4/20/2023 0 Comments Itrace pdfIn contradiction, Zadnik, Mutti and Adams, 1992 reported a 95% limit of agreement for the SE of ☐.63 D for cycloplegic and of ☐.72 D for non-cycloplegic refraction. The reported 95% limit of agreement for the subjective measurement of the spherical equivalent refractive error, which was ☐.29 D, suggesting that the subjective refraction is accurate to about a quarter diopter. Most of the studies used two repetitive measurements of subjective refraction per subject, only Rosenfield and Chiu, 1995 assessed the subjective refraction with five repeated measurements. Published data on the variability of refraction, either assessed subjectively or objectively, were mainly evaluated during studies that assessed the variability and repeatability of auto-refractors. While the assessment of the refractive errors is the core competence of eye care professionals (ECPs), all used methods have to agree between each other and have to be reproducible, as well as repeatable. EyeNetra claims to have an extended range of refractive errors that can be measured (−12.5 D to +5.5 D). Using Opternative, the range of refractive errors that can be measured is between 0 D and −4 D. Thus far, the performance of these products is limited. In contradiction, Opternative (Opternative Inc., Chicago, IL, USA) is an online solution that aims to measure the refraction of the eye in a self-directed way, using a computer-based response to presented stimuli (). Another smartphone-based autorefractor is SVOne (Smart Vision Labs, New York, NY, USA), where a portable Hartmann-Shack wavefront aberrometer is attached to a smartphone. For example, the company EyeNetra (EyeNetra Inc., Somerville, MA, USA) developed a smartphone-based refraction for mobile measurements of refractive errors that uses a pinhole optic to display a stripe pattern on the participant’s retina, where the task of the subject is to align a red and green stimulus. Several “smart” solutions are already available that assess refractive errors objectively and subjectively. Digitalization is already affecting our lives, and its influence will increase in the future the aim is to develop smart products that are able to assess refractive errors in order to provide adequate correction for people living in developing, as well as in industrial, countries. Since it is known that the prevalence of refractive errors is increasing, its assessment will become one of the major tasks in the public health sector worldwide. Uncorrected refractive errors, such as myopia, hyperopia and astigmatism, have a high impact on the prevalence of visual impairment or blindness, as recently reviewed by Naidoo and colleagues. Assessing refractive errors using different subjective methods, results in similar mean differences and 95% limits of agreement, when compared to those reported in studies comparing subjective refraction non-cylcoplegic retinoscopy or autorefraction”. ICCs revealed high correlations between all methods for both examiner ( p 0.9). Mean differences and ☙5% Limits of Agreement for each pair of inter-device agreement regarding the SE for both examiners were as follows: Trial frame vs. Results: Analyzing the variances between the three methods for SE, J0 and J45 using a two-way ANOVA showed no significant differences between the methods (SE: p = 0.13, J0: p = 0.58 and J45: p = 0.96) for examiner 1 and for examiner 2 (SE: p = 0.88, J0: p = 0.95 and J45: p = 1). Intraclass correlation coefficients (ICC’s) were calculated to evaluate correlations between the used methods. Inter-device agreement regarding the measurement of refractive errors was analyzed for differences in terms of the power vector components (spherical equivalent (SE) and the cylindrical power vector components J0 and J45) between the used methods. Refractive errors were assessed using a trial frame, a manual phoropter and a digital phoropter. Methods: Refractive errors of two groups of participants were measured by two examiners (examiner 1 (E1): 36 subjects examiner 2 (E2): 38 subjects). Purpose: To investigate the inter-device agreement and mean differences between a newly developed digital phoropter and the two standard methods (trial frame and manual phoropter).
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