“…No extra vision screening is offered to preterm children. However, preterm children have higher risk of refractive error (Holmstrom & Larsson 2005;Fledelius et al 2015) including anisometropia, strabismus and cerebral vision impairment (CVI) (Slidsborg et al 2011;Dutton 2013). Not all preterm children present with readily observable symptoms of visual problems, and specialized tests might be necessary to identify children with CVI (Dutton 2013;Macintyre-Beon et al 2013;Kaul et al 2016;Leung et al 2018).…”