Menjivar Anne M, Kulp Marjean T, Mitchell G Lynn, Toole Andrew J, Reuter Kathleen
The Ohio State University College of Optometry, Columbus, Ohio, USA.
Clin Exp Optom. 2018 Jul;101(4):578-584. doi: 10.1111/cxo.12661. Epub 2018 Mar 13.
Convergence insufficiency (CI) is a common binocular vision disorder which often causes symptoms when doing near work. However, the best screening test for CI is unknown. The purpose of this study was to evaluate the ability of common tests of binocular and accommodative function to identify children with CI in a school screening setting.
Children aged nine to 14 were invited to participate. Positive fusional vergences, near point of convergence (NPC), accommodative amplitude, accommodative facility, Modified Thorington, and the Convergence Insufficiency Symptom Survey were evaluated.
Of the 282 children tested, approximately 20 per cent had 2-3 signs of CI. One half of 2-3 signs of CI and 66 per cent of three signs of CI subjects were symptomatic. Approximately 61 per cent of subjects with symptomatic 2-3 signs of CI had an accompanying low accommodative amplitude. The largest area under the receiver operating characteristic curve was obtained using NPC break measurements. NPC break ≥ 6 cm for CI and NPC break ≥ 7 cm for symptomatic CI were the cut points that maximised the sum of sensitivity and specificity.
NPC break performed best in identifying children with CI.
集合不足（CI）是一种常见的双眼视觉障碍，在进行近距工作时常常引发症状。然而，CI的最佳筛查测试尚不明确。本研究旨在评估在学校筛查环境中，双眼和调节功能的常见测试对识别患有CI的儿童的能力。
邀请9至14岁的儿童参与。评估了正融合性聚散、集合近点（NPC）、调节幅度、调节灵活度、改良托灵顿测试以及集合不足症状调查。
在接受测试的282名儿童中，约20%有2至3个CI体征。有2至3个CI体征的儿童中有一半以及有三个CI体征的儿童中有66%有症状。有症状的2至3个CI体征的受试者中约61%伴有低调节幅度。使用NPC破裂测量获得的受试者工作特征曲线下面积最大。CI的NPC破裂≥6厘米以及有症状CI的NPC破裂≥7厘米是使灵敏度和特异性之和最大化的切点。
NPC破裂在识别患有CI的儿童方面表现最佳。
