Hoseini-Yazdi Seyed Hosein, Yekta AbbasAli, Nouri Hosein, Heravian Javad, Ostadimoghaddam Hadi, Khabazkhoob Mehdi
Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology , Brisbane , Australia .
Strabismus. 2015;23(1):22-9. doi: 10.3109/09273972.2014.1002622. Epub 2015 Mar 19.
To investigate the frequency of convergence and accommodation anomalies in an optometric clinical setting in Mashhad, Iran, and to determine tests with highest accuracy in diagnosing these anomalies.
From 261 patients who came to the optometric clinics of Mashhad University of Medical Sciences during a month, 83 of them were included in the study based on the inclusion criteria. Near point of convergence (NPC), near and distance heterophoria, monocular and binocular accommodative facility (MAF and BAF, respectively), lag of accommodation, positive and negative fusional vergences (PFV and NFV, respectively), AC/A ratio, relative accommodation, and amplitude of accommodation (AA) were measured to diagnose the convergence and accommodation anomalies. The results were also compared between symptomatic and asymptomatic patients. The accuracy of these tests was explored using sensitivity (S), specificity (Sp), and positive and negative likelihood ratios (LR+, LR-).
Mean age of the patients was 21.3 ± 3.5 years and 14.5% of them had specific binocular and accommodative symptoms. Convergence and accommodative anomalies were found in 19.3% of the patients; accommodative excess (4.8%) and convergence insufficiency (3.6%) were the most common accommodative and convergence disorders, respectively. Symptomatic patients showed lower values for BAF (p = .003), MAF (p = .001), as well as AA (p = .001) compared with asymptomatic patients. Moreover, BAF (S = 75%, Sp = 62%) and MAF (S = 62%, Sp = 89%) were the most accurate tests for detecting accommodative and convergence disorders in terms of both sensitivity and specificity.
Convergence and accommodative anomalies are the most common binocular disorders in optometric patients. Including tests of monocular and binocular accommodative facility in routine eye examinations as accurate tests to diagnose these anomalies requires further investigation.
调查伊朗马什哈德验光临床环境中集合和调节异常的发生率，并确定诊断这些异常最准确的测试方法。
在一个月内到马什哈德医科大学验光诊所就诊的261例患者中，根据纳入标准，其中83例被纳入研究。测量集合近点（NPC）、近距和远距隐斜、单眼和双眼调节灵活度（分别为MAF和BAF）、调节滞后、正融合性聚散和负融合性聚散（分别为PFV和NFV）、AC/A比率、相对调节和调节幅度（AA），以诊断集合和调节异常。还对有症状和无症状患者的结果进行了比较。使用敏感度（S）、特异度（Sp）、阳性似然比和阴性似然比（LR+、LR-）来探究这些测试的准确性。
患者的平均年龄为21.3±3.5岁，其中14.5%有特定的双眼和调节症状。19.3%的患者存在集合和调节异常；调节过度（4.8%）和集合不足（3.6%）分别是最常见的调节和集合障碍。与无症状患者相比，有症状患者的BAF（p = 0.003）、MAF（p = 0.001）以及AA（p = 0.001）值较低。此外，就敏感度和特异度而言，BAF（S = 75%，Sp = 62%）和MAF（S = 62%，Sp = 89%）是检测调节和集合障碍最准确的测试方法。
集合和调节异常是验光患者中最常见的双眼疾病。在常规眼科检查中纳入单眼和双眼调节灵活度测试作为诊断这些异常的准确测试方法，这需要进一步研究。
