手持自动验光仪在学龄前儿童验光中的应用

目的：评估HAR-800手持验光仪对学龄前儿童屈光检查的准确性。

方法：对173例学龄前儿童进行检影验光,首先行HAR-800手持验光仪检查(试验组),然后应用阿托品眼膏进行扩瞳检影验光(对照组),比较两种检影验光的屈光差异。

结果：试验组球镜为1.59±0.61D,对照组为3.15±0.72D,两者有显著统计学差异(t=-82.89, P<0.01),且具有相关性(r=0.87,P<0.01)。试验组散光为-0.62±0.51D,对照组为-0.48±0.55D,两者有显著统计学差异(t=-6.97,P<0.01),且具有显著相关性(r=0.76,P<0.01)。

结论：HAR-800手持验光仪不能替代阿托品检影验光,但其结果可以反映学龄前儿童的屈光状况。     

Cycloplegic refraction in preschool children: comparisons between the hand-held autorefractor, table-mounted autorefractor and retinoscopy

Aims: It is common for refraction to be measured using different testing methods in children, with much debate still ongoing on the preferred method. Therefore, we compared cycloplegic refraction measurements using three objective methods in a large cohort of children. Methods: We present the findings from a total of 51 children who were recruited and examined as part of the Strabismus, Amblyopia and Refractive error in Singapore preschool children (STARS) study. Each child underwent a comprehensive eye examination, which included cycloplegic refraction using a hand‐held autorefractor (Retinomax), a table mounted autorefractor (Canon FK‐1) and streak retinoscopy. Spherical equivalent (SE) was calculated as (sphere + half of minus cylinder) and astigmatism was determined using the negative cylindrical component. Results: The current study sample consisted of 29 boys and 22 girls aged between 24 and 72 months (mean age 52.3 months). The mean spherical equivalent (SE) using the table‐mounted autorefractor (1.03 ± 1.64 D) was not significantly different from the streak retinoscopy (1.09 ± 1.58 D, p = 0.66). However, the mean SE using the hand‐held Retinomax (0.80 ± 1.43 D) was significantly different (more ‘minus’p = 0.0004) to streak retinoscopy. The astigmatism measured using the hand held (?0.89 ± 0.51 D) and table‐mounted autorefractor (?0.83 ± 0.61 D) were significantly greater than that obtained with streak retinoscopy (?0.58 ± 0.56, p = 0.0003). Conclusions: The table‐mounted autorefractor provided a reading more similar to that of streak retinoscopy than to that of the hand‐held autorefractor. However, there were only small differences in mean SE (<0.32 D) between the hand‐held Retinomax and the other methods, which will have implications in research investigations of refractive error.     

Clinical evaluation of the Allergan Humphrey 500 autorefractor and the Nidek AR-1000 autorefractor.

AIMS/BACKGROUND: The intentions of this study were to estimate agreement between two different autorefractors and standard subjective refraction techniques and to evaluate the clinical implications of relying on the autorefractor measurements. METHODS: Subjective refraction was carried out on 448 cycloplegic eyes and compared with cycloplegic readings with the Allergan Humphrey 500 autorefractor (448 eyes) and the Nidek AR-1000 autorefractor (160 eyes). Each refraction was followed by clinical visual acuity measurement. The study population comprised 224 healthy students, 107 men and 117 women, with a mean age of 20.6 (SD 1.1) years. RESULTS: Both the Nidek and Humphrey autorefractors measured more negative or less positive refractive values compared with subjective refraction and these biases were statistically significant (Humphrey right eye -0.23 D, p = 0.0001, left eye -0.20 D, p = 0.0001), (Nidek right eye -0.13 D, p = 0.0001, left eye -0.11 D, p = 0.0002). Comparing the results of autorefraction with subjective refraction, the Nidek was better than the Humphrey autorefractor in several ways: a smaller mean difference, better agreement between spherical equivalent values, narrower limits of agreements, and better visual acuity obtained with the autorefraction. On the other hand, the Humphrey autorefractor agreed better with subjective refraction concerning cylinder axis. CONCLUSION: The results show that both autorefractors represent a valuable complement to subjective refraction, but cannot be used as a replacement.     

Clinical evaluation of the Shin-Nippon SRW-5000 autorefractor in children

The Canon Autoref R-1 is an 'open-field' autorefractor which has been widely used for research purposes for the past 20 years, but is no longer manufactured. A new autorefractor, the Shin-Nippon SRW-5000, is now available, and if measures using this instrument are shown to be equally accurate and reliable, is likely to replace the R-1. Here we report on the accuracy and reliability (repeatability and reproducibility) of refraction measures in a paediatric population (from 4 to 8 years of age). Subject numbers were 44 for cycloplegic measures and 53 for non-cycloplegic measures. As would be expected, agreement with cycloplegic refraction and reliability were better when SRW-5000 measures were taken using cycloplegia. Repeatability results from the SRW-5000 autorefractor, both with and without cycloplegia were similar to those reported for the Canon R-1.     

Comparison of the Retinomax autorefractor with hand-held retinoscopy in 1-year-old infants

This study aimed to determine the accuracy (and usability) of the Retinomax, a hand-held autorefractor, compared to measurements taken from hand-held retinoscopy (HHR) in a sample of normal 1-year-old children. The study was a method comparison set at four Community Child Health Clinics. Infants (n = 2079) of approximately 1 year of age were identified from birth/immunization records and their caregivers were contacted by mail. A total of 327 infants ranging in age from 46 weeks to 81 weeks (mean 61 weeks) participated in the study. The children underwent a full ophthalmic examination. Under cycloplegia, refraction was measured in each eye by streak retinoscopy (HHR) and then re-measured using the Retinomax autorefractor. Sphere, cylinder, axis of cylinder and spherical equivalent measurements were recorded for HHR and Retinomax instruments, and compared. Across the range of refractive errors measured, there was generally close agreement between the two examination methods, although the Retinomax consistently read around 0.3 D less hyperopic than HHR. Significantly more girls (72 infants, 47.7%), struggled during examination with the Retinomax than boys (52 infants, 29.5%) (P < 0.001). Agreement deteriorated between the two instruments if the patient struggled during the examination (P < 0.001). In general, the Retinomax would appear to be a useful screening instrument in early childhood. However, patient cooperation affects the accuracy of results and is an important consideration in determining whether this screening instrument should be adopted for measuring refractive errors in early infancy.     

手持电脑验光仪在招飞体检中的应用

目的：比较手持电脑验光仪与带状光检影仪在招飞屈光检查中屈光值测量的差异,探讨手持电脑验光仪在招飞体检中应用的可行性。
　　方法：对进入屈光检查的招飞学生317名634眼散瞳后,分别用手持电脑验光仪和带状光检影仪进行验光检查。对主要指标(球镜度数、柱镜度数及轴向)的屈光值进行差异性检验和相关性分析,并对淘汰率进行比较分析。
　　结果：手持电脑验光仪球镜和柱镜屈光度值较视网膜检影结果偏负,其差异有统计学意义(P<0.05),但具有统计学相关性(r=0.733,0.694),两者轴位的检验结果差异无统计学意义(P>0.05)。手持验光仪淘汰率较检影高,存在有误淘现象。
　　结论：手持电脑验光仪与检影测量结果有较好的一致性,在招飞屈光检查中有应用的价值。     

手持自动验光仪在儿童屈光不正调查中的应用

目的 :了解手持自动验光仪的准确性及其在儿童屈光不正调查中的应用价值。方法 :对 5 884名 5～ 15岁儿童滴用 1%盐酸环戊通滴眼液麻痹睫状肌后 ,分别由验光师和眼科医师独立地进行视网膜检影和NikonRetinomaxK Plus 手持自动验光仪屈光检查。结果 :视网膜检影和自动验光仪验光的结果间相关系数均在 0 .95或以上。在 95 %的测量中 ,这两种检查结果差异在 0 .75D以内。自动验光仪验光的结果比视网膜检影结果稍小一些。结论 :NikonRetinomaxK Plus 手持自动验光仪与视网膜检影检出的屈光结果具有相当高的一致性 ,其在儿童屈光不正调查中是一种很有用的屈光检查器械     

Examination of preschool children for ametropia: first experiences using a new hand-held autorefractor

INTRODUCTION: Over the last decades, various methods have been investigated for preschool screening for amblyogenic ametropia. The SureSight is a new hand-held wavefront-analyzing autorefractor designed for screening. METHODS: A total of 338 children (3 1/2 - 4 1/2 years-old) were examined in their kindergartens without cycloplegia using the new instrument. Of these, 56 had a cycloplegic retinoscopy as a reference measurement. Hyperopia > or =3 dpt, myopia > or =1 dpt, astigmatism > or =1 dpt and anisometropia > or =1 dpt were considered amblyogenic ametropia. RESULTS: Testability was 99.4%. Accuracy was high for cylinder power and axis but poor for the spherical equivalent. Sensitivity was 41% for the detection of amblyogenic hyperopia, 95% for astigmatism and 75% for anisometropia, with specificity values of 92, 79 and 73%. CONCLUSION: The high testability and accuracy for cylinder power and axis are the strong points. The poor accuracy for the spherical equivalent is probably caused by the lack of cycloplegia. At present, non-cycloplegic autorefractor screening cannot be recommended due to the low specificity. Our findings support the advice that objective refraction in childhood must be performed with cycloplegia.     

Suresight手持验光仪在儿童屈光检查的应用

目的探讨Suresight手持自动验光仪应用于儿童验光的准确性及其特点,为儿童屈光普查和流行病学调查寻找简便可行的验光方法.方法对89例患者(178眼),分别用Suresight手持验光仪进行自然状况下和使用阿托品后验光及散瞳检影验光.结果儿童屈光不正种类以远视性屈光不正为主(82.0%).Suresight手持验光仪与散瞳检影验光相比较,球镜度数:使用阿托品后手持验光仪与散瞳检影法检出的结果呈高度正相关(r=0.890);自然状况下手持验光仪与散瞳检影法检出的结果亦有相关性(r=0.591.).柱镜度数:使用阿托品散瞳后手持验光仪与检影法检出的结果呈高度正相关(r=0.950),自然状况下手持验光仪与散瞳检影法检出的结果亦呈高度正相关(r=0.910).手持验光仪比检影验光法散光的检出率高,但主要是≤0.75D的低度散光.柱镜轴向:手持验光仪在睫状肌麻痹状态下与视网膜检影法测定结果比较,轴向差值≤10°者占81.3%,自然状况下与视网膜检影法比较,轴向差值≤10°者占82.7%.结论Suresight手持验光仪对屈光普查和流行病学调查有较好的使用价值.     

A clinical evaluation of the Topcon RM6000 autorefractor

The Topcon RM6000 autorefractor was evaluated by assessing the repeatability of its results and the extent of their agreement with the findings of conventional subjective refraction. The repeatability of the autorefractor results gives an indication of their reliability. This was determined for the Topcon instrument by comparing the right eye results of 93 patients taken before and after their eye examinations. In 95 per cent of cases the test and retest results of equivalent sphere, cylinder power and cylinder axis differed by less than 0.46 DS, 0.34 DC and 14° respectively. The validity of the autorefractor results differed depending on the age of the patient. In pre-presbyopic patients, the autorefractor gave a more minus (or less plus) result compared with conventional subjective refraction in some cases. This difference could be greater than 1.00 DS. For presbyopic patients, more accurate results were obtained, with approximately 95 per cent of results for equivalent sphere and cylinder being within ±0.50 D.     

Clinical evaluation of refraction using a handheld wavefront autorefractor in young and adult patients

PURPOSE: To determine the accuracy of measurement by the SureSight autorefractor (software version 2.0) and the influence of accommodation. SETTING: Pediatric Section, Department of Ophthalmology, University of Hamburg, Hamburg, Germany. METHODS: In a series of comparative measurements, autorefractor readings were compared with cycloplegic retinoscopy in 195 eyes of 108 patients (1 to 81 years) measured under cycloplegia. Ninety-six eyes were also measured without cycloplegia. RESULTS: The wavefront autorefractor was able to refract human eyes from a distance of 0.35 m. The accuracy was lower than that with conventional tabletop autorefractors. A difference of less than 0.51 diopter (D) was found in 68% of the spherical equivalents under cycloplegia. Many emmetropic and hyperopic children accommodated during the noncycloplegic measurements and were minus-overcorrected up to -6.13 D. In our group of young patients (2 to 17 years), 47% were minus-overcorrected by more than -2.00 D. CONCLUSIONS: The wavefront autorefractor uses a new method to determine the refractive state of the eye from a distance. It was less accurate than other conventional autorefractors. A benefit is its application in infants and disabled and uncooperative subjects. Cycloplegia is necessary in young hyperopic patients.     

Suresight手持式自动验光仪筛查学龄前儿童屈光不正的可行性探讨

目的通过对Suresight手持式自动验光仪在学龄前儿童中筛查屈光不正可行性的探讨,为其在婴幼儿屈光不正筛查中的应用提供理论支持,寻求一种能简单、方便、可靠、客观反映婴幼儿屈光发育情况的筛查方法。方法对就诊的4～6岁的学龄前儿童共148人次,296眼在自然状态下使用Suresight手持式自动验光仪进行屈光检查,与连用1%阿托品2次/日,5天后检影验光的结果比较。结果Suresight手持式自动验光仪屈光检查的结果中柱镜及其轴向与散瞳验光结果的差异无统计学意义(柱镜t=0.902,P=0.368;柱镜轴向t=0.935,P=0.350),球镜及等效球镜的差异有统计学意义(球镜t=2.231,P=0.026;等效球镜t=10.731,P=0.000),Suresight手持式自动验光仪屈光检查的结果球镜及等效球镜比散瞳验光结果轻度偏正,球镜平均0.1759±1.3444D,等效球镜平均0.8679 1.3796D。本文4～6岁的学龄前儿童296眼中远视性屈光不正占多数,比例为64.2%。结论Suresight手持式自动验光仪是一种用于学龄前儿童比较可靠的屈光不正的筛查工具。提示它在婴幼儿屈光不正的筛查中有一定的临床意义。     

应用Suresight对1-3岁婴幼儿屈光状态的筛查与分析研究

目的　应用Ｓｕｒｅｓｉｇｈｔ手持式自动视力筛查仪对１～３岁婴幼儿的屈光状态进行检测,了解婴幼儿视觉系统屈光状态及分布规律。方法　选取２０１３年８月至２０１４年２月于郑州市儿童医院眼科门诊进行视力体检的１～３岁婴幼儿２３９名,按年龄分成４组:１２～１７个月龄组、１８～２３个月龄组、２４～２９个月龄组、３０～３６个月龄组,利用Ｓｕｒｅｓｉｇｈｔ手持式自动视力筛查仪进行屈光检测,并对结果进行统计分析。结果　在２３９名被检测幼儿中,有１８名幼儿未检测出其屈光状态,其总检测率为９２.５％,其中近视状态２例。１２～１７个月龄组、１８～２３个月龄组、２４～２９个月龄组、３０～３６个月龄组屈光球镜值分别为（＋１.９３±０．６３）Ｄ、（＋１．７９±０．５５）Ｄ、（＋１．５０±０．６５）Ｄ、（＋１．５４±０．７１）Ｄ,各组间差异有显著统计学意义（Ｆ＝７．０６２,Ｐ＝０.０００）,屈光柱镜值分别为（０．８２±０．４０）Ｄ、（０．７８±０．４６）Ｄ、（０．６９±０．４９）Ｄ、（０．７２±０．４３）Ｄ,各组间差异无统计学意义（Ｆ＝１．１２５,Ｐ＝０．３３９）。相关及回归分析显示,１～３岁婴幼儿月龄与其屈光球镜值之间存在负相关关系（ｒ＝－０.４１１,Ｐ＝０．０００）,即１～３岁婴幼儿屈光球镜值随年龄增长而降低;１～３岁婴幼儿月龄与其屈光柱镜值之间存在负相关关系（ｒ＝－０．１０５,Ｐ＝０.０３５）,即１～３岁婴幼儿屈光柱镜值随年龄增长而降低,但其相关性较低。结论　建议婴幼儿应从出生后６个月起至少每半年进行一次视力及屈光检查,密切观察屈光及视力的发育状态,保证视力健康发育。     

A Shack-Hartmann-based autorefractor

PURPOSE: Autorefractors are typically based on either the optometer or the Scheiner principles, or a combination of the two techniques. These devices have dominated the market for objective assessment of refractive error for >30 years. The purpose of this investigation is to test a Shack-Hartmann-based system as an alternative to these systems. METHODS: Fourteen subjects with varying levels of refractive error were measured with a Topcon autorefractor and a Shack-Hartmann-based autorefractor. Fourier transform techniques were used to extract sphere, cylinder, and axis information from the Shack-Hartmann images, avoiding the need for image processing. The deviation of the refractive error from a subjective refraction was used as a means of comparing the two devices. RESULTS: The two devices performed similarly on this group of subjects. The mean difference in refraction between the two devices was nearly zero, suggesting that the likelihood and magnitude of errors for the two devices are equivalent. CONCLUSIONS: The Shack-Hartmann-based autorefractor shows promise as an alternative to conventional optometer or Scheiner-based technologies. However, issues with extending the myopic range of the device still need to be resolved.