title: Accuracy of PlusOptix A09 distance refraction in pediatric myopia and hyperopia.
abstract: BACKGROUND
  The PlusOptix photoscreeners (PlusOptix GmbH, Nuremberg, Germany) is used in many vision screening programs. The purpose of the present study was to further explore the accuracy of the PlusOptix A09 photoscreener in children with ametropia (myopia or hyperopia).
  
  
  METHODS
  A total of 70 eyes (35 children) were prospectively included. Before administration with the cycloplegia treatment 1 % cyclopentolate hydrochloride, children underwent refraction measurement with the PlusOptix A09. A refraction was then performed after cycloplegia with either Retinomax hand-held or Nidek autorefractor before and after 3 years old, respectively.
  
  
  RESULTS
  The median (interquartile range) age was 58 (18 to 86) months. The mean (SD) spherical equivalent differed between PlusOptix A09 and cycloplegic autorefraction (+0.54 [1.82] D vs +1.06 [2.04] D, p = 0.04). PlusOptix A09 refraction was positively correlated with cycloplegic autorefraction (r = 0.81, p < 0.001) with higher coefficient in myopic than in hyperopic children (r = 0.91, p = 0.0002 and r = 0.52, p = 0.01, respectively). The mean (SD) difference between PlusOptix A09 and cycloplegic autorefraction was higher with hyperopia than myopia (0.73 [1.34] vs 0.05 [0.66], p = 0.01). The proportion of children with < 1-D difference between cycloplegic and PlusOptix A09 refraction was 68.8 %, higher with myopia than hyperopia (90 % vs 54.5 %, p = 0.01).
  
  
  CONCLUSIONS
  The spherical equivalent value with non-cycloplegic PlusOptix A09 refraction is closer to that with cycloplegic autorefraction than non-cycloplegic autorefraction. The PlusOptix A09 photoscreener underestimated the hyperopia of 0.73 D and slightly overestimated myopia of 0.05 D. The PlusOptix A09 could be used for screening with higher accuracy in myopic than hyperopic children.
authors.affiliation: Department of Ophthalmology, Gui De Chauliac Hospital, CHU de Montpellier, 80, avenue Augustin Fliche, 34295 cedex 5, Montpellier, F-34000, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Payerols
authors.affiliation: Department of Ophthalmology, Gui De Chauliac Hospital, CHU de Montpellier, 80, avenue Augustin Fliche, 34295 cedex 5, Montpellier, F-34000, France.
authors.forename: Claudie
authors.initials: C
authors.lastname: Eliaou
authors.affiliation: Department of Ophthalmology, Gui De Chauliac Hospital, CHU de Montpellier, 80, avenue Augustin Fliche, 34295 cedex 5, Montpellier, F-34000, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Trezeguet
authors.affiliation: Department of Ophthalmology, Gui De Chauliac Hospital, CHU de Montpellier, 80, avenue Augustin Fliche, 34295 cedex 5, Montpellier, F-34000, France.|Univ Montpellier 1, Montpellier, F-34000, France.
authors.forename: Max
authors.initials: M
authors.lastname: Villain
authors.affiliation: Department of Ophthalmology, Gui De Chauliac Hospital, CHU de Montpellier, 80, avenue Augustin Fliche, 34295 cedex 5, Montpellier, F-34000, France. vincent.daien@gmail.com.|Univ Montpellier 1, Montpellier, F-34000, France. vincent.daien@gmail.com.|Inserm, U1061, Montpellier, F-34093, France. vincent.daien@gmail.com.
authors.forename: Vincent
authors.initials: V
authors.lastname: Daien
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000175:diagnosis* / Q000503:physiopathology; D007223:Infant; D008297:Male; D009216:Myopia / Q000175:diagnosis* / Q000503:physiopathology; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015351:Vision Screening / Q000379:methods*
keywords: Amblyopia; Cycloplegia; Refraction; Screening