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Arnaud Payerols, Claudie Malrieu-Eliaou, Max Villain, Vincent Daien; Comparison of non-cycloplegic refraction with the PlusOptix A09 distance refraction and cycloplegic refraction. . Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2209.
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© ARVO (1962-2015); The Authors (2016-present)
<br /> Accurate measurement of refraction in paediatric ophthalmology is mandatory. Cycloplegic refraction is the gold standard before first spectacle and during strabismus or amblyopia management. In this study we aimed to identify the distance refraction values as compared with non-cycloplegic refraction and cycloplegic refraction. <br />
<br /> A total of 32 children (corresponding to 64 eyes) ranging from 7 to 139 months of age where prospectively included. Before cycloplegic administration of 1% cyclopentolate hydrochloride, each child underwent refraction with the PlusOptix A09 and with the Retinomax hand-held or the Nidek autorefractor when possible. Same measurements were performed after cycloplegia. Paired t-tests were used to compare spherical equivalent between each refraction. Pearson coefficients were used to correlate refraction values. The Bland-Altman method was used to assess the difference in refraction between distance PlusOptix A09 and cycloplegic refraction. Right eye was considered for all comparisons.
<br /> We observed significant differences of mean (interquartile range) spherical equivalent between classic refraction (-0.70 [-2.0;1.1] D) and PlusOptix A09 (+0.54 [-0.8;1.9] D), p=0.008 and between spherical equivalent from PlusOptix A09 (+0.54 [-0.8;1.9] D) and cycloplegic refraction (+1.06 [-0.4;2.0] D), p=0.02. The refraction value with the PlusOptix A09 was positively and significantly correlated to cycloplegic refraction (r =+0.81, p<0.001). The mean difference between PlusOptix A09 and cycloplegic refraction was +0.52 (IC95: 0.10 - 0.93) and the limit of agreement range from - 1.55 D to +3.15 D.
<br /> This study documented the spherical equivalent value of non cycloplegic refraction performed with PlusOptix A09 that give closer value to cycloplegic refraction than classic refraction. Distance refraction can constitute a tool for screening or follow up that have higher value than classical non-cycloplegic refraction. However it cannot replace the cycloplegic refraction for first spectacle correction and during strabismus or amblyopia management.
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