Pennsylvania College of Optometry at Salus University, Philadelphia, Pennsylvania 19141, USA.
Optom Vis Sci. 2009 Sep;86(9):1096-103. doi: 10.1097/OPX.0b013e3181b6210f.
To assess the long-term stability of improvements in symptoms and signs in 9- to 17-year-old children enrolled in the Convergence Insufficiency Treatment Trial who were asymptomatic after treatment for convergence insufficiency.
Seventy-nine patients who were asymptomatic after a 12-week therapy program for convergence insufficiency were followed for 1 year [33/60 in office-based vergence/accommodative therapy (OBVAT), 18/54 in home-based pencil push-ups (HBPP), 12/57 in home-based computer vergence/accommodative therapy and pencil push-ups (HBCVAT+), and 16/54 in office-based placebo therapy (OBPT)]. Symptoms and clinical signs were measured 6 months and 1 year after completion of the 12-week therapy program. The primary outcome measure was the mean change on the Convergence Insufficiency Symptom Survey (CISS). Secondary outcome measures were near point of convergence, positive fusional vergence at near, and proportions of patients who remained asymptomatic or who were classified as successful or improved based on a composite measure of CISS, near point of convergence, and positive fusional vergence.
One-year follow-up visit completion rate was 89% with no significant differences between groups (p = 0.26). There were no significant changes in the CISS in any treatment group during the 1-year follow-up. The percentage who remained asymptomatic in each group was 84.4% (27/32) for OBVAT, 66.7% (10/15) for HBPP, 80% (8/10) for HBCVAT+, and 76.9% (10/13) for OBPT. The percentage who remained either successful or improved 1-year posttreatment was 87.5% (28/32) for OBVAT, 66.6% (10/15) for HBPP, 80% (8/10) for HBCVAT+, and 69.3% (9/13) for OBPT.
Most children aged 9 to 17 years who were asymptomatic after a 12-week treatment program of OBVAT for convergence insufficiency maintained their improvements in symptoms and signs for at least 1 year after discontinuing treatment. Although the sample sizes for the home-based and placebo groups were small, our data suggest that a similar outcome can be expected for children who were asymptomatic after treatment with HBPP or HBCVAT+.
评估参加集合不足治疗试验的9至17岁儿童在集合不足治疗后无症状的情况下，症状和体征改善的长期稳定性。
79例在为期12周的集合不足治疗方案后无症状的患者接受了1年的随访[33例/60例接受基于办公室的聚散/调节治疗（OBVAT），18例/54例接受基于家庭的铅笔俯卧撑训练（HBPP），12例/57例接受基于家庭的计算机聚散/调节治疗和铅笔俯卧撑训练（HBCVAT+），16例/54例接受基于办公室的安慰剂治疗（OBPT）]。在12周治疗方案结束后的6个月和1年测量症状和临床体征。主要结局指标是集合不足症状调查（CISS）的平均变化。次要结局指标是集合近点、近距正融合性聚散，以及根据CISS、集合近点和正融合性聚散的综合测量仍无症状或被分类为成功或改善的患者比例。
1年随访完成率为89%，各组之间无显著差异（p = 0.26）。在1年随访期间，任何治疗组的CISS均无显著变化。OBVAT组中仍无症状的百分比为84.4%（27/32），HBPP组为66.7%（10/15），HBCVAT+组为80%（8/10），OBPT组为7,6.9%（10/13）。治疗后1年仍保持成功或改善的百分比为OBVAT组87.5%（28/32），HBPP组66.6%（10/15），HBCVAT+组80%（8/10），OBPT组69.3%（9/13）。
大多数9至17岁儿童在接受为期12周的OBVAT集合不足治疗方案后无症状，在停止治疗后至少1年保持症状和体征的改善。尽管基于家庭和安慰剂组的样本量较小，但我们的数据表明，接受HBPP或HBCVAT+治疗后无症状的儿童可能会有类似的结果。
