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Comparison of the accommodative amplitude measured with and without the use of a specialised accommodative rule in

Hassan Hashemi1, Payam Nabovati2, Mehdi Khabazkhoob3

  • 1Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran.

BMJ Open Ophthalmology
|September 21, 2024
PubMed

Insights

Measurements of accommodative amplitude (AoA) in children show poor agreement when using an accommodative rule versus without it. The accommodative rule resulted in a significantly lower mean AoA, indicating potential discrepancies in clinical assessments.

Area of Science:

  • Ophthalmology
  • Pediatric Optometry
  • Vision Science

Background:

  • Accurate measurement of accommodative amplitude (AoA) is crucial for assessing visual function in children.
  • Standardized methods for measuring AoA are essential for reliable clinical practice and research.
  • The use of specialized tools, such as accommodative rules, may influence measurement outcomes.

Purpose of the Study:

  • To evaluate the agreement between accommodative amplitude (AoA) measurements in children obtained with and without a specialized accommodative rule.
  • To compare the reliability and consistency of two distinct methods for assessing pediatric accommodative function.

Main Methods:

  • 502 children (mean age 11.7 years) underwent optometric examinations, including visual acuity, refraction, and AoA measurement.
  • AoA was measured monocularly using a -4 D lens, both with and without the Berens accommodative rule.
  • Agreement was assessed using 95% limits of agreement (LoA) and interclass correlation coefficient (ICC).

Main Results:

  • Mean AoA was 20.02±6.02 D with the rule and 22.46±6.32 D without the rule.
  • The 95% LoA was -12.5 to 7.5 D, with an ICC of 0.67, indicating poor agreement.
  • Agreement varied by age, sex, and refractive error, and decreased with higher AoA values.

Conclusions:

  • There is poor and inconsistent agreement between AoA measurements made with and without an accommodative rule in children.
  • The accommodative rule consistently yielded lower AoA values (mean difference of 2.5 D).
  • Clinical decisions based on AoA measurements may differ depending on the method used.
Abstract

Keywords:
Child HealthDiagnostic tests/InvestigationEpidemiology

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