Agreement Between Retinoscopy, Autorefractometry and Subjective Refraction for Determining Refractive Errors in Congolese Children

Figures & data

Table 1 Comparison of Retinoscopy, Autorefractometry and Subjective Refraction Before and After Cycloplegia

Refraction Method and Significance Level	Sphere	Cylinder	SE
Non-cycloplegic retinoscopy	0.43 ± 1.32	−1.33 ± 0.94	−0.24 ± 1.07
Non-cycloplegic autorefraction	0.07 ± 1.38	−0.84 ± 0.68	−0.35 ± 1.36
Cycloplegic retinoscopy	1.12 ± 1.37	−0.80 ± 1.10	0.72 ± 1.00
Cycloplegic autorefraction	1.22 ± 1.06	−0.62 ± 0.66	0.91 ± 1.10
Subjective refraction	0.61 ± 0.84	−0.23 ± 0.35	0.52 ± 0.93
P1	0.17	0.001	0.58
P2	0.009	<0.001	<0.001
P3	<0.001	0.021	<0.001
P4	0.70	0.019	0.014
P5	0.022	<0.001	0.051
P6	0.002	<0.001	<0.001

Notes: P₁ = significance level of the difference between non-cycloplegic retinoscopy et non-cycloplegic autorefractometry; P₂ = significance level of the difference between non-cycloplegic and cycloplegic retinoscopy; P₃ = significance level of the difference between non-cycloplegic and cycloplegic autorefractometry; P₄ = significance level of the difference between cycloplegic retinoscopy and cycloplegic autorefractometry; P₅ = significance level of the difference between cycloplegic retinoscopy and subjective refraction; P₆ = significance level of the difference between cycloplegic autorefractometry and subjective refraction.

Abbreviation: SE, spherical equivalent.

Table 2 Frequency of Misclassification, Underestimation and Overestimation of Refractive Errors After Cycloplegic Retinoscopy and Autorefractometry

	Retinoscopy			Autorefractometry
	M	U	O	M	U	O	NC
Hyperopia	23 (54.8%)	17 (40.4%)	2 (4.8%)	21 (46.7%)	22 (48.9%)	–	2 (4.4%)
Myopia	1 (10.0%)	3 (30.0%)	6 (60.0%)	–	1 (11.1%)	6 (66.7%)	2 (22.2%)
Emmetropia	2 (100%)	–	–	–	–	–	–

Abbreviations: M, misclassification; U, underestimation; O, overestimation; NC, no change.

Table 3 Agreement Data Between Cycloplegic Retinoscopy, Autorefractometry and Subjective Refraction

	Retinoscopy vs Autorefractometry	Retinoscopy vs Subjective Refraction	Autorefractometry vs Subjective Refraction
	Bias (95% CI LoA)	Bias (95% CI LoA)	Bias 95% CI LoA
Sphere	−0.09 ± 0.16 (−0.40 to 0.22)*	0.51 ± 0.32 (−0.12 to 1.14)**	0.60 ± 0.24 (0.13 to 1.07)**
Cylinder	−0.18 ± 0.20 (−0.57 to 0.21)*	−0.57 ± 0.36 (−1.28 to 0.14)**	−0.39 ± 0.21 (−0.80 to 0.02)**
SE	−0.26 ± 0.17 (−0.67 to 0.15)**	0.11 ± 0.31 (−0.51 to 0.73)*	0.37 ± 0.41 (−0.43 to 1.17)**

Notes: *Non-significant; **significant.

Abbreviations: CI, confidence interval; LoA, limit of agreement; SE, spherical equivalent.

Figure 1 Bland–Altman plots of the agreement between retinoscopy and autorefractometry refraction, between subjective refraction and retinoscopy and between subjective refraction and autorefraction for measuring the power of spherical, cylindrical and SE in children.