AIM:To compare the consistency of two autorefractors(Tianle RM-9000 and Topcon KR-800)for school-age myopia children,and to provide a basis for largescale data analysis and comparison.METHODS:The refractive error in 9...AIM:To compare the consistency of two autorefractors(Tianle RM-9000 and Topcon KR-800)for school-age myopia children,and to provide a basis for largescale data analysis and comparison.METHODS:The refractive error in 909 subjects(age 4–18y)were measured using both autorefractors without cycloplegia.The data were analyzed using Fourier decomposition and the correlation coefficients,intraclass correlation coefficients(ICC),and Bland-Altman limits of agreement(LoA)for each parameter were calculated.RESULTS:There was a strong correlation between the spherical equivalent(SE),sphere diopter(DS),and cylinder diopter(DC)readings of the Tianle RM-9000 and those of the Topcon KR-800,with correlation coefficient values of 0.98,0.98 and 0.83 and ICC values of 0.99,0.99 and 0.93,respectively.However,the correlation coefficients and ICC values of J0 and J45 were unreliable(R=-0.004,-0.034;both ICC<0.10).Bland-Altman analysis revealed that SE,DS,and DC measured by the Tianle RM-9000 were significantly biased toward myopia compared with the Topcon KR-800,and the mean differences were-0.072,-0.026,-0.091 D,respectively(all P<0.01).The minimum absolute value of the difference within the 95%LoA for SE,DS,and DC was 0.63 D,0.50 D,0.62 D,respectively;all these values were in the clinically acceptable range.For J0 and J45,the mean differences were close to zero(P=0.43,0.84);however,the 95%LoA were relatively wide(J0 SD:0.53;95%CI:-1.00,1.10;J45 SD:0.52;95%CI:-1.00,1.00).CONCLUSION:The two autorefractors are consistent with each other,as the differences in SE,DS,and DC were within the clinically acceptable range.Readers can compare the data measured by either device in different studies and use the two devices in the same study to generate a dataset that can be analyzed together.However,the J0 and J45 vectors are unreliable and should not be used to assess astigmatism.展开更多
AIM:To compare noncycloplegic and cycloplegic results of Retinomax measurements with findings achieved after cycloplegia using table-top autorefractor and retinoscopy.METHODS:The study included 127 patients(mean age96...AIM:To compare noncycloplegic and cycloplegic results of Retinomax measurements with findings achieved after cycloplegia using table-top autorefractor and retinoscopy.METHODS:The study included 127 patients(mean age96.7mo,range 21 to 221).Retinomax(Rmax)(Nikon Inc.,Japan)was used to obtain noncycloplegic refraction.Under cycloplegia,refraction was measured with Rmax,table-top autorefractor(TTR)(Nikon NRK 8000,Inc.,Japan)and retinoscopy.The values of sphere,spherical equivalent,cylinder and axis of cylinder were recorded for Rmax,TTR and retinoscopy in each eye.All results were analyzed statistically.RESULTS:The mean spheric values(SV),spherical equivalent values(SEV)and cylindrical values(CV)of the noncycloplegic Rmax(SV:0.64 D,SEV:0.65 D and CV:0.03 D,respectively)were found to be significantly lower than cycloplegic TTR(1.43 D,1.38 D and 0.3 D;P=0.012,P=0.011 and P=0.04,respectively)and retinoscopy(1.34 D,1.45 D and 0.23 D;P=0.04,P=0.002 and P=0.045,respectively).Mean cycloplegic SV,SEV,CV were not significantly different between Rmax and TTR,Rmax and retinoscopy,TTR and retinoscopy.Cycloplegic or noncycloplegic axis values were not different between any method.CONCLUSION:Rmax may be used successfully as a screening tool but may not be accurate enough for actual spectacle prescription.Cycloplegic Rmax measurements may be able to identify refractive error in children because of approximate results to retinoscopy.展开更多
AIM: To evaluate the accuracy, efficiency, and reliability of a handheld infrared eccentric autorefractor(h ICA) with artificial intelligence(AI) by comparing its refraction measurements to those recorded using h ICA ...AIM: To evaluate the accuracy, efficiency, and reliability of a handheld infrared eccentric autorefractor(h ICA) with artificial intelligence(AI) by comparing its refraction measurements to those recorded using h ICA and a clinical table-mounted automatic refractor(TAR).METHODS: A cross-sectional study using three optometers, including h ICA with or without AI and TAR, for refractometry of adults(aged 19-49 years old) with no signs of ocular disease or trauma in the absence of cycloplegia. Right and left eye refraction data were recorded, including the spherical equivalent(SE), diopter of spherical power(DS), diopter of cylindrical power(DC) decomposed into vectors J0 and J45, and measurement times. To avoid analytical difficulties associated with the interdependence of observations between eyes from the same individual, the Generalized Estimation Equation was used to compare the SE, DS, J0 and J45 measurements, and the times thereof, among the different groups. The intraclass correlation coef f icient(ICC) and Spearman’s rank correlation coefficient were used to evaluate correlations among the measurements recorded by the three different instruments. Bland-Altman were used to analyze the precision of the equipment by the agreement. RESULTS: A total of 70 patients(140 eyes;mean age: 31.37 y;range: 19-49 y) were assessed using refractometry. In a brightly lit environment, there was no significant difference between the mean SE recorded using TAR and that recorded using h ICA with AI or without AI(both P>0.05). In an intense-light environment, h ICA equipped with AI showed a better detection rate than without AI. Light intensity had a greater effect on dioptric measurements recorded using h ICA without AI(P<0.001) than on those recorded using the one equipped with AI(P<0.05). Measurement times varied significantly between the different light intensities and instruments(P<0.05).CONCLUSION: For the normal human eyes, AI may improve the accuracy, efficiency, and reliability of measurements recorded using h ICA in various light environments.展开更多
BACKGROUND Retinoscopy is arguably the most important method in the eye clinic for diagnosing and managing refractive errors.Advantages of retinoscopy include its noninvasive nature,ability to assess patients of all a...BACKGROUND Retinoscopy is arguably the most important method in the eye clinic for diagnosing and managing refractive errors.Advantages of retinoscopy include its noninvasive nature,ability to assess patients of all ages,and usefulness in patients with limited cooperation or communication skills.AIM To discuss the history of retinoscopes and examine current literature on the subject.METHODS A search was conducted on the PubMed and with the reference citation analysis(https://www.referencecitationanalysis.com)database using the term"Retinoscopy,"with a range restricted to the last 10 years(2013-2023).The search string algorithm was:"Retinoscopy"(MeSH Terms)OR"Retinoscopy"(All Fields)OR"Retinoscopes"(All Fields)AND[(All Fields)AND 2013:2023(pdat)].RESULTS This systematic review included a total of 286 records.Publications reviewed iterations of the retinoscope into autorefractors,infrared photo retinoscope,television retinoscopy,and the Wifi enabled digital retinoscope.CONCLUSION The retinoscope has evolved significantly since its discovery,with a significant improvement in its diagnostic capabilities.While it has advantages such as non-invasiveness and broad applicability,limitations exist,and the need for skilled interpretation remains.With ongoing research,including the integration of artificial intelligence,retinoscopy is expected to continue advancing and playing a vital role in eye care.展开更多
基金Supported by the National Natural Science Foundation of China(No.81873683).
文摘AIM:To compare the consistency of two autorefractors(Tianle RM-9000 and Topcon KR-800)for school-age myopia children,and to provide a basis for largescale data analysis and comparison.METHODS:The refractive error in 909 subjects(age 4–18y)were measured using both autorefractors without cycloplegia.The data were analyzed using Fourier decomposition and the correlation coefficients,intraclass correlation coefficients(ICC),and Bland-Altman limits of agreement(LoA)for each parameter were calculated.RESULTS:There was a strong correlation between the spherical equivalent(SE),sphere diopter(DS),and cylinder diopter(DC)readings of the Tianle RM-9000 and those of the Topcon KR-800,with correlation coefficient values of 0.98,0.98 and 0.83 and ICC values of 0.99,0.99 and 0.93,respectively.However,the correlation coefficients and ICC values of J0 and J45 were unreliable(R=-0.004,-0.034;both ICC<0.10).Bland-Altman analysis revealed that SE,DS,and DC measured by the Tianle RM-9000 were significantly biased toward myopia compared with the Topcon KR-800,and the mean differences were-0.072,-0.026,-0.091 D,respectively(all P<0.01).The minimum absolute value of the difference within the 95%LoA for SE,DS,and DC was 0.63 D,0.50 D,0.62 D,respectively;all these values were in the clinically acceptable range.For J0 and J45,the mean differences were close to zero(P=0.43,0.84);however,the 95%LoA were relatively wide(J0 SD:0.53;95%CI:-1.00,1.10;J45 SD:0.52;95%CI:-1.00,1.00).CONCLUSION:The two autorefractors are consistent with each other,as the differences in SE,DS,and DC were within the clinically acceptable range.Readers can compare the data measured by either device in different studies and use the two devices in the same study to generate a dataset that can be analyzed together.However,the J0 and J45 vectors are unreliable and should not be used to assess astigmatism.
文摘AIM:To compare noncycloplegic and cycloplegic results of Retinomax measurements with findings achieved after cycloplegia using table-top autorefractor and retinoscopy.METHODS:The study included 127 patients(mean age96.7mo,range 21 to 221).Retinomax(Rmax)(Nikon Inc.,Japan)was used to obtain noncycloplegic refraction.Under cycloplegia,refraction was measured with Rmax,table-top autorefractor(TTR)(Nikon NRK 8000,Inc.,Japan)and retinoscopy.The values of sphere,spherical equivalent,cylinder and axis of cylinder were recorded for Rmax,TTR and retinoscopy in each eye.All results were analyzed statistically.RESULTS:The mean spheric values(SV),spherical equivalent values(SEV)and cylindrical values(CV)of the noncycloplegic Rmax(SV:0.64 D,SEV:0.65 D and CV:0.03 D,respectively)were found to be significantly lower than cycloplegic TTR(1.43 D,1.38 D and 0.3 D;P=0.012,P=0.011 and P=0.04,respectively)and retinoscopy(1.34 D,1.45 D and 0.23 D;P=0.04,P=0.002 and P=0.045,respectively).Mean cycloplegic SV,SEV,CV were not significantly different between Rmax and TTR,Rmax and retinoscopy,TTR and retinoscopy.Cycloplegic or noncycloplegic axis values were not different between any method.CONCLUSION:Rmax may be used successfully as a screening tool but may not be accurate enough for actual spectacle prescription.Cycloplegic Rmax measurements may be able to identify refractive error in children because of approximate results to retinoscopy.
基金Supported by the Science and Technology Commission of Shanghai(No.17DZ2260100)。
文摘AIM: To evaluate the accuracy, efficiency, and reliability of a handheld infrared eccentric autorefractor(h ICA) with artificial intelligence(AI) by comparing its refraction measurements to those recorded using h ICA and a clinical table-mounted automatic refractor(TAR).METHODS: A cross-sectional study using three optometers, including h ICA with or without AI and TAR, for refractometry of adults(aged 19-49 years old) with no signs of ocular disease or trauma in the absence of cycloplegia. Right and left eye refraction data were recorded, including the spherical equivalent(SE), diopter of spherical power(DS), diopter of cylindrical power(DC) decomposed into vectors J0 and J45, and measurement times. To avoid analytical difficulties associated with the interdependence of observations between eyes from the same individual, the Generalized Estimation Equation was used to compare the SE, DS, J0 and J45 measurements, and the times thereof, among the different groups. The intraclass correlation coef f icient(ICC) and Spearman’s rank correlation coefficient were used to evaluate correlations among the measurements recorded by the three different instruments. Bland-Altman were used to analyze the precision of the equipment by the agreement. RESULTS: A total of 70 patients(140 eyes;mean age: 31.37 y;range: 19-49 y) were assessed using refractometry. In a brightly lit environment, there was no significant difference between the mean SE recorded using TAR and that recorded using h ICA with AI or without AI(both P>0.05). In an intense-light environment, h ICA equipped with AI showed a better detection rate than without AI. Light intensity had a greater effect on dioptric measurements recorded using h ICA without AI(P<0.001) than on those recorded using the one equipped with AI(P<0.05). Measurement times varied significantly between the different light intensities and instruments(P<0.05).CONCLUSION: For the normal human eyes, AI may improve the accuracy, efficiency, and reliability of measurements recorded using h ICA in various light environments.
文摘BACKGROUND Retinoscopy is arguably the most important method in the eye clinic for diagnosing and managing refractive errors.Advantages of retinoscopy include its noninvasive nature,ability to assess patients of all ages,and usefulness in patients with limited cooperation or communication skills.AIM To discuss the history of retinoscopes and examine current literature on the subject.METHODS A search was conducted on the PubMed and with the reference citation analysis(https://www.referencecitationanalysis.com)database using the term"Retinoscopy,"with a range restricted to the last 10 years(2013-2023).The search string algorithm was:"Retinoscopy"(MeSH Terms)OR"Retinoscopy"(All Fields)OR"Retinoscopes"(All Fields)AND[(All Fields)AND 2013:2023(pdat)].RESULTS This systematic review included a total of 286 records.Publications reviewed iterations of the retinoscope into autorefractors,infrared photo retinoscope,television retinoscopy,and the Wifi enabled digital retinoscope.CONCLUSION The retinoscope has evolved significantly since its discovery,with a significant improvement in its diagnostic capabilities.While it has advantages such as non-invasiveness and broad applicability,limitations exist,and the need for skilled interpretation remains.With ongoing research,including the integration of artificial intelligence,retinoscopy is expected to continue advancing and playing a vital role in eye care.
