소아에서 플러스옵틱스 에스09로 측정한 굴절력의 신뢰성과 유용성
Reliability and Usefulness of Refractive Measurements by PlusoptiX S09 in Children
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목적: 소아에서 PlusoptiX S09로 측정한 굴절값을 조절마비 굴절검사의 굴절값과 비교하여 신뢰성과 유용성을 평가하였다. 대상과 방법: 소아 134명 268안을 대상으로 PlusoptiX S09와 조절마비 굴절검사로 측정한 굴절값을 비교해 보았다. 또한 원시 3.5D이상, 근시 3.0D 이상, 직난시 또는 도난시 1.5D 이상, 사난시 1.0D 이상을 약시 위험인자라고 정의하고, PlusoptiX S09가 이 위험인자를 발견하는 유용성을 분석하였다. 결과: PlusoptiX S09의 구면 도수의 평균은 -0.81 ± 1.68D, 구면렌즈 대응치의 평균은 -1.20 ± 1.62D이었고, 조절마비 굴절검사의구면 도수 평균은 -0.26 ± 2.00D, 구면렌즈 대응치 평균은 -0.64 ± 1.94D, 평균 차이가 각각 -0.54 ± 0.61D, -0.56 ± 0.62D로PlusoptiX S09가 조절마비 굴절검사에 비해 근시로 측정되었고, 통계적으로 유의한 차이를 보였다(p<0.001). PlusoptiX S09의 원주도수의 평균은 -0.79 ± 0.93D, 조절마비 굴절검사의 원주 도수의 평균은 -0.76 ± 0.94D, 평균의 차이가 -0.03 ± 0.33D로 통계적으로 유의한 차이를 보이지 않았다(p=0.135). 굴절이상에 의한 약시 위험인자를 발견하는 PlusoptiX S09의 민감도와 특이도는 각각88.0%, 96.3%였다. 결론: PlusoptiX S09는 비교적 쉬운 방법으로 약시 위험인자를 발견하는 데 유용하게 사용될 수 있다. 그러나 조절마비 굴절검사와비교하여 더 근시로 측정되고, 원시군에서는 민감도가 떨어지는 한계점이 있다.
Abstract
Purpose: To compare the refractive measurements obtained using a photorefractor (PlusoptiX S09, PlusoptiX GmbH, Germany)with those obtained using cycloplegic refraction in children. Methods: We assessed the refractive status of 268 eyes in 134 children. The values acquired via photorefraction with aPlusoptiX S09 device were compared with those obtained by cycloplegic retinoscopy. Hyperopia (≥+3.5 D), myopia (≥-3.0 D),with the rule or against the rule astigmatism (≥-1.5 D), and oblique astigmatism (≥-1.0 D) were set as diagnostic criteria for refractiveamblyopia risk factors (RARFs). The difference in the detection of RARFs by the two methods was the main outcomemeasure. Results: The average spherical refractive power was -0.81 ± 1.68 D for PlusoptiX S09 versus -0.26 ± 2.00 D for cycloplegic retinoscopy(average difference -0.54 ± 0.61 D; p < 0.001). The average spherical equivalent was -1.20 ± 1.62 D for PlusoptiX S09versus -0.64 ± 1.94 D for cycloplegic retinoscopy (average difference -0.56 ± 0.62 D; p < 0.001). The average cylinder power was-0.79 ± 0.93 D for PlusoptiX S09 versus -0.76 ± 0.94 D for cycloplegic retinoscopy (average difference -0.03 ± 0.33 D; p = 0.135). Even though cycloplegic retinoscopy is considered the gold standard, the sensitivity and specificity for detecting RARFs with thePlusoptiX S09 were 88.0% and 96.3%, respectively. Conclusions: PlusoptiX S09 is a relatively useful method for detecting RARFs, but the device tends toward myopic shift comparedto cycloplegic refraction, and hyperopia is underestimated.
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