[Accuracy of two autorefractors--Pediatric Autorefractor plusoptiX and Retinomax--in cycloplegic children in comparison to retinoscopy].
METHODS
In children, measuring refraction is of interest particularly with regard to the risk of amblyopia. Cycloplegic retinoscopy is the gold standard method for this age group. In a prospective study we compared readings from two hand-held photorefractors, the Pediatric Autorefractor and the Retinomax, to those from retinoscopy.


METHODS
74 patients were recruited consecutively at the outpatient department of Heidelberg University Eye Hospital's Section for Strabismology and Neuroophthalmology. All patients underwent standardised cycloplegia measurements first by the Pediatric Autorefractor plusoptiX A 08 in 1 metre working distance, then adding an infrared filter to reduce interferences, followed by the Retinomax K-plus 3 in 5 cm working distance and retinoscopy as reference on the right eye.


RESULTS
Spherical equivalents measured by the Pediatric Autorefractor plusoptiX A 08 coincided in 51.2% with retinoscopy (± 0.5 D). Adding an infrared filter increased this to 60.0%. However, the success rate of measurement decreased to 47% on adding an infrared filter as compared to 55.4% in cycloplegia alone. Children showed no cooperation in 11% and 16% with the infrared filter, respectively. The remaining children were not measurable by means of the device. With regard to spherical equivalents, the measurements done with Retinomax K-plus 3 coincide in 57% with those done in retinoscopy. The success rate of measurements with the Retinomax was 91%. The remaining children showed no cooperation.


CONCLUSIONS
Retinoscopy in cycloplegia is still the method of choice when determining refraction in children. Autorefractors quickly provide results for comparison which coincide with retinoscopy in 50-60% in spherical equivalent and in 80-90% in cylindrical values. The Pediatric Autorefractor is not suited for everyday clinical routine due to a low success rate of 50% and tight measuring range of + 5.0 to -7.0 D in spherical equivalents.
Augenklinik, Universitätsklinikum Heidelberg. Annette.SchmidtBacher@med.uni-heidelberg.de
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Schmidt-Bacher
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Kahlert
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Kolling
D000293:Adolescent; D000550:Amblyopia / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003519:Cyclopentolate; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009184:Mydriatics; D009883:Ophthalmic Solutions; D012029:Refraction, Ocular; D042261:Retinoscopes; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*; D014787:Vision Tests / Q000295:instrumentation*
D009184:Mydriatics; D009883:Ophthalmic Solutions; D003519:Cyclopentolate