Abstract
Purpose :
To assess test-retest repeatability of the accommodative response (AR) in children 5 to < 11 years with and without amblyopia using the Grand Seiko autorefractor.
Methods :
The AR was measured monocularly in 25 children with amblyopia (20/40 - 20/125) and 36 children without amblyopia (control participants) using the Grand Seiko autorefractor. Participants viewed 20/125 single presentation letter stimuli at 33cm on an iPod. Testing order was counterbalanced. Five measures were obtained from each eye. Participants were given a break in between the test and the retest. The sphero-cylinder measures were transformed to spherical equivalent then averaged for each eye. Mean AR was compared between amblyopic and fellow eye of the amblyopic participants and between the two eyes of the control participants (Eye 1 & Eye 2) using paired t-test. Test-retest reliability was assessed using Bland-Altman plots and the 95% limits of agreement (LOA).
Results :
In amblyopic participants, the mean AR was significantly less (P < 0.001, 95% CI = -1.01 to -0.31) in the amblyopic eye (mean = -1.03 ± 0.77D) compared to the fellow eye (mean = -1.69 ± 0.70D). A significant difference between eyes was not detected in the control participants (Eye 1 = -1.76 ± 0.44D, Eye 2 = -1.72 ± 0.49D, P = 0.26, 95% CI: -0.11 to 0.03). The mean difference between tests in amblyopic participants was 0.19 ± 0.68D in the amblyopic eyes. The mean difference between tests of the fellow eye of the amblyopic participants and each eye of the control participants was negligible (fellow eye = 0.05 ± 0.37 D; Eye 1 = 0.02 ± 0.38D; Eye 2 = 0.04 ± 0.28D). The upper and lower limits of the 95% LOA were greatest in the amblyopic eyes of the amblyopic participants (1.52D, -1.13D). The 95% LOA was similar in the fellow eye (0.68D, -0.78D) of the amblyopic participants and both eyes of the control participants (Eye 1: 0.75D, -0.72D; Eye 2: 0.60D, -0.50D).
Conclusions :
The test-retest repeatability of the AR using the Grand Seiko autorefractor in the fellow eyes of children with amblyopia and children without amblyopia is similar to previously reported measures of repeatability found in adult participants. However, the AR in the amblyopic eye in children with amblyopia is less repeatable. The greater difference in test-retest in amblyopic eyes maybe due to the amblyopic eye having a larger depth of focus.
This is a 2020 ARVO Annual Meeting abstract.