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. Author manuscript; available in PMC: 2013 Apr 1.
Published in final edited form as: Arch Ophthalmol. 2011 Dec 12;130(4):470–479. doi: 10.1001/archophthalmol.2011.377

Table 7.

Comparison of Manual Refraction with Auto Refraction and Supplemental Manual Refraction Visual Acuity Letter Score by Subgroups (website)

MR-EVAsupl – MR-EVA AR-EVA – MR-EVA
N Difference* Absolute Difference** N Difference* Absolute Difference**
Median (5th, 95th
percentiles)		 P value Median (5th, 95th
percentiles)		 P value Median (5th, 95th
percentiles)		 P value Median (5th, 95th
percentiles)		 P value
VA Tester Masked 0.05 0.006 0.02 0.71
 Yes 35 0 (−7, +2) 1 (0, 7) 800 −2 (−19, +7) 3(0, 21)
 No 843 0 (−5, +7) 2 (0, 9) 78 −1 (−13, +8) 4 (0, 14)
Age 0.91 0.87 0.01 0.14
 <60 311 0 (−5, +7) 2 (0, 9) 311 −1 (−14, +7) 3 (0, 18)
 60−<70 337 0 (−4, +8) 2 (0, 8) 337 −1 (−19, +9) 4 (0, 23)
 ≥70 230 0 (−6, +6) 2 (0, 9) 230 −2 (−20, 5) 4 (0, 21)
Gender 0.55 0.05 0.35 0.50
 Women 380 0 (−5, +7) 2 (0, 8) 380 −1 (−17, +8) 3 (0, 20)
 Men 498 0 (−6, +7) 2 (0, 9) 498 −1 (−17, +7) 4 (0, 20)
Race/Ethnicity 0.75 0.33 0.58 0.99
 White 591 0 (−5, +6) 2 (0, 8) 591 −2 (−17, +7) 4 (0, 20)
 Non-White 287 0 (−6, +8) 2 (0, 10) 287 −1 (−16, +7) 3 (0, 22)
DME on clinical exam a 0.36 0.12 0.18 0.07
 None 163 0 (−6, +8) 2 (0, 9) 163 −2 (−20, +7) 4 (0, 22)
 Present, center
involvement none/uncertain		 178 0 (−5, +7) 2(0, 11) 178 −1 (−23, +8) 4 (0, 23)
 Present, center involved 529 +1 (−5, +7) 2 (0, 8) 529 −1 (−16, +7) 3 (0, 16)
Primary cause of vision
loss b 		0.53 0.36 0.31 0.47
 DME 544 +1 (−5, +7) 2 (0, 9) 544 −1 (−17, +8) 4 (0, 20)
 Other 146 +1 (−5, +9) 2 (0, 9) 146 0 (−20, +9) 4 (0, 22)
Pupil Size c 0.75 0.98 0.30 0.02
 1.0-3.0 397 0 (−6, +9) 2 (0, 10) 397 −2 (−23, +8) 4 (0, 24)
 3.5-6.0 415 0 (−5, +6) 2 (0, 7) 415 −1 (−11, +6) 3 (0, 12)
Lens status 0.59 0.55 0.35 0.54
 Phakic 585 0 (−5, +7) 2 (0, 9) 585 −1 (−16, +7) 3 (0, 19)
 Pseudophakic 293 0 (−6, +6) 2 (0, 8) 293 −2 (−21, +8) 4 (0, 21)
Severity of DME (based
on OCT CSF thicknessd) 		0.75 <.001 0.73 0.002
 <250 269 0 (−6, +8) 2 (0, 10) 269 −2 (−23, +8) 4 (0, 26)
 250-<400 446 0 (−5, +6) 2 (0, 8) 446 −2 (−15, +7) 3 (0, 16)
 400-<500 89 0 (−4, +6) 2 (0, 8) 89 −1 (−15, +6) 3 (0, 18)
 ≥500 52 +1 (−5, +6) 2 (0, 9) 52 −3 (−14, +5) 4 (0, 14)
Manual Refraction
Spherical Equivalent 		0.36 0.49 0.82 0.35
 < −3.00 64 +1 (−5, +6) 2 (0, 8) 64 −1 (−7, +9) 3 (0, 11)
 −3.00−<−1.00 133 0 (−4, +8) 2 (0, 9) 133 0 (−14, +7) 4 (0, 18)
 −1.00−<+1.00 467 0 (−5, +7) 2 (0, 8) 467 −1 (−16, +7) 3 (0, 20)
 +1.00-<+3.00 176 0 (−7, +8) 2 (0, 9) 176 -3 (−22, +6) 4 (0, 24)
 ≥ +3.00 38 +1 (−4, +5) 2 (0, 9) 38 -2 (−20, +5) 4 (0, 20)
*

MR EVAsupl minus MR EVA and AR- EVA minus MR- EVA, respectively.

**

Absolute Value of the Difference

a

Exclude 8 eyes (Cannot determine)

b

Exclude 188 eyes (no vision loss)

c

Missing for 66 eyes (pupil not done)

d

Missing for 22 eyes; categories based on thickness on Zeiss Stratus; categories for Topcon 3D-OCT are <275, 275-<425, 425-<525, ≥525; categories for Zeiss Cirrus or Heidelberg Spectralis are <310, 310-<460, 460-<560, ≥560.

MR-EVA= Manual refraction Electronic Diabetic Retinopathy Study Visual Acuity Test letter score; AR-EVA= Autorefraction Electronic Early Treatment Diabetic Retinopathy Study Visual Acuity Test letter score; MR-EVAsupl= Supplemental Manual refraction Electronic Early Treatment Diabetic Retinopathy Study Visual Acuity Test letter score; OCT= Optical Coherence Tomography; CSF= Central Subfied