Screening of changes in refractometry after stroke: a retrospective cohort study case control.

Ms Marion DELORMEa, Dr Jérôme FROGERa, Dr Charles BENAIMb, Prof Arnaud DUPEYRONc

a Unité de rééducation et réadaptation neurologique et locomotrice Hôpital universitaire de rééducation et de réadaptation, b CHU Dijon, c CHU Nîmes

Objective:To compare prevalence of refractometry disorders in post-stroke patients compared to case control in hospital, using the refractometer plusoptiX®.

Material / Patients and Methods:The measurement was made using a refractometer plusoptiX®: binocular measurement a meter away in the dark with usual patient pre-existing correction. The same examiner performed 3 measurements at 2 different times to study reproducibility. 28 patients (mean age 59.6 years) who experienced an ischemic or haemorrhagic stroke than 3 months were included, and 28 controls without neurological history, matched on age and sex.

Results: 24 patients had an ischemic stroke (82.7%) and 4 patients haemorrhagic stroke. Wearing optical correction did not differ significantly.The refractometer intrajuge reproducibility was good, 0.84 average correlation coefficient for measures 2 different days.The ideal refractometry with correction is zero, and reduced in absolute value was on the right average 1,46 (DS 1,28) for patients versus 0,95 (DS 0,63) for case control ( p = 0,79 ) and on the left 1,28 DS (0,95) versus 0,86 DS (0,77) (p= 0,48). In contrast, in the 18 patients with refractometry > 1.5 to baseline, only 18% of neurological patients complained of visual impairment against 50% of controls.

Discussion:There are few available data on refractometry disorders prevalence after stroke, some authors report around 20 to 25%2 . Despite non-significant results, and because of the important refractometer disorders in stroke patients, expressing few visual impairment, this study suggests the interest of a refractometer plusoptiX® testing to improve their rehabilitation and quality of life1.

Références :

(1). Jones SA, Shinton RA. Improving outcome in stroke patients with visual problems. Age Ageing. 2006 Nov 1; 35(6):560-5.

(2). Rowe F, Brand D, Jackson CA, Price A, Walker L, Harrison S, et al. Visual impairment following stroke: do stroke patients require vision assessment? Age Ageing. 2009 Mar 1; 38(2):188-93

Keywords : refractometry: refractometer; stroke; visual impairment ; rehabilitation