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Inicio Archivos de la Sociedad Española de Oftalmología (English Edition) Correlation and agreement between the Mohindra and cycloplegic retinoscopy techn...
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Vol. 97. Issue 1.
Pages 9-16 (January 2022)
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Vol. 97. Issue 1.
Pages 9-16 (January 2022)
Original article
Correlation and agreement between the Mohindra and cycloplegic retinoscopy techniques in children
Correlación y concordancia entre la técnica de retinoscopia de Mohindra y la retinoscopia con ciclopléjico en la infancia
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H. Morales Ruiza, D. Fernández-Agrafojoa, G. Cardonab,
Corresponding author
genis.cardona@upc.edu

Corresponding author.
a Centro INOF, Centro Médico Teknon, Barcelona, Spain
b Facultad de Óptica y Optometría de Terrassa, Barcelona, Spain
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Table 1. Refractive results (median, maximum and minimum) with Mohindra technique (MR), cycloplegic (CR) and autorefractometer (AR), and values of relative difference (Diff.) between each pair of techniques with Wilcoxon test results.
Abstract
Purpose

As an objective technique to assess refractive status, retinoscopy is particularly useful in children. The Mohindra technique (RM) is an alternative for those patients not good candidates for cycloplegic retinoscopy (RC). The aim of the present research was to compare both techniques and to determine the correlation and agreement of their measurements.

Material and methods

A total of 47 boys and girls of ages ranging from 3 to 11 years old were included in the study. Cycloplegic (cyclopentolate 1%) and Mohindra retinoscopy were conducted in both eyes, and refraction was also assessed with an autorefractometre (AR). The results from the three techniques were compared and a correction factor between RM and RC was calculated.

Results

Statistically significant differences were found between RM and RC (median of −0.42 D; p < 0.001) and between RM and AR (median of −0.42 D; p = 0.008), but not between RC and AR (median of 0.00 D; p = 0.758). A strong correlation was found between RM and RC (rho = 0.846; p < 0.001), although the Bland–Altman test revealed a larger difference between these techniques in patients with larger hyperopic refractive errors, with a correction factor of RC = 1.15 RM + 0.42.

Conclusions

The Mohindra technique may be considered a valid alternative to cycloplegic retinoscopy in patients of young age, with a good correlation between both techniques, albeit less agreement in patients with high hyperopic refractions.

Keywords:
Mohindra
Cycloplegia
Retinoscopy
Refraction
Paediatric optometry
Resumen
Objetivo

La retinoscopía, como técnica objetiva de evaluación del estado refractivo, es especialmente útil en la edad infantil. La técnica de Mohindra (RM) es una alternativa para aquellos pacientes en los que no es viable la retinoscopía mediante ciclopléjico (RC). En el presente estudio se pretende comparar ambas técnicas para determinar su correlación y concordancia.

Materiales y métodos

Se seleccionaron 47 niños y niñas con edades comprendidas entre los 3 y 11 años. Se determinó para ambos ojos la refracción con RM y RC (ciclopentolato 1%), así como con autorefractómetro (AR). Se compararon los resultados de las tres técnicas y se calculó el factor de corrección correspondiente para equiparar RM con RC.

Resultados

Se encontraron diferencias significativas entre RM y RC (mediana de −0,42 D; p < 0,001) y entre RM y AR (mediana de −0,42 D; p = 0,008), pero no entre RC y AR (mediana de 0,00 D; p = 0,758). La correlación entre RM y RC fue excelente (rho = 0,846; p < 0,001) pero el test de Bland–Altman evidenció una mayor discrepancia entre técnicas a medida que aumentaba la refracción hipermetrópica, con un factor de corrección de RC = 1,15 RM + 0,42.

Conclusiones

La técnica de Mohindra se puede considerar una alternativa válida a la retinoscopía mediante ciclopléjico en pacientes en edad escolar y preescolar, con una buena correlación entre ambas técnicas, pero menor concordancia en hipermetropías elevadas.

Palabras clave:
Mohindra
Ciclopléjico
Retinoscopia
Refracción
Optometría pediátrica

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