A Comparison of Optical Biometers Used in Children for Myopia Control

Abstract

Purpose To assess the reproducibility (i.e., inter-device reliability) of the biometers Topcon MYAH, Oculus Myopia Master, and Haag-Streit Lenstar LS900 with the Carl Zeiss IOLMaster 700 and the intra-subject repeatability in myopic children in order to reliably detect axial growth for myopia management.

Methods Twenty-two myopic children (11.1 ± 2.4 yr) with a spherical equivalent of − 3.53 ± 2.35 D were examined with each of the biometers to assess axial length (AL) and corneal parameters (steepK, flatK, meanK, vectors J0, J45), and16 of these children agreed to a second round of measurements. Reproducibility of the first measurements between the IOLMaster and every other biometer was assessed employing a Bland-Altman approach and paired Studentʼs t-test. Repeatability was assessed as intra-subject standard deviation and was used to estimate the minimum time interval required between two AL measurements to reliably detect axial growth of an eye of at least 0.1 mm/year.

Results Repeatability for AL measurements was as follows: IOLMaster: 0.05 mm, Myopia Master: 0.06 mm, Myah: 0.06 mm, Lenstar: 0.04 mm; the respective minimal time interval for axial growth assessment in myopia management was estimated as 5.6, 6.6, 6.7, and 5.0 months, respectively. Best reproducibility of the AL measurement was found between IOLMaster and Lenstar [95% Limits of Agreement (LoA) for reproducibility − 0.06 to 0.02]. As regards to the measured means, Lenstar gave measures of AL that were longer than with the IOLMaster by 0.02 mm (p < 0.001). Myopia Master measures of meanK were significantly lower (by 0.21 D with p < 0.001) than the values from the IOLMaster. As for J0, all biometers deviated significantly from IOLMaster measurements (p < 0.05).

Conclusion Generally good agreement was observed between all the biometers. When assessing myopia progression in children, a time frame of at least 6 months between the AL measurements is advisable in order to reliably determine any deviation from a normal growth pattern.

Zusammenfassung

Ziel der Arbeit Beurteilung der Reproduzierbarkeit (Zuverlässigkeit zwischen den Geräten) der Biometer Topcon MYAH, Oculus Myopia Master und Haag-Streit Lenstar LS900 mit dem Carl Zeiss IOLMaster 700 und der Wiederholbarkeit der Messergebnisse innerhalb einer Testperson, um zuverlässig ein Augenlängenwachstum im Myopiemanagement zu erkennen.

Methodik 22 kurzsichtige Kinder (11,1 ± 2,4 Jahre) mit einem sphärischen Äquivalent von − 3,53 ± 2,35 dpt wurden mit den verschiedenen Biometern untersucht, um die Achslänge und die Hornhautparameter (steepK, flatK, meanK, Vektoren J0, J45) zu bestimmen. 16 dieser Kinder stimmten einer 2. Messung an den Geräten zu. Die Reproduzierbarkeit der ersten Messungen zwischen dem IOLMaster und jedem anderen Biometer wurde mittels Bland-Altman-Analyse und gepaarten t-Tests bewertet. Die Wiederholbarkeit wurde als Standardabweichung innerhalb einer Testperson bestimmt, damit das minimale Zeitintervall errechnet werden kann, welches zwischen 2 Achslängenmessungen liegen sollte, um ein Augenlängenwachstum von mindestens 0,1 mm/Jahr zu erkennen.

Ergebnisse Die Wiederholbarkeit der Achslängenmessungen beträgt: IOLMaster: 0,05 mm, Myopia Master: 0,06 mm, Myah: 0,06 mm, Lenstar: 0,04 mm; das jeweilige minimale Zeitintervall für die Beurteilung eines Augenlängenwachstums von 0,1 mm/Jahr im Myopiemanagement bei Kindern wurde auf 5,6, 6,6, 6,7 bzw. 5,0 Monate geschätzt. Die beste Reproduzierbarkeit der Achslängenmessung zeigte sich zwischen IOLMaster und Lenstar [95% Übereinstimmungsbereich bei − 0,06 bis 0,02 mm]. Im Mittel misst der Lenstar eine um 0,02 mm länger Achslänge (p < 0,001) und der Myopia Master eine um 0,21 dpt geringere Hornhautbrechkraft (p < 0,001) als der IOLMaster. Für J0 wichen alle Biometer signifikant von den IOLMaster-Messungen ab (p < 0.05).

Schlussfolgerung Es wurde eine gute Übereinstimmung zwischen den Biometern festgestellt. Bei der Beurteilung der Myopieprogression bei Kindern ist ein Zeitraum von mindestens 6 Monaten zwischen den Achslängenmessungen ratsam, um eine Abweichung von einem physiologischen Augenlängenwachstum sicher erkennen zu können.

Conclusion Box

Already known:

• Myopia onset and progression can be described as a deviation from a normal eye growth pattern.

• It is recommended to use the same biometer in follow-up visits when monitoring AL growth in children.

Newly described:

• The intra-subject repeatability of AL measurements in children is comparable to the repeatability in adults.

• In myopia control management, childrenʼs individual axial eye growth should be monitored in a time interval not shorter than 6 months.

Key words

myopia - axial length - children - biometry - refractive error - progressive myopia

Schlüsselwörter

Myopie - Achslänge - Kinder - Biometrie - Refraktionsfehler - fortschreitende Myopie

Publikationsverlauf

Eingereicht: 24. März 2023

Angenommen: 20. Juni 2023

Accepted Manuscript online:
26. Juni 2023

Artikel online veröffentlicht:
29. August 2023

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