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The role of clinical diagnosis criteria on the frequency of accommodative insufficiency

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García Montero, María and Antona Peñalba, Beatriz and Barrio de Santos, Ana Rosa and Nieto Zayas, Carmen and Martínez Alberquilla, Irene and Hernández Verdejo, José Luis (2019) The role of clinical diagnosis criteria on the frequency of accommodative insufficiency. International journal of ophthalmology, 12 (4). pp. 647-653. ISSN 2222-3959

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Official URL: https://dx.doi.org/10.18240%2Fijo.2019.04.20




Abstract

AIM: To estimate and compare the frequency of accommodative insufficiency (AI) within the same clinical population sample depending on the type of clinical criteria used for diagnosis. Comparing the frequency within the same population would help to minimize bias due to sampling or methodological variability.
METHODS: Retrospective study of 205 medical records of symptomatic subjects free of any organic cause and symptoms persisting despite optical compensation evaluated. Based on the most commonly clinical diagnostics criteria found in the literature, four diagnostics criteria were established for AI (I, II, III and IV) based on subjective accommodative tests: monocular accommodative amplitude two or more diopters below Hofstetter’s minimum value [15-(0.25×age)] (I, II, III, IV); failing monocular accommodative facility with minus lens, establishing the cut-off in 0 cycles per minute (cpm) (I) and in 6 cpm (II, III); failing binocular accommodative facility with minus lens, establishing the cut-off in 0 cpm (I) and in 3 cpm (II).
RESULTS: The proportion of AI (95%CI) for criteria I, II, III and IV were 1.95% (0.04%-3.86%), 2.93% (0.31%-4.57%), 6.34% (1.90%-7.85%) and 41.95% (35.14%-48.76%) respectively, with a statistically significant difference shown between these values (χ2=226.7, P<0.001). A pairwise multiple comparison revealed that the proportion of AI detected for criterion IV was significantly greater than the proportion for the rest of the criteria (P-adjusted<0.05 in all cases).
CONCLUSION: The prevalence of cases of AI within the same clinical population varies with the clinical diagnostic criteria selected. The variation is statistically significant when considering the monocular accommodative amplitude as the only clinical diagnostic sign.


Item Type:Article
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Received:April 04, 2018 Revised:October 11, 2018

Uncontrolled Keywords:Epidemiology; Amplitude of accommodation; Accommodative facility
Subjects:Medical sciences > Optics > Optometry
ID Code:55523
Deposited On:04 Jun 2019 07:32
Last Modified:04 Jun 2019 07:32

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