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Comparison of Techniques for Objective Measurement of Accommodative Amplitude

Parks, Sidney Marie
http://rave.ohiolink.edu/etdc/view?acc_num=osu171259920118906

Abstract Details

2024, Master of Science, Ohio State University, Vision Science.
Significance This study provides a faster method for objectively measuring accommodative amplitude with an open-field autorefractor and identifies the optimal stimulus locations for eliciting the maximum accommodative response. Purpose Objective measures of accommodative amplitude with an autorefractor take time due to the numerous stimulus demands tested. This study compares three protocols using different amounts and types of demands to shorten the process. This study also aims to determine the optimal accommodative demand or demands that are needed to identify maximum accommodative amplitude in the quickest and most efficient manner. Methods One hundred participants were recruited for four age bins (5-9, 10-14, 15-19, and 20-24 years) and monocular amplitude was measured with an autorefractor using three protocols: 13-demand proximal, 5-demand proximal-lens (letter), and 5-demand proximal-lens (picture). For proximal, measurements were taken as participants viewed a 0.9 mm “E” placed at 13 demands (40 cm to 3.3 cm = 2.5 to 30 D). The other protocols used a target (either the “E” or a detailed picture) placed at 33 and 12.5 cm followed by 12.5 cm with a series of lenses (-2 D, -4 D, and -5.5 D). Accommodative amplitude was defined as the greatest accommodative response measured with each technique. Repeated measures ANOVA was used to compare group mean amplitudes across protocols and one-way ANOVA was used to compare differences between the letter protocols by age bin. Measurements taken at single demands and groups of demands were also analyzed to determine the demand or combination of demands that correctly identified maximum accommodative amplitude. Results Amplitudes were significantly different between protocols (P<0.001) with the proximal having higher amplitudes (mean ± SD = 8.04 ± 1.70 D) than both proximal-lens protocols (letter: 7.48 ± 1.42 D, picture: 7.43 ± 1.42 D) by post-hoc Tukey analysis. Differences in amplitude between the proximal and proximal-lens (letter) protocol were different by age group (P=0.003), with the youngest group having larger differences (1.14 ± 1.58 D) than the oldest groups (0.17 ± 0.58 D and 0.29 ± 0.48 D respectively). Variations of demands were analyzed for each age bin to determine the dioptric positions that identified maximum accommodative amplitude. Using measurements taken at demand positions 10.5 and 12 D identified true accommodative amplitude for 80% of 5 to 9 year-olds, 95.8% of 10 to 14 year-olds, 96.2% of 15 to 19 year-olds, and 92% of 20 to 24 year-olds correctly, within 1.0 D of their true maximum. The largest difference from true maximum amplitude was approximately 2 D for 5 to 9 and 10 to 14 year-olds and 1.5 D for 15 to 19 and 20 to 24 year-olds. Conclusions The proximal-lens protocols took less time and identified maximum accommodative amplitude in participants age 15 – 24 years; however, they may under-estimate true amplitude in younger children. Utilization of dioptric positions 10.5 and 12 D alone may be a quicker alternative for measurement of accommodative amplitude with good accuracy, given the high percentage of true amplitudes identified with responses from these positions across all age groups.
Heather Anderson, O.D., PhD (Advisor)
Marjean Kulp, O.D., M.S. (Advisor)
Donald Mutti, O.D., PhD (Committee Member)
Ann Morrison, O.D., PhD (Committee Member)
Ophthalmology; Optics
accommodative amplitude; accommodation; clinical assessment; autorefractor; clinical measurement; clinical procedures; objective measurement of accommodative amplitude

Recommended Citations

Citations

  • Parks, S. M. (2024). Comparison of Techniques for Objective Measurement of Accommodative Amplitude [Master's thesis, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu171259920118906

    APA Style (7th edition)

  • Parks, Sidney. Comparison of Techniques for Objective Measurement of Accommodative Amplitude. 2024. Ohio State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu171259920118906.

    MLA Style (8th edition)

  • Parks, Sidney. "Comparison of Techniques for Objective Measurement of Accommodative Amplitude." Master's thesis, Ohio State University, 2024. http://rave.ohiolink.edu/etdc/view?acc_num=osu171259920118906

    Chicago Manual of Style (17th edition)

osu171259920118906
33
© 2024, all rights reserved.
This open access ETD is published by The Ohio State University and OhioLINK.