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Plusoptix Vision Screener™: The accuracy and repeatability of refractive measurements using a new autorefractor
  1. Annegret Hella Dahlmann-Noor (adahlmann{at}doctors.net.uk),
  2. Oliver Comyn (olivercomyn{at}doctors.org.uk),
  3. Vasileios Kostakis (vkostakis{at}doctors.org.uk),
  4. Aseema Misra (aseemamisra{at}doctors.org.uk),
  5. Nitin Gupta (riniku2000{at}yahoo.com),
  6. Jayne Heath (jayne.hillerby{at}wsh.nhs.uk),
  7. Janet Brown (janet.brown{at}wsh.nhs.uk),
  8. Abigail Iron (abigail.iron{at}wsh.nhs.uk),
  9. Stuart McGill (stuart.mcgill{at}wsh.nhs.uk),
  10. Kalliopi Vrotsou (kv234{at}medschl.cam.ac.uk),
  11. Anthony J. Vivian (anthony.vivian{at}wsh.nhs.uk)
  1. Institute of Ophthalmology, United Kingdom
  2. West Suffolk Hospital, United Kingdom
  3. West Suffolk Hospital, United Kingdom
  4. West Suffolk Hospital, United Kingdom
  5. West Suffolk Hospital, United Kingdom
  6. West Suffolk Hospital, United Kingdom
  7. West Suffolk Hospital, United Kingdom
  8. West Suffolk Hospital, United Kingdom
  9. West Suffolk Hospital, United Kingdom
  10. Centre for Applied Medical Statistics, Department of Public Health and Primary Care, Univ. Cambridge, United Kingdom
  11. West Suffolk Hospital, United Kingdom

    Abstract

    Background: The Plusoptix Vision Screener™ (PVS) is a new non-cycloplegic videoretinoscopy autorefractor. Refractive accuracy may affect its performance as a screening tool.

    Aims: Study 1: To determine intra- and interobserver variability of PVS measurements. Study 2: To compare PVS measurements with gold standard manual cycloplegic retinoscopy (MCR).

    Methods: Study 1: PVS refraction of 103 children with mean (SD) age 5.5 (0.6) years by two observers. Study 2: PVS and MCR refraction of 126 children with mean (SD) age 5.5 (1.5) years, including 43 children with manifest strabismus ≥ 5PD, comparing mean spherical equivalent (MSE) and Jackson cross cylinders J0 and J45.

    Results: Study 1: Repeatability coefficients (observer 1): MSE: 0.63D, J0: 0.24D, J45: 0.18 D; those of observer 2 were nearly identical. Mean difference (95% limits of agreement) between the two observers for MSE, J0 and J45 were, respectively, 0.03 (-0.62 to 0.68D), -0.008 (-0.25 to 0.23 D), 0.013 (–0.18 to 0.20) D. Study 2: MSE tended to be lower on PVS than MCR, with differences of up to 8.00 D. Less than 20% of values were within +/-0.50D of each other. Agreement was better for J0 and J45. Strabismus was associated with an odds ratio of 3.7 (95% CI: 1.3 to 10.5) of the PVS failing to obtain a reading.

    Conclusions: The PVS may underestimate children’s refractive error.

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