关键词: 远程医疗, 屈光不正, 主觉验光

Abstract:

Objective To evaluate the agreement of refractive error detected by the traditional and telecontrolled subjective refraction. Design Diagnosis test. Participants 49 volunteers with refractive error. Method Traditional and telecontrolled subjective refraction were processed the laboratory of different floors in National Ophthalmology Diagnosis and Treatment Engineering Research Center. The same volunteers were checked with traditional and telecontrolled subjective refraction by the same professional optometrist on different dates (within 7 days). Integrated automated phoropter was used to process traditional subjective refraction. Telecontrolled subjective refraction was operated with integrated automated phoropter via internet. A non-professional assistant operated the autorefraction. The results were transmitted to the tablet computer via Bluetooth, then conveyed to the optometrist's computer via internet. Optometrist remotely operated the integrated automated refractor through the internet and communicated with volunteers online. According to refractive power, all eyes were divided into myopia group [spherical equivalent (SE)≤-0.50 D] and hyperopia group (SE≥+0.50 D). The MedCalc12.7 software was used for statistical analysis. Agreement of refractive error among traditional and telecontrolled subjective refraction was analyzed by Bland-Altman plots. Main Outcome Measures The 95% agreement of limit (LoA) for spherical power (S), cylindrical power (C), cylindrical axis (A) and SE measured by traditional and telecontrolled subjective refraction. The ratio of S, C, A, and SE points outside 95% LoA. Results The 95% LoA of S, C, A, SE of all eyes was (0.00±0.54) D, (-0.02±0.34) D, (0.70±24.30) ° and (0.00±0.52) D respectively. The ratio of S, C, A, and SE points outside 95% LoA of all eyes was 1.02%, 4.84%, 4.84%, 2.04% respectively. The 95% LoA of S, C, A, SE of myopia and hyperopia group was (-0.01±0.52)D, (-0.01±0.32)D,  （1.10±18.40）°, （-0.01±0.51）D respectively, and (0.20±0.54）D, （-0.05±0.22）D, （-8.00±40.80）°, (0.18±0.53）D respectively; the ratio of points outside 95% LoA was 1.08%, 3.51%, 5.26%, 2.15% respectively and 0.00%、0.00%、0.00%、0.00% respectively. Conclusion The agreement is good for S, C, SE, but poor for A among traditional and telecontrolled subjective refraction.

Key words: telemedicine, refractive error, subjective refraction