소아에서 자동굴절검사와 수동굴절검사의 연령대별 비교

Clinical Comparison of Autorefractor versus Retinoscopic Refraction in Children according to the Age

정지웅;김용은;백혜정
Jung, Jee-Woong;Kim, Yong-Eun;Paik, Hae-Jung

  • 발행 : 20051100

초록

목적 : 소아의 굴절검사에서 조절마비 전과 후에 시행한 자동굴절검사와 수동굴절검사를 연령별로 비교해 보았다. 대상과 방법 : 시력을 측정할 수 있는 소아에서 최대교정시력이 0.6이상인 환아를 대상으로, 총 84명의 153안을 연령에 따라 4개의 군으로 나누었다. 29~57개월이 제 1군(36안), 58~75개월이 제 2군(47안), 76~95개월이 제 3군(36안), 96~121개월이 제 4군(34안)이었다. 조절마비 전과 후에 자동굴절검사기(Canon Auto Ref RK-2)로 굴절력을 측정하고 검영기로 수동굴절검사를 시행하였다. 결과 : 대상 소아 전 연령 군에서 조절마비와 관계없이 자동굴절검사가 수동굴절검사에 비해 더 근시로 측정되는 경향을 보였다. 또한 전 연령 군에서 조절마비 전 자동굴절검사와 조절마비 후 수동굴절검사의 비교에서 구면도수와 구면렌즈 대응치가 통계학적으로 유의한 차이를 보였지만(P=0.00), 조절마비 후 자동굴절검사와 수동굴절검사의 굴절검사 수치들의 경우 유의한 차이가 없었다. 결론 : 소아의 굴절력 측정은 조절마비 후 굴절검사를 사용함이 원칙이지만, 조절마비 후의 자동굴절검사의 경우 굴절검사 측정에 제한적으로 이용이 가능하리라 생각된다.

Purpose: We analyzed the difference in values between noncycloplegic and cycloplegic autorefraction and refraction, as measured by ophthalmologist, in children according to age. Methods: We classified the 84 children (153 eyes) whose best corrected visual acuity was better than 0.6 into four groups according to age. The first age group ranged from 29 to 57 months (36 eyes); the second age group ranged from 58 to 75 months (47 eyes); the third age group ranged from 76 to 95 months (36 eyes); and the fourth age group ranged from 96 to 121 months (34 eyes). The children were examined with an autorefractometer (Canon Auto Ref RK-2) and a retinoscope before and after cycloplegia. Results: The children in all age groups tend to show more myopia in autorefraction than refraction regardless of cycloplegia. Also, differences in spherical component and spherical equivalents in noncycloplegic autorefraction and cycloplegic refraction were regarded as significant statistically (P<0.05) in all age groups. However, in all groups, none of the refractive values in cycloplegic autorefraction and refraction were statistically significant. Conclusion: Refraction measurement should be recommended for cycloplegic refraction in children. It is suggested that cycloplegic autorefraction could be useful for the refraction partially.

키워드

참고문헌

  1. Kim MS, Chang HR. The evaluation of noncyclopegic and cycloplegic autorefration in children according to the age. J Korean Ophthalmol Soc 1998;39:728-34
  2. Konrad P, Harrison SW. A comparison of autorefractor performance. Optom Vis Sci 2004;81:554-8 https://doi.org/10.1097/00006324-200407000-00018
  3. Yun DH, Lee SW, Choi Y. Refraction. In : Ophthalmology, 6th ed. Seoul: Ilchokak, 2002; chap. 16
  4. Helveston EM, Pachtman MA, Cadera W, et al. Clinical evaluation of the Nidek AR autorefractor. J Pediatr Ophthalmol Strabismus 1984;21:227-30
  5. Charman WN. A pioneering instrument, the Collins electronic refractionmeter. Ophthalmic Optician 1976:16;345
  6. Nayak BK, Ghose S, Singh JP. A comparison of cycloplegic and manifest refractions on the NR-1000F objective autorefractometer. Br J Ophthalmol 1987;71:73-5 https://doi.org/10.1136/bjo.71.1.73
  7. Wood IC. A review of autorefractors. Eye 1987;1:529-35 https://doi.org/10.1038/eye.1987.80
  8. Perrigin DM, Perrigin J, Grosvenor T. A clinical evaluation of the American Optical SR III subjective refractor. AM J Ophthalmol 1981;58:581-9
  9. Kim YS, An HS, Jin YH. A study about the accuracy of automated refraction. J Korean Ophthalmol Soc 1995;36:2207-12
  10. Wong EK, Patella V, Pratt M, et al. Clinical evalution of Humphrey automatic refractor. Arch Ophtahlmol 1984;102:870-5 https://doi.org/10.1001/archopht.1984.01040030690020
  11. Charman WN, Jennings JA, Whitefoot H. The refraction of the eye in relation to spherical aberration and pupil size. Br J Physiol Opt 1978;32:78-93