Official ESCRS | European Society of Cataract & Refractive Surgeons


Comparison of open-field autorefractor (Shin-Nippon NVision-K 5001), closed-field autorefractor (Topcon KR-800) and retinoscopy in refractive measurement of children and adolescents in Taiwan

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Session Details

Session Title: Moderated Poster Session: A Bouquet of Topics

Venue: Poster Village: Pod 2

First Author: : Y.Kuo TAIWAN

Co Author(s): :    C. Chiu                       

Abstract Details


To evaluate the accuracy and effectiveness of noncycloplegic and cycloplegic autorefraction using two types of autorefractors compared with subjective retinoscopy in children and adolescent.


This cross-sectional study was conducted from June 2017 to December 2017 and recruited elementary and high school students in East Taiwan. According to their age, the subjects were divided into younger (6 to 11 years old) and older (12 to 17 years old) groups.


The measurements were obtained before and after cycloplegia with the Shin-Nippon NVision-K 5001 and Topcon KR-800 autorefractor and after cycloplegia with retinoscopy. The results underwent vectorial transformation to produce the spherical equivalent (M) and two Jackson cross-cylinder (J0 and J45) values. The intraclass correlation (ICC) and Bland-Altman plot were used to evaluate the agreement between autorefractors and retinoscopy. One-way analysis of variance (ANOVA) and receiver operating characteristic (ROC) curve analysis were adopted to compare the performance of different autorefractors.


A total of 308 children and adolescents (157 male) were included in the study. Mean age was 10.65 ± 2.85 years. The measurement of two autorefractors, including with and without cylcoplegia, showed good reliability in evaluating M and J0(ICC=0.894~0.988), whereas Shin-Nippon NVision-K 5001 outperformed in evaluating J45(ICC=0.866). Among four conditions of measurement, the results from Shin-Nippon without cycloplegia were closest to retinoscopy. In ROC curve analysis, Shin-Nippon surpassed than Topcon in the refractive measurement. After stratification, the measurement of Shin-Nippon without cycloplegia had better Area under ROC curve (AUC) in detection of hyperopia among younger school children.


Although Both Topcon KR-800 and Shin-Nippon NVision-K 5001 showed great agreement with retinoscopy in the measurement of refractive error, the results from Shin-Nippon NVision-K 5001 without cycloplegia were most similar to those from retinoscopy, especially in the detection of hyperopia among younger students.

Financial Disclosure:

... is employed by a competing company

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