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Objectives: Amblyopia is the most common cause of preventable vision impairment in children. This study tried to evaluate the cost-effectiveness of photoscreeners in identifying refractive errors making children at risk of amblyopia. Materials and Methods: This was designed as a prospective, open?label, randomized controlled study to compare the cost?effectiveness of photoscreeners (2WIN Adaptica and Plusoptix) versus autorefractor and Mohindra retinoscopy to identify the at?risk amblyopia. This study was conducted from October 2018 to December 2018 in coordination with Nanna Kannu school screening project and children in the age group of 5–11 years were included in the study. The photoscreening was done by lay screeners. Asupervising ophthalmologist collated all data. Cost-effectiveness was calculated for the individual instruments and compared. The average time is taken for each instrument to record the refractive error was calculated and compared with the Mohindra retinoscopy. Results: Number of children included in this study was 2910. The mean age of the children was 7.82 + 0.65 years. The mean time taken for 2WIN Adaptica was 6 sec, Topcon –10 s, and Plusoptix –4 s. Plusoptix showed the minimal time for screening a child when compared to all other methods. The Plusoptix and 2WIN Adaptica were shown to be cost?effective when compared to Mohindra retinoscopy (P < 0.05). Conclusion: Photoscreening using Plusoptix and 2WIN Adaptica with lay screeners was < seven times the cost incurred and five times faster than the trained optometrists using either autorefractor or Mohindra retinoscopy and thus more cost?effective in screening a large number of young children with at-risk amblyopia at the community level.
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@#AIM: To evaluate the accuracy of the Plusoptix A09 photorefraction with and without cycloplegia compared to an autorefractometer in pediatric patients.<p>METHODS: We assessed the refractive status of 180 eyes in 90 pediatric patients. Refractions were measured with the Plusoptix A09 photorefractor(Plusoptix GmbH, Nürnberg, Germany)with and without cycloplegia and compared with those obtained by autorefractometer(Topcon KR-8900, Tokyo, Japan)after cycloplegia. Spherical equivalent, spherical power cylindrical power and cylindrical axis J0, J45 values measurements were analyzed with Bland-Altman analysis. <p>RESULTS: The mean age of the patients was 7.48±3.01(range 3 to 13y). Between the non-cycloplegic Plusoptix A09 photorefractometer and the cycloplegic autorefractometer measurements, there was significant difference between spherical power and spherical equivalent values(<i>P</i><0.001)but there was no significant difference between cylindrical power, J0 and J45 values(<i>P</i>>0.05). Between the cycloplegic Plusoptix A09 photorefractometer and the cycloplegic autorefractometer measurements, there was significant difference between spherical power and spherical equivalent values(<i>P</i><0.001)but there was no significant difference between the cylindric power, J0 and J45 values(<i>P</i>>0.05). Bland-Altman correlation analysis revealed an excellent correlation for the spherical power, cylindrical power and spherical equivalent measurements, but poor correlation for J0 and J45 values between the non-cycloplegic, cycloplegic Plusoptix A09 and the cycloplegic autorefractometer measurements.<p>CONCLUSION: To determine refractive errors in children, the Plusoptix A09 measurements with and without cycloplegia can give reliable results. But it is inadequate when measuring the cylindrical axis and high refractive values. This device can be an effective option to detect and screen refractive errors in uncooperative children.
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AlM: To report refractive error findings and other eye abnormalities in preschool children population in Greater Area Jakarta using the Plusoptix pediatric autorefractor A09. METHODS: Cross sectional study of preschool age children with mean age 4. 46 ( range 2-6 years old) of 3 preschools in 3 municipalities in Greater Area Jakarta ( South Tangerang, Bekasi and West Jakarta ) were screened for refractive errors and other eye abnormalities. RESULTS:Totally 166 children, consisting of 51. 2% (n=85) male and 48. 8% (n=81) female were screened. Using the Arthur modification criteria for vision screening referral, 15. 67% (n=26) were given recommendations for further comprehensive ophthalmology examination. From those given recommendations, 2 had high hyperopia, 14 had significant astigmatism, 6 had combined hyperopia/astigmatism, 1 had anisometropia, 1 unable to measure, 2 had other ocular conditions ( congenital ptosis and severe ecchymosis and subconjunctival bleeding due to chronic cough) . CONCLUSlON: The finding of amblyopia risk factors in using Plusoptix A09 was 15. 67% in this study. This percentage should warrant healthcare providers in lndonesia, where the importance of preschool vision screening is not widely acknowledged, especially for the risk of irreversible amblyopia.
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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 a PlusoptiX S09 device were compared with those obtained by cycloplegic retinoscopy. Hyperopia (> or =+3.5 D), myopia (> or =-3.0 D), with the rule or against the rule astigmatism (> or =-1.5 D), and oblique astigmatism (> or =-1.0 D) were set as diagnostic criteria for refractive amblyopia risk factors (RARFs). The difference in the detection of RARFs by the two methods was the main outcome measure. 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 S09 versus -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 the PlusoptiX 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 compared to cycloplegic refraction, and hyperopia is underestimated.