Serna Angela, Rogers David L, McGregor Mary Lou, Golden Richard P, Bremer Don L, Rogers Gary L
Nationwide Children's Hospital, Department of Ophthalmology, Columbus, Ohio, USA.
J AAPOS. 2011 Apr;15(2):140-3. doi: 10.1016/j.jaapos.2010.11.023. Epub 2011 Mar 31.
To determine the efficacy of a home-based computer orthoptic program to treat symptomatic convergence insufficiency.
A retrospective review of consecutive patients with symptomatic convergence insufficiency treated with a home-based computer orthoptic program was performed. Symptomatic convergence insufficiency was defined as: near point of convergence (NPC) >6 cm, decreased positive fusional vergence, exophoria at near at least 4(Δ) greater than at far, and documented complaints of asthenopia, diplopia, or headaches with reading or near work. The Computer Orthoptics CVS program was used for this study. Before beginning the computer orthoptic program, patients with an NPC >50 cm were given 4 base-in prisms and push-up exercises (NPC exercises with an accommodative target) for 2 weeks.
A total of 42 patients were included. Mean treatment duration was 12.6 weeks; mean follow-up, 8.5 months. Of the 42 patients, 35 were treated with the home-based computer orthoptic program and push-up exercises; the remaining 7 only used the computer orthoptic program. Because of a remote NPC, 5 patients were given base-in Fresnel prism before starting treatment. Baseline mean NPC was 24.2 cm; posttreatment mean NPC improved to 5.6 cm: 39 patients (92.8%) achieved an NPC of ≤6 cm (p < 0.001). Positive fusional vergence improved in 39 patients (92.8%). Fourteen patients reduced their near exophoria by ≥5(Δ). A total of 27 patients (64.2%) reported resolution of symptoms after treatment.
In our study, home-based computer orthoptic exercises reduced symptoms and improved NPC and fusional amplitudes. The computer orthoptic program is an effective option for treating symptomatic convergence insufficiency.
确定基于家庭的电脑视轴矫正训练方案治疗症状性集合不足的疗效。
对采用基于家庭的电脑视轴矫正训练方案治疗的症状性集合不足连续患者进行回顾性研究。症状性集合不足定义为：集合近点（NPC）>6 cm，正融合性聚散力下降，近距外隐斜至少比远距时大4（Δ），且有阅读或近距离工作时眼疲劳、复视或头痛的记录性主诉。本研究使用电脑视轴矫正CVS程序。在开始电脑视轴矫正训练方案前，NPC>50 cm的患者给予4棱镜底向内及推近训练（使用调节目标的NPC训练）2周。
共纳入42例患者。平均治疗时间为12.6周；平均随访8.5个月。42例患者中，35例接受了基于家庭的电脑视轴矫正训练方案及推近训练；其余7例仅使用电脑视轴矫正训练方案。因集合近点远，5例患者在开始治疗前给予了菲涅尔棱镜底向内。基线时平均NPC为24.2 cm；治疗后平均NPC改善至5.6 cm：39例患者（92.8%）达到NPC≤6 cm（p<0.001）。39例患者（92.8%）正融合性聚散力得到改善。14例患者近距外隐斜减少≥5（Δ）。共有27例患者（64.2%）报告治疗后症状消失。
在我们的研究中，基于家庭的电脑视轴矫正训练减轻了症状，改善了NPC及融合幅度。电脑视轴矫正训练方案是治疗症状性集合不足的有效选择。
