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Comparing School-Aged Refraction Measurements Using the 2WIN-S Portable Refractor in Relation to Cycloplegic
Ziming Liu1,2, Emmanuel Eric Pazo1, Hong Ye1
1He Eye Specialist Hospital, Shenyang, China.
Purpose:
To assess the repeatability and agreement of refractive measurements using 2WIN-S photoscreening with the gold-standard cycloplegic retinoscope refraction.
Design:
Single centre, cross-sectional study.
Methods:
Spherical, cylindrical, axis, and spherical equivalent of 194 bilateral eyes of 97 children were assessed using a retinoscope and 2WIN-S. One week later, another operator repeated the 2WIN-S measurements. The primary outcome measures were to assess the repeatability and agreement between spherical equivalent, J0, and J45 readings of 2WIN-S. The repeatability of measurements was assessed by the within-subject standard deviation (2.77 Sw) and intraclass correlation coefficient (ICC). The agreement between devices was assessed using 95% limits of agreement. The extent of the agreement between cycloplegic retinoscopy and noncycloplegic 2WIN-S measurements was assessed using Bland-Altman analysis.
Results:
The mean age ± SD was 10.3 ± 2.46 year (range, 4-14 years). The sphere, cylinder, and spherical equivalent measurements were found to be consistent with both apparatus (r value >0.86). ICC for SE, J0, and J45 was 0.900, 0.666, and 0.639, respectively; Sw for SE, J0, and J45 was 0.61D, 0.30D, and 0.31D, respectively; Bland-Altman analysis of retinoscopy with cycloplegia and 2WIN-S for SE was 184/194 (95%) in 95% confidence interval, and the mean value was 0.46. J0 was 184/194 (95%), and the mean value is -0.04. J45 was 181/194 (93%), and the mean value is -0.15.
Conclusion:
The objective refractive measurement of 2WIN-S had good reliability and high agreement with the gold-standard retinoscopy refraction in children and adolescents. While consistency was observed, it is essential to take into consideration that it is a screening tool.
