CAN RETROILLUMINATION DATA OBTAINED WITH AN AUTOREFRACTOMETER BE USED IN CATARACT DIAGNOSIS? RELIABILITY-AND-REPEATABILITY-ANALYSIS

The aim of this study is to evaluate retroillumination measurements obtained using an autorefractometer (Tonoref III) in patients diagnosed with cataract.

Department of Ophthalmology, Serdivan State Hospital, Sakarya,Türkiye

The results of patients diagnosed with cataracts whose retroillumination data were obtained through two consecutive measurements with an autorefractometer were retrospectively analyzed. COI-H (representing the vertical extent of opacity in a 3-mm central area); COI-A (representing the percentage of opacity in a 3-mm central area); and POI (reflecting the percentage of peripheral opacities) were obtained. The Bland-Altman method and intraclass correlation coefficients (ICCs) were used to assess the repeatability and reliability of Tonoref III measurements.

The study evaluated 146 eyes of 88 patients, 41 females and 47 males. The mean age of the patients was 66.85 ± 7.36. A moderate to strong negative correlation was found between best-corrected visual acuity and retroillumination data (p < 0.001). The mean differences in COI-A, COI-H, and POI between two sessions of TONOREF III measurements were -0.79 (95% CI: -8.47 to +6.89), -0.02 (95% CI: -0.53 to +0.48), and -0.61 (95% CI: -9.55 to +8.32), respectively. The mean difference and 95% limits of agreement were small, and there was no trend for the difference to increase with mean COI-A, COI-H, and POI values (p = .29, p = .88, p = .79, respectively). The ICC for the measurements of retroillumination data using the TONOREF III was greater than 0.97. 

The repeatability of objective retroillumination measurements using the Tonoref III was good. Instrument reliability was excellent. Cataract diagnosis using the Tonoref III in clinical practice is feasible.