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Wave-front Analysis used as Screening Technique for Amblyogenic Ametropia

1Schimitzek T., 2Schworm H. D.,
1Albert-Ludwigs-Universität, Augenklinik (Freiburg)
2Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Augenheilkunde, Bereich Orthoptik und Pleoptik (Hamburg)

Background: Since many years several attempts were made to find an easy, effective and inexpensive method to screen children for amblyogenic ametropia. Wave front analysis is a new way to determine the refractive state of the eye from distance. Thus, it could be a useful tool for infant screening. Purpose of the present study is the evaluation of the efficiency of a commercially available wave front analysing autorefractometer (SureSightTM, software version 2.0) in detecting amblyogenic ametropia in patients with and without cycloplegia.
Methods: 195 eyes (-8.13 D to +5.75 D spherical equivalent) of 108 patients (1 - 81 years) were examined with the wave-front autorefractometer under cycloplegia. Prior to this investigation, 100 eyes (-7.75 D to +5.75 D) of 53 out of these patients (2 - 76 years) were refracted without cycloplegia. The readings of the wave-front autorefractometer were compared to the results of retinoscopy under cycloplegia.
Results: Without cycloplegia, the sensitivity in detecting any amblyogenic ametropia like anisometropia, astigmatism, myopia or hyperopia was 94%, the specificity was 63%. With cycloplegia, the sensitivity decreased to 87% and the specificity increased to 80%.
Conclusions: The wave-front analysing refractometry is a new method suitable for screening infants. At this state of development its efficiency in detecting amblyogenic ametropia is similar when compared to other screening-techniques and instruments that operate at a distance.