• J Formos Med Assoc · Aug 2020

    Comparison of open-field autorefraction, closed-field autorefraction, and retinoscopy for refractive measurements of children and adolescents in Taiwan.

    • Yi-Chun Kuo, Jen-Hung Wang, and Cheng-Jen Chiu.
    • Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
    • J Formos Med Assoc. 2020 Aug 1; 119 (8): 1251-1258.

    PurposeTo evaluate the accuracy and effectiveness of noncycloplegic and cycloplegic autorefraction using two types of autorefractors (ARs) compared with retinoscopy in children and adolescents.MethodsThis cross-sectional study included 308 students (6-17 years old) from eastern Taiwan. Noncycloplegic and cycloplegic refractive measurements were obtained using open-field AR (Shin-Nippon NVision-K 5001), closed-field AR (Topcon KR-800), and cycloplegic retinoscopy. Three optical components emerged from the measurements: spherical equivalent (M) and two Jackson cross-cylinder values (J0 and J45). Agreement between both ARs and retinoscopy was evaluated using intraclass correlation coefficient. Measurement discrepancies from retinoscopy among different ARs and cycloplegic status were compared using repeated measures ANOVA and receiver operating characteristic curve analysis.ResultsCompared with retinoscopy, measurements obtained before and after cycloplegia with both ARs showed excellent reliability for evaluating M and J0 and fair to good results for J45. More myopic results were obtained using KR-800 before cycloplegia; more hyperopic results were obtained using KR-800 and NVision-K 5001 after cycloplegia(all p < 0.05). J45 data obtained using NVision-K 5001 were closest to those obtained by retinoscopy; J0 data obtained using both ARs were comparable with retinoscopy after cycloplegia. NVision-K 5001 outperformed KR-800 in refractive measurements, particularly in hyperopia diagnosis among younger children.ConclusionsBoth autorefractors showed great agreement with retinoscopy. Results obtained using NVision-K 5001 without cycloplegia were most similar to those by retinoscopy, especially for oblique astigmatism and hyperopia detection in younger children. For large vision screening in elementary school, Shin-Nippon NVision-K 5001 might be a more suitable autorefractor.Copyright © 2020 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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