Comparability of the Retinomax K-plus 3 handheld autorefractometer in quick mode versus on-table autorefractometer in standard mode | Archivos de la Sociedad Española de Oftalmología (English Edition)

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Castilla Martinez, C.P. Tarazona Jaimes, C. Gutierrez Amoros, A. Fernandez Nadal, D. Romero Valero, J. Escolano Serrano, C.E. Monera Lucas, J.J. Martinez Toldos" "autores" => array:8 [ 0 => array:4 [ "nombre" => "G." "apellidos" => "Castilla Martinez" "email" => array:1 [ 0 => "germiswim@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "C.P." "apellidos" => "Tarazona Jaimes" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Gutierrez Amoros" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Fernandez Nadal" ] 4 => array:2 [ "nombre" => "D." "apellidos" => "Romero Valero" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Escolano Serrano" ] 6 => array:2 [ "nombre" => "C.E." "apellidos" => "Monera Lucas" ] 7 => array:2 [ "nombre" => "J.J." "apellidos" => "Martinez Toldos" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Hospital General Universitario de Elche, Elche, Alicante, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Comparabilidad del autorrefractómetro portátil Retinomax K-plus 3 en modo rápido versus autorrefractómetro de sobremesa en modo estándar" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2439 "Ancho" => 2508 "Tamanyo" => 325769 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Bland-Altman plots for both instruments with and without cycloplegia. SPH = sphere; CYL = cylinder; SE = spherical equivalent. The X-axis shows the average measurement of the two instruments and the Y-axis shows the difference in measurements between the two instruments. The mean ± SD shows a higher concordance in the measurements made under cycloplegia for all 3 parameters." ] ] ] "textoCompleto" => "IntroductionThe refractive examination of children is a basic tool for detecting visual health problems. Its diagnosis and correction at an early age will facilitate good vision development, avoiding amblyopia, and will contribute to the development of other sensory and motor systems with which it is connected.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>Depending on the age of the child, the tests to be performed in the examination and the results will vary. Children under 3 years of age have problems with tests to assess visual acuity and stereopsis, so the testability (ability to complete them) of these tests is low. On the other hand, from this age onwards it rises and in those over 5 years of age it is really high.<a class="elsevierStyleCrossRef" href="#bib0010">2</a> Because of this, other tests that provide information on the refractive power of the eye are used at this age.Classically, retinoscopy (1926) has been used, a test considered the gold standard. It is an objective test from the patient's point of view, although the result is clearly subjective as it depends on the examiner’s criteria. However, over the years, various instruments were developed that provided an objective and quicker measurement. Particularly, autorefractometers have become the most widely used devices in current optometric and ophthalmic practice to establish a starting point in the subject’s subjective refraction.<a class="elsevierStyleCrossRef" href="#bib0015">3</a>The popularity of autorefractometers is attributed to their speed of measurement, ease of use, good results and excellent acceptance by patients and clinicians. At present, autorefractometers offer a wide range of applications and have even improved their portability, making it easier to scan children in any position without the need for them to be properly supported on a tabletop autorefractometer. One of their latest updates has been the Quick mode which, unlike the normal mode, does not have fogging to minimise accommodation (with all that this implies, as the high accommodative power of children of this age could alter the results), thus speeding up the measurement process and is useful in very young uncooperative children.A range of autorefractometer models have been studied and compared to confirm the accuracy of their measurements, because although it was initially considered that they were not sufficiently accurate to replace subjective refraction and retinoscopy, nowadays their evolution has made them very useful for routine clinical practice.Therefore, the aim of this study is to analyse the comparability of measurements taken by a Topcon KR-800 desktop autorefractometer in standard mode and a Retinomax K-plus 3 portable autorefractometer in Quick mode on pediatric patients in our health department, and to establish the correlation between both.Materials and methodsIn this retrospective comparative analytical study, after approval by the Ethics Committee of our institution, we consecutively reviewed the pediatric ophthalmology consultations performed in the Ophthalmology Department of the Hospital General Universitario de Elche from January 2021 to December 2021. The data came from patients whose refractive power had been measured during the general examination using two instruments: the Retinomax K-plus 3 Portable Kerato-Refractometer (OftalTech Solutions, S.L.U.®) and the KR-800 Desktop Kerato-Refractometer (Topcon Healthcare Solutions, Inc.).Inclusion criteria were as follows: patients had to be between 2 and 16 years of age at the time of scanning, and to have been scanned with the Retinomax in Quick mode and with the Topcon KR-800 without and with cycloplegia. Patients with corneal or lenticular disease that could significantly alter the result of the measurements and those who, due to age, behaviour or other associated pathologies, would have been unable to undergo the measurements adequately, were excluded.All measurements were taken by two qualified professionals during the same visit and the same two previously calibrated instruments were used. The variables measured were: spherical dioptric power (SPH), cylindrical dioptric power (CYL), cylinder axis (AX) and spherical equivalent (SE). These 4 measurements were taken by both instruments under baseline conditions and after administration of cycloplegic (Cyclopentolate 10 mg/ml 1 drop every 10 min three times and then 30 min wait), so in total 16 measurements were obtained. Each measurement was taken 5 times (and each instrument estimates which measurement of the 5 repetitions is the most repeated). For the Retinomax, the Quick mode was used in all cases.Data were recorded in an MS Excel spreadsheet. Statistical analysis between the two instruments was performed using Student’s t-test for paired samples to compare the mean, standard deviation and confidence interval, and to establish a p-value of statistical significance for the SPH, CYL and SE parameters. Pearson's correlation coefficient was then calculated, and the dispersion of each of the comparative results was plotted using Bland-Altman graphical analysis, both for the total sample and for the subgroup of patients under 4 years of age. Finally, a descriptive analysis was performed representing the percentages of measurements differing ≤0.25D, between 0.26D and 0.5D, between 0.51D and 0.75D and >0.75D for SPH, CYL and SE, as well as ≤10°, between 11 and 20°, >20° for AX.ResultsThis study included 98 eyes of 49 subjects. The mean age of the patients was 7.1 ± 2.2 years (age range 3–16 years), 55% (n = 54) were female and 45% (n = 44) were male patients. <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the mean and standard deviation of the refractive measurements obtained with both instruments. It was found that the SPH data without cycloplegia are practically identical, while with cycloplegia there is a deviation of +0.5DP towards a more positive SPH value measured with Retinomax. Regarding CYL, the results are very similar both with and without cycloplegia. Finally, the SE data without cycloplegia are very similar, while with cycloplegia there is a deviation of +0.6DP towards a more positive SE value measured with Retinomax.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the Pearson correlation results for both instruments. Pearson's r values are higher than 0.91 in all cases, being especially high for SPH with cycloplegia (0.99). For CYL, the correlation is identical with and without cycloplegia (0.94).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>A description of the percentage variability of measurements that differed ≤0.25D, between 0.26D and 0.5D, between 0.51D and 0.75D and >0.75D for SPH, CYL and SE, as well as ≤10°, between 11 and 20°, >20° for AX is shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>. CYL values have the highest percentage within the difference group ≤0.25DP (83.7% with cycloplegia and 87.8% without cycloplegia). Under cycloplegia, differences of 0.5DP or less are found in 64% of comparisons for SPH, 96% for CYL and 62% for SE. Under non-cycloplegia differences of 0.5DP or less can be found in 47% of comparisons for SPH, 96% for CYL and 46% for SE. Regarding the degrees of deviation from the CYL axis, the results with and without cycloplegia are similar.<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>The Bland-Altman plots for each variable are shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, where the point spread shows smaller differences on the y-axis for SPH and SE parameters measured with cycloplegia (SPH 0.507 ± 0.285; SE 0.556 ± 0.281) than those measured without cycloplegia (SPH −0.053 ± 1.111; SE 0.010 ± 1.117). On the other hand, CYL measurements are practically the same without cycloplegia (0.002 ± 0.303) as with cycloplegia (0.025 ± 0.313).<elsevierMultimedia ident="fig0005"></elsevierMultimedia><a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> shows the analysis of the subgroup of patients aged 3 and 4 years (26 eyes of 13 subjects). Pearson correlation and Bland-Altman dispersion values are very similar to those described for the total sample, with a positive SPH bias towards Retinomax of +0.536DP and an almost equal CYL value with and without cycloplegia.<elsevierMultimedia ident="tbl0020"></elsevierMultimedia>DiscussionLooking at the accuracy achieved by autorefractometers, it is logical to think that the next step in evolution would be speed of measurement and convenience. This is particularly important in the pediatric population, and is what the Quick mode portable autorefractometers aim to achieve. Although several comparative studies have been published between various autorefractometers, this is the first to our knowledge that compares the desktop Topcon with the portable Retinomax K-plus 3 in Quick mode.Juo et al.'s group study<a class="elsevierStyleCrossRef" href="#bib0020">4</a> compares the portable Retinomax K-plus 2 in standard mode with the desktop Topcon on 116 children measured with cycloplegia (232 eyes) and 156 children measured without cycloplegia (312 eyes). This study found virtually no bias in the mean difference in SPH measured with cycloplegia (<0.1DP), while without cycloplegia they found a myopic bias of −0.59DP in favour of the Retinomax. This contrasts with the results presented, where the mean SPH is very similar without cycloplegia (<0.1DP), but has a hypermetropic bias of +0.5DP in favour of Retinomax under cycloplegic conditions. Theoretically, the hypothesis that the Quick mode was not correctly inhibiting accommodation is not valid, since this bias is present under cycloplegia. Similarly, it could be due to a systematic bias due to a lack of calibration of one of the two instruments, but in this case it was checked repeatedly. Accordingly, the difference observed with respect to the Topcon device is present and constant (according to the Bland-Altman plots in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, this hypermetropic trend is observed). This helps us to know our instruments better and gives us the reliability not to discard their main disadvantage: the fast acquisition time (0.8 s in Quick mode vs. up to 6 s in standard mode). It would therefore be interesting to check the results of the Retinomax in Quick mode with other autorefractometers.In line with the above, the literature on different Retinomax models in standard mode reveals similar or slightly more myopic results under cycloplegia with respect to different tested autorefractometers or retinoscopy.<a class="elsevierStyleCrossRefs" href="#bib0025">5–12</a> Regarding the latter, Yilmaz et al.<a class="elsevierStyleCrossRef" href="#bib0030">6</a> compare in their article the Retinomax K-plus 3 in standard mode versus retinoscopy under cycloplegic conditions in children, and also reveal a bias in spherical power of -0.58DP in favour of the Retinomax. On the other hand, with reference to other portable autorefractometer models, studies on Retinomax in standard mode show very similar results to HandyRef-K, although with the latter's CYL values being more positive (+0.1DP approximately).<a class="elsevierStyleCrossRefs" href="#bib0025">5,9</a> As for the PlusOptix model, most studies compare it under non-cycloplegic conditions to other autorefractometers or to retinoscopy under cycloplegic conditions (including Retinomax). In this respect, PlusOptix seems to be a useful tool for non-cycloplegic screening, being more accurate for HPS than Retinomax and HandyRef,<a class="elsevierStyleCrossRef" href="#bib0045">9</a> but under cycloplegia there is controversy. On the one hand, Yilmaz et al.<a class="elsevierStyleCrossRef" href="#bib0030">6</a> compares PlusOptix in non-cycloplegic conditions versus Retinomax Kplus 3 and retinoscopy under cycloplegia, and shows a mean SPH value very similar to retinoscopy and +0.5DP compared to Retinomax, with a nearly identical CYL value. On the other hand, Kinori et al.<a class="elsevierStyleCrossRef" href="#bib0065">13</a> compare the testability, sensitivity and specificity of PlusOptix and Retinomax Kplus 3 in 330 children aged 3–5 years. The results reveal that they were unable to test PlusOptix in 49 children while all could be tested with Retinomax. Furthermore, the sensitivity and specificity of Retinomax for detecting refractive problems was about 95% while that of PlusOptix was about 85%. Therefore, it was less useful for screening because of this lack of testability and less accurate measurements, in agreement with Bui Quoc et al.<a class="elsevierStyleCrossRef" href="#bib0070">14</a> and Schmidt-Bacher et al.<a class="elsevierStyleCrossRef" href="#bib0075">15</a>Regarding the cylinder, Retinomax shows very accurate results, both with and without cycloplegia. This confirms what is described in other studies by Juo,<a class="elsevierStyleCrossRefs" href="#bib0020">4,16</a> in which we find comparisons with a Topcon autorefractometer, but also with the classical retinoscopy method, as in the study by Peng.<a class="elsevierStyleCrossRef" href="#bib0085">17</a> We can also conclude that cycloplegia has little influence on the measurements taken by both autorefractometers, as the results are very similar with and without cycloplegia, an aspect that is also studied and affirmed in the article by Tuncer10 and Cordonnier.<a class="elsevierStyleCrossRef" href="#bib0090">18</a> Furthermore, according to <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> the proportion of AX measurements that differed ≤10° is around 60% for cycloplegic and non-cycloplegic eyes, values significantly lower in the cycloplegic results (around 85% in the first study by Juo4 and 75% in the second study<a class="elsevierStyleCrossRef" href="#bib0080">16</a>) and different in the non-cycloplegic ones (around 50% in the first study by Juo<a class="elsevierStyleCrossRef" href="#bib0020">4</a> and 75% in the second study<a class="elsevierStyleCrossRef" href="#bib0080">16</a>) compared to the reviewed studies.On the other hand, the measures between the instruments show good agreement, especially if we evaluate them under cycloplegia. This is illustrated in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>, which shows that the lowest Pearson’s r value is 0.942 for CYL, being higher than 0.99 for both SPH and SE, and in the Bland Altman plots, where the mean difference does not have a strong clinical implication for any of the 3 parameters (SPH 0.507 ± 0.285; CYL 0.02 ± 0.313; SE 0.556 ± 0.281). These Retinomax Quick mode results are in agreement with the majority of the Retinomax standard mode results described in the reviewed articles.<a class="elsevierStyleCrossRefs" href="#bib0020">4–20</a>One limitation of the present study was the sample size, which was sufficient to perform a correct analysis but too small to segment the sample into sufficiently large age groups. However, <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> shows a small analysis of the subgroup aged 4 years or younger, the ideal patients to use this instrument, which shows very similar results to those obtained when analysing the total sample.ConclusionIn conclusion, Retinomax in Quick mode provides good agreement for SPH, CYL and SE in cycloplegic conditions, with a particularly good correlation for CYL both with and without cycloplegia. SPH in cycloplegic conditions presents a hypermetropic bias of 0.5DP that would need to be confirmed in further studies. If we consider the convenience, speed and safety of the measurements compared to a desktop Topcon, the Retinomax becomes a useful alternative for young children and uncooperative patients to establish a starting point for refraction.Conflicts of interestNone." "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1955835" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1683392" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1955834" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1683391" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Materials and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflicts of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2023-04-10" "fechaAceptado" => "2023-07-04" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1683392" "palabras" => array:5 [ 0 => "Retinomax" 1 => "Quick mode" 2 => "Hyperopic bias" 3 => "Children" 4 => "Cylinder" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1683391" "palabras" => array:5 [ 0 => "Retinomax" 1 => "Modo rápido" 2 => "Sesgo hipermetrópico" 3 => "Niños" 4 => "Cilindro" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionThis study analyzes the comparability of measurements taken by a Retinomax K-plus 3 handheld autorefractometer in Quick mode and a Topcon KR-800 on-table autorefractometer in standard mode on the pediatric population, and establishes their correlation. MethodsIt is a retrospective comparative study. Spherical diopter power (SPH), cylindrical diopter power (CYL), angle of cylindrical axis (AX), and spherical equivalent (SE) were measured with the Retinomax in Quick mode and with the Topcon in standard mode. Each patient was evaluated in cycloplegic and non-cycloplegic conditions by both autorefractometers. Student’s t-test was performed between the two instruments for SPH, CYL, and SE. The Pearson correlation coefficient was calculated and the dispersion was represented using Bland-Altman graphs, also evaluating the subgroup of patients under 4 years of age. A descriptive analysis of the percentages of measures that differed was performed. ResultsIt included 98 eyes of 49 subjects (age range: 3–16 years). The data for HPS without cycloplegia are virtually identical, whereas with cycloplegia there is a hyperopic bias of +0.5 diopters measured with Retinomax. CYL results are very similar with and without cycloplegia. There is a high Pearson correlation for both instruments (>0.91) and a low degree of dispersion in the Bland-Altman plots under cycloplegia. ConclusionThe Retinomax data were consistent with those obtained by Topcon. The Retinomax is a useful instrument for detecting refractive errors in children between 3 and 16 years of age." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónEste estudio analiza la comparabilidad de las medidas tomadas por un autorefractómetro portátil Retinomax K-plus 3 en modo Quick (rápido) y un autorrefractómetro de sobremesa Topcon KR-800 en modo estándar sobre población pediátrica, y establece su correlación. MétodosEs un estudio comparativo retrospectivo. Se midieron las variables potencia dióptrica esférica (SPH), potencia dióptrica cilíndrica (CYL), ángulo del eje cilíndrico (AX) y equivalente esférico (SE) con el Retinomax en modo Quick y con el Topcon en modo estándar. Cada paciente fue evaluado en condiciones ciclopléjicas y no ciclopléjicas por ambos autorefractómetros. Se realizó la prueba t de Student entre ambos instrumentos para SPH, CYL y SE. Se calculó el coeficiente de correlación de Pearson y se representó la dispersión mediante gráficas de Bland-Altman, evaluándose también el subgrupo de pacientes menores de 4 años. Se realizó un análisis descriptivo de los porcentajes de medidas que diferían. ResultadosIncluyó 98 ojos de 49 sujetos (rango de edad: 3–16 años). Los datos de SPH sin cicloplejia son prácticamente idénticos, mientras que con cicloplejia hay un sesgo hipermetrópico de +0,5 dioptrías medidas con Retinomax. Los resultados de CYL son muy similares con y sin cicloplejia. Existe una gran correlación de Pearson para ambos instrumentos (>0,91) y un bajo grado de dispersión en los gráficos de Bland-Altman bajo cicloplejia. ConclusiónLos datos del Retinomax fueron consistentes con los obtenidos por el Topcon. El Retinomax es un instrumento útil para detectar errores de refracción en niños de entre 3 y 16 años." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "multimedia" => array:5 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2439 "Ancho" => 2508 "Tamanyo" => 325769 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Bland-Altman plots for both instruments with and without cycloplegia. SPH = sphere; CYL = cylinder; SE = spherical equivalent. The X-axis shows the average measurement of the two instruments and the Y-axis shows the difference in measurements between the two instruments. The mean ± SD shows a higher concordance in the measurements made under cycloplegia for all 3 parameters." ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "DP = dioptre; SD = standard deviation; SPH = sphere; CYL = cylinder; SE = spherical equivalent." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SPH (DP)</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CYL (DP)</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SE (DP)</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Without cycloplegia \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">With cycloplegia \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Without cycloplegia \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">With cycloplegia \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Without cycloplegia \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">With cycloplegia \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Topcon (Mean ± SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.5 ± 2.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.5 ± 3.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.8 ± 0.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.8 ± 0.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.9 ± 2.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.1 ± 3.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Retinomax (Mean ± SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.5 ± 2.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.0 ± 3.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.8 ± 0.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.8 ± 0.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.9 ± 2.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.7 ± 3.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Student's t test (p) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.886 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.234 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.983 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.840 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.979 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.203 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3255638.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Mean, standard deviation and Student's t-test between the two types of autorefractometers for cycloplegic and non-cycloplegic eyes." ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "DP = dioptre; SPH = sphere; CYL = cylinder; CI = confidence interval; DOP = dioptre; SPH = sphere; CYL = cylinder." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">r Pearson \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HPS without cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.911 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.870–0.940 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CYL without cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.943 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.917–0.962 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SE without cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.913 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.872–0.941 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HPS with cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.995 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.993–0.996 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CYL with cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.942 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.915–0.961 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SE with cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.958 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.993–0.997 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3255636.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Pearson correlation and 95% CI between the two types of autorefractometers for cycloplegic and non-cycloplegic eyes." ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "DP = dioptre; SPH = sphere; CYL = cylinder; SE = spherical equivalent; AX = axis of the cylinder." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">≤0.25 DP \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">0.26−0.5 PD \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">0.51−0.75 PD \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">>0.75 PD \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HPS without cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.7% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.3% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20.4% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32.6% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CYL without cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">87.8% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.2% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SE without cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18.4% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.1% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≤10° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11−20º \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">>20° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AX without cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.3% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.7% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≤0.25 DP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,26−0,5DP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.51−0.75 PD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">>0.75 PD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HPS with cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.6% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38.8% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.1% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CYL with cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">83.7% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.2% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.1% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SE with cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22.4% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.1% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≤10° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11−20º \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">>20° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AX with cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.3% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.7% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3255635.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Relationship of agreement between measurements in different categories between Retinomax and Topcon." ] ] 4 => array:8 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "DP = dioptre; SPH = sphere; CYL = cylinder; CI = confidence interval." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">r Pearson \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Bland-Altman \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HPS without cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.876 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.747–0.941 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.143 +/− 1.181 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CYL without cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.964 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.922–0.983 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.000 +/− 0.347 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SE without cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.870 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.736–0.938 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.143 +/− 1.195 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HPS with cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.989 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.976–0.995 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.536 +/− 0.331 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CYL with cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.941 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.875–0.972 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.018 +/− 0.402 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SE with cycloplegia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.958 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.993– 0.997 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.536 +/− 0.324 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3255637.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Pearson correlation, 95% CI and mean +/− standard deviation in Bland-Altman ratio between the two types of autorefractometers for cycloplegic and non-cycloplegic eyes in children under 4 years of age." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Visuomotor behaviour in amblyopia: Deficits and compensatory adaptations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E. Niechwiej-Szwedo" 1 => "L. Colpa" 2 => "A.M.F. Wong" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2019/6817839" "Revista" => array:2 [ "tituloSerie" => "Neural Plast" "fecha" => "2019" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:1 [ "host" => array:2 [ 0 => array:1 [ "Libro" => array:3 [ "titulo" => "Vision in children ages 6 months to 5 years: Screening. Uspreventiveservicestaskforce.org." "fecha" => "2017" "editorial" => "US Preventive Services Taskforce" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/vision-in-children-ages-6-months-to-5-years-screening" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Entendiendo los defectos de refracción: miopía, hipermetropía y astigmatismo" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R. Ruiz Mesa" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "editores" => "R.Ruiz Mesa, P.Tañá Rivero" "titulo" => "Óptica para el cirujano Faco-Refractivo" "paginaInicial" => "57" "paginaFinal" => "83" "serieFecha" => "2015" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of measurements of refractive errors between the hand-held Retinomax and on-table autorefractors in cyclopleged and noncyclopleged children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C.-L. Liang" 1 => "K.-S. Hung" 2 => "N. Park" 3 => "P. Chan" 4 => "S.-H.H. 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Karalezli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12886-021-02199-5" "Revista" => array:4 [ "tituloSerie" => "BMC Ophthalmol" "fecha" => "2021" "volumen" => "21" "paginaInicial" => "424" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of the Plusoptix A09 and Retinomax K-Plus 3 with retinoscopy in children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "I. Yilmaz" 1 => "A. Ozkaya" 2 => "Z. Alkin" 3 => "S. Ozbengi" 4 => "A.T. Yazici" 5 => "A. 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Comparability of the Retinomax K-plus 3 handheld autorefractometer in quick mode versus on-table autorefractometer in standard mode

Comparabilidad del autorrefractómetro portátil Retinomax K-plus 3 en modo rápido versus autorrefractómetro de sobremesa en modo estándar

G. Castilla Martinez

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germiswim@gmail.com

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, C.P. Tarazona Jaimes, C. Gutierrez Amoros, A. Fernandez Nadal, D. Romero Valero, J. Escolano Serrano, C.E. Monera Lucas, J.J. Martinez Toldos

Hospital General Universitario de Elche, Elche, Alicante, Spain

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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Bland-Altman plots for both instruments with and without cycloplegia&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">SPH&#8239;&#61;&#8239;sphere&#59; CYL&#8239;&#61;&#8239;cylinder&#59; SE&#8239;&#61;&#8239;spherical equivalent&#46; The X-axis shows the average measurement of the two instruments and the Y-axis shows the difference in measurements between the two instruments&#46;</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The mean&#8239;&#177;&#8239;SD shows a higher concordance in the measurements made under cycloplegia for all 3 parameters&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The refractive examination of children is a basic tool for detecting visual health problems&#46; Its diagnosis and correction at an early age will facilitate good vision development&#44; avoiding amblyopia&#44; and will contribute to the development of other sensory and motor systems with which it is connected&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Depending on the age of the child&#44; the tests to be performed in the examination and the results will vary&#46; Children under 3 years of age have problems with tests to assess visual acuity and stereopsis&#44; so the testability &#40;ability to complete them&#41; of these tests is low&#46; On the other hand&#44; from this age onwards it rises and in those over 5 years of age it is really high&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Because of this&#44; other tests that provide information on the refractive power of the eye are used at this age&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Classically&#44; retinoscopy &#40;1926&#41; has been used&#44; a test considered the gold standard&#46; It is an objective test from the patient&#39;s point of view&#44; although the result is clearly subjective as it depends on the examiner&#8217;s criteria&#46; However&#44; over the years&#44; various instruments were developed that provided an objective and quicker measurement&#46; Particularly&#44; autorefractometers have become the most widely used devices in current optometric and ophthalmic practice to establish a starting point in the subject&#8217;s subjective refraction&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The popularity of autorefractometers is attributed to their speed of measurement&#44; ease of use&#44; good results and excellent acceptance by patients and clinicians&#46; At present&#44; autorefractometers offer a wide range of applications and have even improved their portability&#44; making it easier to scan children in any position without the need for them to be properly supported on a tabletop autorefractometer&#46; One of their latest updates has been the <span class="elsevierStyleItalic">Quick</span> mode which&#44; unlike the normal mode&#44; does not have fogging to minimise accommodation &#40;with all that this implies&#44; as the high accommodative power of children of this age could alter the results&#41;&#44; thus speeding up the measurement process and is useful in very young uncooperative children&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">A range of autorefractometer models have been studied and compared to confirm the accuracy of their measurements&#44; because although it was initially considered that they were not sufficiently accurate to replace subjective refraction and retinoscopy&#44; nowadays their evolution has made them very useful for routine clinical practice&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Therefore&#44; the aim of this study is to analyse the comparability of measurements taken by a Topcon KR-800 desktop autorefractometer in standard mode and a Retinomax K-plus 3 portable autorefractometer in <span class="elsevierStyleItalic">Quick mode</span> on pediatric patients in our health department&#44; and to establish the correlation between both&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">In this retrospective comparative analytical study&#44; after approval by the Ethics Committee of our institution&#44; we consecutively reviewed the pediatric ophthalmology consultations performed in the Ophthalmology Department of the Hospital General Universitario de Elche from January 2021 to December 2021&#46; The data came from patients whose refractive power had been measured during the general examination using two instruments&#58; the Retinomax K-plus 3 Portable Kerato-Refractometer &#40;OftalTech Solutions&#44; S&#46;L&#46;U&#46;&#174;&#41; and the KR-800 Desktop Kerato-Refractometer &#40;Topcon Healthcare Solutions&#44; Inc&#46;&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Inclusion criteria were as follows&#58; patients had to be between 2 and 16 years of age at the time of scanning&#44; and to have been scanned with the Retinomax in <span class="elsevierStyleItalic">Quick mode</span> and with the Topcon KR-800 without and with cycloplegia&#46; Patients with corneal or lenticular disease that could significantly alter the result of the measurements and those who&#44; due to age&#44; behaviour or other associated pathologies&#44; would have been unable to undergo the measurements adequately&#44; were excluded&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">All measurements were taken by two qualified professionals during the same visit and the same two previously calibrated instruments were used&#46; The variables measured were&#58; spherical dioptric power &#40;SPH&#41;&#44; cylindrical dioptric power &#40;CYL&#41;&#44; cylinder axis &#40;AX&#41; and spherical equivalent &#40;SE&#41;&#46; These 4 measurements were taken by both instruments under baseline conditions and after administration of cycloplegic &#40;Cyclopentolate 10&#8239;mg&#47;ml 1 drop every 10&#8239;min three times and then 30&#8239;min wait&#41;&#44; so in total 16 measurements were obtained&#46; Each measurement was taken 5 times &#40;and each instrument estimates which measurement of the 5 repetitions is the most repeated&#41;&#46; For the Retinomax&#44; the <span class="elsevierStyleItalic">Quick</span> mode was used in all cases&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Data were recorded in an MS Excel spreadsheet&#46; Statistical analysis between the two instruments was performed using Student&#8217;s <span class="elsevierStyleItalic">t-test</span> for paired samples to compare the mean&#44; standard deviation and confidence interval&#44; and to establish a <span class="elsevierStyleItalic">p-value</span> of statistical significance for the SPH&#44; CYL and SE parameters&#46; Pearson&#39;s correlation coefficient was then calculated&#44; and the dispersion of each of the comparative results was plotted using Bland-Altman graphical analysis&#44; both for the total sample and for the subgroup of patients under 4 years of age&#46; Finally&#44; a descriptive analysis was performed representing the percentages of measurements differing &#8804;0&#46;25D&#44; between 0&#46;26D and 0&#46;5D&#44; between 0&#46;51D and 0&#46;75D and &#62;0&#46;75D for SPH&#44; CYL and SE&#44; as well as &#8804;10&#176;&#44; between 11 and 20&#176;&#44; &#62;20&#176; for AX&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0055" class="elsevierStylePara elsevierViewall">This study included 98 eyes of 49 subjects&#46; The mean age of the patients was 7&#46;1&#8239;&#177;&#8239;2&#46;2 years &#40;age range 3&#8211;16 years&#41;&#44; 55&#37; &#40;n&#8239;&#61;&#8239;54&#41; were female and 45&#37; &#40;n&#8239;&#61;&#8239;44&#41; were male patients&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the mean and standard deviation of the refractive measurements obtained with both instruments&#46; It was found that the SPH data without cycloplegia are practically identical&#44; while with cycloplegia there is a deviation of &#43;0&#46;5DP towards a more positive SPH value measured with Retinomax&#46; Regarding CYL&#44; the results are very similar both with and without cycloplegia&#46; Finally&#44; the SE data without cycloplegia are very similar&#44; while with cycloplegia there is a deviation of &#43;0&#46;6DP towards a more positive SE value measured with Retinomax&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the Pearson correlation results for both instruments&#46; Pearson&#39;s <span class="elsevierStyleItalic">r</span> values are higher than 0&#46;91 in all cases&#44; being especially high for SPH with cycloplegia &#40;0&#46;99&#41;&#46; For CYL&#44; the correlation is identical with and without cycloplegia &#40;0&#46;94&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">A description of the percentage variability of measurements that differed &#8804;0&#46;25D&#44; between 0&#46;26D and 0&#46;5D&#44; between 0&#46;51D and 0&#46;75D and &#62;0&#46;75D for SPH&#44; CYL and SE&#44; as well as &#8804;10&#176;&#44; between 11 and 20&#176;&#44; &#62;20&#176; for AX is shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; CYL values have the highest percentage within the difference group &#8804;0&#46;25DP &#40;83&#46;7&#37; with cycloplegia and 87&#46;8&#37; without cycloplegia&#41;&#46; Under cycloplegia&#44; differences of 0&#46;5DP or less are found in 64&#37; of comparisons for SPH&#44; 96&#37; for CYL and 62&#37; for SE&#46; Under non-cycloplegia differences of 0&#46;5DP or less can be found in 47&#37; of comparisons for SPH&#44; 96&#37; for CYL and 46&#37; for SE&#46; Regarding the degrees of deviation from the CYL axis&#44; the results with and without cycloplegia are similar&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The Bland-Altman plots for each variable are shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#44; where the point spread shows smaller differences on the y-axis for SPH and SE parameters measured with cycloplegia &#40;SPH 0&#46;507&#8239;&#177;&#8239;0&#46;285&#59; SE 0&#46;556&#8239;&#177;&#8239;0&#46;281&#41; than those measured without cycloplegia &#40;SPH &#8722;0&#46;053&#8239;&#177;&#8239;1&#46;111&#59; SE 0&#46;010&#8239;&#177;&#8239;1&#46;117&#41;&#46; On the other hand&#44; CYL measurements are practically the same without cycloplegia &#40;0&#46;002&#8239;&#177;&#8239;0&#46;303&#41; as with cycloplegia &#40;0&#46;025&#8239;&#177;&#8239;0&#46;313&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> shows the analysis of the subgroup of patients aged 3 and 4 years &#40;26 eyes of 13 subjects&#41;&#46; Pearson correlation and Bland-Altman dispersion values are very similar to those described for the total sample&#44; with a positive SPH bias towards Retinomax of &#43;0&#46;536DP and an almost equal CYL value with and without cycloplegia&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0080" class="elsevierStylePara elsevierViewall">Looking at the accuracy achieved by autorefractometers&#44; it is logical to think that the next step in evolution would be speed of measurement and convenience&#46; This is particularly important in the pediatric population&#44; and is what the <span class="elsevierStyleItalic">Quick</span> mode portable autorefractometers aim to achieve&#46; Although several comparative studies have been published between various autorefractometers&#44; this is the first to our knowledge that compares the desktop Topcon with the portable Retinomax K-plus 3 in <span class="elsevierStyleItalic">Quick</span> mode&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Juo et al&#46;&#39;s group study<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> compares the portable Retinomax K-plus 2 in standard mode with the desktop Topcon on 116 children measured with cycloplegia &#40;232 eyes&#41; and 156 children measured without cycloplegia &#40;312 eyes&#41;&#46; This study found virtually no bias in the mean difference in SPH measured with cycloplegia &#40;&#60;0&#46;1DP&#41;&#44; while without cycloplegia they found a myopic bias of &#8722;0&#46;59DP in favour of the Retinomax&#46; This contrasts with the results presented&#44; where the mean SPH is very similar without cycloplegia &#40;&#60;0&#46;1DP&#41;&#44; but has a hypermetropic bias of &#43;0&#46;5DP in favour of Retinomax under cycloplegic conditions&#46; Theoretically&#44; the hypothesis that the <span class="elsevierStyleItalic">Quick</span> mode was not correctly inhibiting accommodation is not valid&#44; since this bias is present under cycloplegia&#46; Similarly&#44; it could be due to a systematic bias due to a lack of calibration of one of the two instruments&#44; but in this case it was checked repeatedly&#46; Accordingly&#44; the difference observed with respect to the Topcon device is present and constant &#40;according to the Bland-Altman plots in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#44; this hypermetropic trend is observed&#41;&#46; This helps us to know our instruments better and gives us the reliability not to discard their main disadvantage&#58; the fast acquisition time &#40;0&#46;8&#8239;s in <span class="elsevierStyleItalic">Quick</span> mode vs&#46; up to 6&#8239;s in standard mode&#41;&#46; It would therefore be interesting to check the results of the Retinomax in <span class="elsevierStyleItalic">Quick</span> mode with other autorefractometers&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">In line with the above&#44; the literature on different Retinomax models in standard mode reveals similar or slightly more myopic results under cycloplegia with respect to different tested autorefractometers or retinoscopy&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#8211;12</span></a> Regarding the latter&#44; Yilmaz et al&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> compare in their article the Retinomax K-plus 3 in standard mode versus retinoscopy under cycloplegic conditions in children&#44; and also reveal a bias in spherical power of -0&#46;58DP in favour of the Retinomax&#46; On the other hand&#44; with reference to other portable autorefractometer models&#44; studies on Retinomax in standard mode show very similar results to HandyRef-K&#44; although with the latter&#39;s CYL values being more positive &#40;&#43;0&#46;1DP approximately&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;9</span></a> As for the PlusOptix model&#44; most studies compare it under non-cycloplegic conditions to other autorefractometers or to retinoscopy under cycloplegic conditions &#40;including Retinomax&#41;&#46; In this respect&#44; PlusOptix seems to be a useful tool for non-cycloplegic screening&#44; being more accurate for HPS than Retinomax and HandyRef&#44;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> but under cycloplegia there is controversy&#46; On the one hand&#44; Yilmaz et al&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> compares PlusOptix in non-cycloplegic conditions versus Retinomax Kplus 3 and retinoscopy under cycloplegia&#44; and shows a mean SPH value very similar to retinoscopy and &#43;0&#46;5DP compared to Retinomax&#44; with a nearly identical CYL value&#46; On the other hand&#44; Kinori et al&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> compare the testability&#44; sensitivity and specificity of PlusOptix and Retinomax Kplus 3 in 330 children aged 3&#8211;5 years&#46; The results reveal that they were unable to test PlusOptix in 49 children while all could be tested with Retinomax&#46; Furthermore&#44; the sensitivity and specificity of Retinomax for detecting refractive problems was about 95&#37; while that of PlusOptix was about 85&#37;&#46; Therefore&#44; it was less useful for screening because of this lack of testability and less accurate measurements&#44; in agreement with Bui Quoc et al&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> and Schmidt-Bacher et al&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Regarding the cylinder&#44; Retinomax shows very accurate results&#44; both with and without cycloplegia&#46; This confirms what is described in other studies by Juo&#44;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;16</span></a> in which we find comparisons with a Topcon autorefractometer&#44; but also with the classical retinoscopy method&#44; as in the study by Peng&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> We can also conclude that cycloplegia has little influence on the measurements taken by both autorefractometers&#44; as the results are very similar with and without cycloplegia&#44; an aspect that is also studied and affirmed in the article by Tuncer10 and Cordonnier&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> Furthermore&#44; according to <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> the proportion of AX measurements that differed &#8804;10&#176; is around 60&#37; for cycloplegic and non-cycloplegic eyes&#44; values significantly lower in the cycloplegic results &#40;around 85&#37; in the first study by Juo4 and 75&#37; in the second study<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>&#41; and different in the non-cycloplegic ones &#40;around 50&#37; in the first study by Juo<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and 75&#37; in the second study<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>&#41; compared to the reviewed studies&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">On the other hand&#44; the measures between the instruments show good agreement&#44; especially if we evaluate them under cycloplegia&#46; This is illustrated in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#44; which shows that the lowest Pearson&#8217;s r value is 0&#46;942 for CYL&#44; being higher than 0&#46;99 for both SPH and SE&#44; and in the Bland Altman plots&#44; where the mean difference does not have a strong clinical implication for any of the 3 parameters &#40;SPH 0&#46;507&#8239;&#177;&#8239;0&#46;285&#59; CYL 0&#46;02&#8239;&#177;&#8239;0&#46;313&#59; SE 0&#46;556&#8239;&#177;&#8239;0&#46;281&#41;&#46; These Retinomax <span class="elsevierStyleItalic">Quick</span> mode results are in agreement with the majority of the Retinomax standard mode results described in the reviewed articles&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#8211;20</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">One limitation of the present study was the sample size&#44; which was sufficient to perform a correct analysis but too small to segment the sample into sufficiently large age groups&#46; However&#44; <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> shows a small analysis of the subgroup aged 4 years or younger&#44; the ideal patients to use this instrument&#44; which shows very similar results to those obtained when analysing the total sample&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusion</span><p id="par0110" class="elsevierStylePara elsevierViewall">In conclusion&#44; Retinomax in <span class="elsevierStyleItalic">Quick</span> mode provides good agreement for SPH&#44; CYL and SE in cycloplegic conditions&#44; with a particularly good correlation for CYL both with and without cycloplegia&#46; SPH in cycloplegic conditions presents a hypermetropic bias of 0&#46;5DP that would need to be confirmed in further studies&#46; If we consider the convenience&#44; speed and safety of the measurements compared to a desktop Topcon&#44; the Retinomax becomes a useful alternative for young children and uncooperative patients to establish a starting point for refraction&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflicts of interest</span><p id="par0115" class="elsevierStylePara elsevierViewall">None&#46;</p></span></span>"
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    "fechaAceptado" => "2023-07-04"
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            1 => "Quick mode"
            2 => "Hyperopic bias"
            3 => "Children"
            4 => "Cylinder"
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            0 => "Retinomax"
            1 => "Modo r&#225;pido"
            2 => "Sesgo hipermetr&#243;pico"
            3 => "Ni&#241;os"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">This study analyzes the comparability of measurements taken by a Retinomax K-plus 3 handheld autorefractometer in Quick mode and a Topcon KR-800 on-table autorefractometer in standard mode on the pediatric population&#44; and establishes their correlation&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">It is a retrospective comparative study&#46; Spherical diopter power &#40;SPH&#41;&#44; cylindrical diopter power &#40;CYL&#41;&#44; angle of cylindrical axis &#40;AX&#41;&#44; and spherical equivalent &#40;SE&#41; were measured with the Retinomax in Quick mode and with the Topcon in standard mode&#46; Each patient was evaluated in cycloplegic and non-cycloplegic conditions by both autorefractometers&#46; Student&#8217;s <span class="elsevierStyleItalic">t</span>-test was performed between the two instruments for SPH&#44; CYL&#44; and SE&#46; The Pearson correlation coefficient was calculated and the dispersion was represented using Bland-Altman graphs&#44; also evaluating the subgroup of patients under 4 years of age&#46; A descriptive analysis of the percentages of measures that differed was performed&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">It included 98 eyes of 49 subjects &#40;age range&#58; 3&#8211;16 years&#41;&#46; The data for HPS without cycloplegia are virtually identical&#44; whereas with cycloplegia there is a hyperopic bias of &#43;0&#46;5 diopters measured with Retinomax&#46; CYL results are very similar with and without cycloplegia&#46; There is a high Pearson correlation for both instruments &#40;&#62;0&#46;91&#41; and a low degree of dispersion in the Bland-Altman plots under cycloplegia&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">The Retinomax data were consistent with those obtained by Topcon&#46; The Retinomax is a useful instrument for detecting refractive errors in children between 3 and 16 years of age&#46;</p></span>"
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          0 => array:2 [
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Este estudio analiza la comparabilidad de las medidas tomadas por un autorefract&#243;metro port&#225;til Retinomax K-plus 3 en modo <span class="elsevierStyleItalic">Quick</span> &#40;r&#225;pido&#41; y un autorrefract&#243;metro de sobremesa Topcon KR-800 en modo est&#225;ndar sobre poblaci&#243;n pedi&#225;trica&#44; y establece su correlaci&#243;n&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Es un estudio comparativo retrospectivo&#46; Se midieron las variables potencia di&#243;ptrica esf&#233;rica &#40;SPH&#41;&#44; potencia di&#243;ptrica cil&#237;ndrica &#40;CYL&#41;&#44; &#225;ngulo del eje cil&#237;ndrico &#40;AX&#41; y equivalente esf&#233;rico &#40;SE&#41; con el Retinomax en modo <span class="elsevierStyleItalic">Quick</span> y con el Topcon en modo est&#225;ndar&#46; Cada paciente fue evaluado en condiciones ciclopl&#233;jicas y no ciclopl&#233;jicas por ambos autorefract&#243;metros&#46; Se realiz&#243; la prueba t de Student entre ambos instrumentos para SPH&#44; CYL y SE&#46; Se calcul&#243; el coeficiente de correlaci&#243;n de Pearson y se represent&#243; la dispersi&#243;n mediante gr&#225;ficas de Bland-Altman&#44; evalu&#225;ndose tambi&#233;n el subgrupo de pacientes menores de 4 a&#241;os&#46; Se realiz&#243; un an&#225;lisis descriptivo de los porcentajes de medidas que difer&#237;an&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Incluy&#243; 98 ojos de 49 sujetos &#40;rango de edad&#58; 3&#8211;16 a&#241;os&#41;&#46; Los datos de SPH sin cicloplejia son pr&#225;cticamente id&#233;nticos&#44; mientras que con cicloplejia hay un sesgo hipermetr&#243;pico de &#43;0&#44;5 dioptr&#237;as medidas con Retinomax&#46; Los resultados de CYL son muy similares con y sin cicloplejia&#46; Existe una gran correlaci&#243;n de Pearson para ambos instrumentos &#40;&#62;0&#44;91&#41; y un bajo grado de dispersi&#243;n en los gr&#225;ficos de Bland-Altman bajo cicloplejia&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Los datos del Retinomax fueron consistentes con los obtenidos por el Topcon&#46; El Retinomax es un instrumento &#250;til para detectar errores de refracci&#243;n en ni&#241;os de entre 3 y 16 a&#241;os&#46;</p></span>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Bland-Altman plots for both instruments with and without cycloplegia&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">SPH&#8239;&#61;&#8239;sphere&#59; CYL&#8239;&#61;&#8239;cylinder&#59; SE&#8239;&#61;&#8239;spherical equivalent&#46; The X-axis shows the average measurement of the two instruments and the Y-axis shows the difference in measurements between the two instruments&#46;</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The mean&#8239;&#177;&#8239;SD shows a higher concordance in the measurements made under cycloplegia for all 3 parameters&#46;</p>"
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">With cycloplegia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Without cycloplegia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">With cycloplegia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Without cycloplegia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">With cycloplegia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Topcon &#40;Mean&#8239;&#177;&#8239;SD&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8722;0&#46;5&#8239;&#177;&#8239;2&#46;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;9&#8239;&#177;&#8239;2&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;1&#8239;&#177;&#8239;3&#46;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retinomax &#40;Mean&#8239;&#177;&#8239;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;0&#46;5&#8239;&#177;&#8239;2&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;0&#8239;&#177;&#8239;3&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;0&#46;8&#8239;&#177;&#8239;0&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;8&#8239;&#177;&#8239;0&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;9&#8239;&#177;&#8239;2&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;7&#8239;&#177;&#8239;3&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Student&#39;s <span class="elsevierStyleItalic">t</span> test <span class="elsevierStyleItalic">&#40;p&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;886&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;234&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;983&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;840&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;979&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;203&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab3255638.png"
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          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Mean&#44; standard deviation and Student&#39;s <span class="elsevierStyleItalic">t</span>-test between the two types of autorefractometers for cycloplegic and non-cycloplegic eyes&#46;</p>"
        ]
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          "leyenda" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">DP&#8239;&#61;&#8239;dioptre&#59; SPH&#8239;&#61;&#8239;sphere&#59; CYL&#8239;&#61;&#8239;cylinder&#59; CI&#8239;&#61;&#8239;confidence interval&#59; DOP&#8239;&#61;&#8239;dioptre&#59; SPH&#8239;&#61;&#8239;sphere&#59; CYL&#8239;&#61;&#8239;cylinder&#46;</p>"
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                  <table border="0" frame="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;870&#8211;0&#46;940&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;943&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;917&#8211;0&#46;962&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SE without cycloplegia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;913&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;872&#8211;0&#46;941&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HPS with cycloplegia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;995&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;993&#8211;0&#46;996&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CYL with cycloplegia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;942&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;915&#8211;0&#46;961&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SE with cycloplegia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;958&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;993&#8211;0&#46;997&nbsp;\t\t\t\t\t\t\n
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                  """
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          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Pearson correlation and 95&#37; CI between the two types of autorefractometers for cycloplegic and non-cycloplegic eyes&#46;</p>"
        ]
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          "leyenda" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">DP&#8239;&#61;&#8239;dioptre&#59; SPH&#8239;&#61;&#8239;sphere&#59; CYL&#8239;&#61;&#8239;cylinder&#59; SE&#8239;&#61;&#8239;spherical equivalent&#59; AX&#8239;&#61;&#8239;axis of the cylinder&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#62;0&#46;75 PD&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">32&#46;6&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CYL without cycloplegia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">87&#46;8&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SE without cycloplegia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#46;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#46;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">AX without cycloplegia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">16&#46;7&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HPS with cycloplegia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#46;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">38&#46;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#46;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">5&#46;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CYL with cycloplegia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">83&#46;7&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">12&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">1&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SE with cycloplegia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">22&#46;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">40&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">23&#46;5&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">AX with cycloplegia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">58&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">27&#46;3&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">14&#46;7&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;747&#8211;0&#46;941&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;143 &#43;&#47;&#8722; 1&#46;181&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SE without cycloplegia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">0&#46;018 &#43;&#47;&#8722; 0&#46;402&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">SE with cycloplegia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;958&nbsp;\t\t\t\t\t\t\n
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