Measurement of Refractive Error in Native American Preschoolers: Validity and Reproducibility of Autorefraction

Harvey, Erin M.; Miller, Joseph M.; Dobson, Velma; Tyszko, Robert; Davis, Abigail

doi:10.1097/00006324-200003000-00013

Cited by 72 publications

(38 citation statements)

References 15 publications

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“…21 In our report, we found the photorefractors often correlated better with each other than the doctor’s gold standard. It is possible that the photorefractors provide a truer reading, or it is possible that they have similar methodology and work with the same bias.…”

Section: Discussionmentioning

confidence: 49%

Photoscreeners in the Pediatric Eye Office: Compared Testability and Refractions on High-Risk Children

Peterseim¹,

Papa²,

Wilson³

et al. 2014

American Journal of Ophthalmology

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PURPOSE To compare refractive data and testability of Spot (PediaVision) and Plusoptix A09 (Plusoptix, Inc) photoscreeners and to compare each device with traditional cycloplegic retinoscopy. DESIGN Prospective, interventional case series. METHODS After informed consent, patients underwent testing with the Spot and Plusoptix photoscreeners before their examination by a pediatric ophthalmologist masked to the results. Data including testability and estimated refractions were entered into a Research Electronic Data Capture database for statistical analysis. RESULTS A total of 265 children were enrolled (mean age, 6.0 ± 3.4 years). Both devices produced a computer printout result in 250 (94.3%) of the patients. The Spot photoscreener provided a refractive estimate in all computer printouts, whereas the Plusoptix, used binocularly, provided a refractive estimate in 75.2% (188/250) of the printouts. Compared with cycloplegic retinoscopy, both devices underestimated hyperopia or overestimated myopia (−1.35 diopters [D] and −0.64 D, Spot and Plusoptix, respectively) and overestimated astigmatism (0.36 D and 0.32 D, Spot and Plusoptix, respectively). The intraclass correlation coefficient for spherical equivalents indicated good agreement between cycloplegic retinoscopy and Spot (0.806) and excellent agreement between cycloplegic retinoscopy and Plusoptix (0.898). CONCLUSIONS The Spot photoscreener provided refractive data on a greater percentage of children. The photorefractors correlated with cycloplegic retinoscopy refractive findings for sphere and spherical equivalents, but underestimated hyperopia or overestimated myopia and overestimated astigmatism. The binocular refractions of Plusoptix agreed more closely with the refractions of our pediatric ophthalmologists.

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Section: Discussionmentioning

confidence: 49%

Photoscreeners in the Pediatric Eye Office: Compared Testability and Refractions on High-Risk Children

Peterseim¹,

Papa²,

Wilson³

et al. 2014

American Journal of Ophthalmology

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“…The validity and reproducibility of Retinomax measurements in this population have previously been reported. 22 …”

Section: Methodsmentioning

confidence: 99%

Longitudinal Change and Stability of Refractive, Keratometric, and Internal Astigmatism in Childhood

Harvey¹,

Miller²,

Twelker³

et al. 2014

Investigative Ophthalmology & Visual Science

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PURPOSE. To assess longitudinal change in refractive, keratometric, and internal astigmatism in a sample of students from a population with a high prevalence of with-the-rule (WTR) astigmatism and to determine the optical origins of changes in refractive astigmatism. METHODS.A retrospective analysis of longitudinal measurements of right eye refractive and keratometric astigmatism in Tohono O'odham Native American children was conducted. Changes in refractive and keratometric astigmatism per year were compared in a younger cohort (n ¼ 1594, 3 to <11 years old) and an older cohort (n ¼ 648, 11 to <19 years old). Data were analyzed in clinical notation (Cyl) and vector notation (J0, J45). RESULTS.On average, refractive astigmatism (means: 1.19 diopters [D] Cyl, þ0.54 J0, þ0.03 J45) resulted primarily from WTR corneal astigmatism (means: þ0.85 J0, À0.02 J45) and against-the-rule (ATR) internal astigmatism (means: À0.31 J0, þ0.05 J45). Mean longitudinal changes in astigmatism were statistically significant (younger cohort À0.02 D/y Cyl; older cohort þ0.06 D/y Cyl). In the younger cohort, astigmatism decreased with age in low and moderate astigmats (<3.00 D) and increased with age in high astigmats ( ‡3.00 D). In the older cohort, astigmatism increased with age across all levels of astigmatism. Longitudinal changes in keratometric and internal astigmatism were negatively correlated in both cohorts.CONCLUSIONS. Cross-sectional data suggest the presence of a constant ATR contribution from internal astigmatism (0.60 D Cyl) that is close to the 0.50 D ATR constant reported by Javal and others. Highly astigmatic 3-to <11-year-old children and children older than age 11 years show a small (not clinically significant) increase in astigmatism with age. A negative correlation between changes in keratometric astigmatism and internal astigmatism suggests an active compensation that may contribute to the stability of astigmatism in Tohono O'odham children.Keywords: astigmatism, refractive error development, children, Native American R esearch conducted over the past 15 years has yielded a large longitudinal database on refractive development in Tohono O'odham children. There is a high prevalence of astigmatism among elementary school children who are members of this Native American tribe.1-4 The high prevalence of refractive astigmatism in Tohono O'odham children is present in infancy and persists at least through elementary school. 1,2,4-7 A longitudinal study of corneal astigmatism in 960 Tohono O'odham children aged 6 months through 7 years showed that in early development (6 months to <3 years), astigmatism decreased in children with high astigmatism (À0.37 diopters [D]/y) and remained stable in children with little or no astigmatism (þ0.05 D/y).7 From age 3 through 7 years, astigmatism decreased in children with both high astigmatism (À0.11 D/y) and low/no astigmatism (À0.03 D/y). 7 A detailed account of changes in astigmatism beyond age 7 years in this population has not yet been reported. However, a recent report on change...

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“…A previous report has shown that the Retinomax provides reliable and valid measures of refractive error in this population. 15 …”

Section: Methodsmentioning

confidence: 99%

Astigmatism and Myopia in Tohono O’odham Native American Children

Twelker

Miller²,

Sherrill

et al. 2013

Optometry and Vision Science

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Purpose To describe change in spherical equivalent (M) in a longitudinal sample of Tohono O'odham students ages 3 to 18 years and to test the hypothesis that astigmatism creates complex cues to emmetropization, resulting in increased change in M in the direction of increasing myopia and increased occurrence of myopia. Methods Subjects were 777 Tohono O'odham Native American children on whom cycloplegic right eye autorefraction was measured on at least two study encounters between ages 3 and 18 years (first encounter prior to age 5.5 years, final encounter ≥ 3 years later). Regression lines were fit to individual subjects’ longitudinal M data to estimate rate of change in M (regression slope, D/year). Regression was also used to predict if a subject would be myopic (≤−0.75D M) by age 18 years. ANCOVA was used to assess the relation between M slope and magnitude of baseline M and astigmatism. Chi-square analyses were used to assess the relation between predicted myopia onset and magnitude of baseline M and astigmatism. Results Mean M slope was significantly more negative for hyperopes (M ≥ +2.00) than for myopes (M ≤ −0.75) or for subjects neither hyperopic nor myopic (NHM, M > −0.75 and < +2.00), but there was no significant difference between the myopic and NHM groups. Chi-square analysis indicated that final myopia status varied across level of baseline astigmatism. Subjects with high astigmatism were more likely to be predicted to have significant myopia by age 18 years. Conclusions The association between greater shift in M towards myopia with age in subjects who were hyperopic at baseline is consistent with continued emmetropization in the school years. Results regarding predicted myopia development imply that degradation of image quality due to refractive astigmatism creates complex cues to emmetropization, resulting in increased occurrence of myopia.

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Measurement of Refractive Error in Native American Preschoolers: Validity and Reproducibility of Autorefraction

Abstract: C-Autoref provided reliable and valid measurements of refractive error in young children. NC-Autoref measurements were reliable within subjects, but there was large variability in validity among subjects.

Cited by 72 publications

References 15 publications

Photoscreeners in the Pediatric Eye Office: Compared Testability and Refractions on High-Risk Children

Photoscreeners in the Pediatric Eye Office: Compared Testability and Refractions on High-Risk Children

Longitudinal Change and Stability of Refractive, Keratometric, and Internal Astigmatism in Childhood

Astigmatism and Myopia in Tohono O’odham Native American Children

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