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Impressum
Sensitivity and specificity of a video-autorefractometer used as a screening device for amblyogenic ametropia.
Schimitzek T., Schworm H. D., Haase W.
Universitätsaugenklinik Hamburg/Eppendorf, Bereich Orthoptik und Pleoptik, Leiter: Prof. Dr. H. D. Schworm, Martinistraße 52, 20246 Hamburg
Objective: The aim of the study was to examine the efficiency
of a commercially available infrared videorefractometer (PowerRefractorTM)
in measuring children and to evaluate the reliability in detecting amblyogenic
factors due to ametropia. Does this method require cycloplegia?
Methods: 255 eyes (-28.25 D to +7.88 D spherical equivalent) of
128 patients (1 - 81 years) underwent cycloplegic retinoscopy. All of
them were investigated with the PowerRefractor™ under cycloplegia.
54 of these patients (108 eyes) were additionally examined without cycloplegia.
The device measures both eyes simultaneous at a distance of 1m based on
technique of eccentric photorefraction. A video-analysis of each eye is
computed in 3 meridians. The subject can be observed in real-time on a
screen. The refraction is immediately displayed on a screen.
Results: Measurement of refraction was possible at all ages. Young
children who did not cooperate well with the procedure of conventional
table-top autorefractometers required more effort. The mean sensitivity
for detection of any amblyogenic ametropia was 78% under cycloplegia and
80% without cycloplegia. The specificity was 75% and 80%, respectively.
In detection of anisometropia, hyperopia and astigmatism the rate of false
negatives ranged from 11% to 24%. Especially high astigmatic and hyperopic
ametropia remained frequently undetected.
Conclusion: The reliability of the evaluated photorefractor in
detecting amblyogenic ametropia was comparable to that of other methods
described in the literature. Cycloplegia did not show clinically significant
influence on the results. Peripheral aberrations can disturb the measurement
in dilated pupils. No relevant induction of accommodation was observed.
The method works well in children, but anisometropia and high astigmatic
and hyperopic ametopia in some cases remained undetected.