儿童症状性集合不足治疗后视差性集合的客观评估
Objective Assessment of Disparity Vergence after Treatment of Symptomatic Convergence Insufficiency in Children.
作者信息
Scheiman Mitchell, Talasan Henry, Alvarez Tara L
出版信息
Optom Vis Sci. 2019 Jan;96(1):3-16. doi: 10.1097/OPX.0000000000001320.
SIGNIFICANCE
This first report of the use of objective measures of disparity vergence as outcome measures for symptomatic convergence insufficiency in children provides additional information that is not accessible with clinical tests. The study results also demonstrate that objective measures of vergence could be used in future randomized clinical trials of binocular vision disorders with children.
PURPOSE
This study was designed to evaluate changes in objective measures of disparity vergence after office-based vergence/accommodative therapy (OBVAT) for convergence insufficiency in children 12 to 17 years old.
METHODS
In this prospective trial, we recruited 10 participants with normal binocular vision and 12 with convergence insufficiency. All participants with convergence insufficiency were treated with 12 weeks of OBVAT. The primary outcome measure was average peak velocity for 4° symmetrical convergence steps. Other objective outcome measures of disparity vergence included time to peak velocity, latency, and accuracy. Changes in clinical measures (near point of convergence, positive fusional vergence at near) and symptoms were evaluated.
RESULTS
There was a statistically significant increase in peak velocity and more accurate response amplitude to 4° symmetrical convergence step stimuli after OBVAT compared with baseline measurements. Near point of convergence, positive fusional vergence, and symptoms also statistically significantly improved after OBVAT. Ten of the 12 participants met clinical success criteria.
CONCLUSIONS
In this prospective study on the treatment of symptomatic convergence insufficiency in children in which both clinical and objective eye movement measurements were used to evaluate the results of treatment, significant changes were found in symptoms and both clinical and objective measures of disparity vergence after completion of OBVAT in children with symptomatic convergence insufficiency.
意义
这是首次将视差性聚散的客观测量指标用作儿童症状性集合不足的疗效指标的报告，提供了临床检查无法获取的额外信息。研究结果还表明，聚散的客观测量指标可用于未来针对儿童双眼视觉障碍的随机临床试验。
目的
本研究旨在评估针对12至17岁儿童的集合不足进行门诊聚散/调节治疗（OBVAT）后，视差性聚散客观测量指标的变化。
方法
在这项前瞻性试验中，我们招募了10名双眼视觉正常的参与者和12名集合不足的参与者。所有集合不足的参与者均接受了为期12周的OBVAT治疗。主要疗效指标是4°对称集合步骤的平均峰值速度。视差性聚散的其他客观疗效指标包括达到峰值速度的时间、潜伏期和准确性。评估了临床指标（集合近点、近距离正融像性聚散）和症状的变化。
结果
与基线测量相比，OBVAT后4°对称集合步骤刺激的峰值速度有统计学意义的增加，且反应幅度更准确。OBVAT后集合近点、正融像性聚散和症状也有统计学意义的显著改善。12名参与者中有10名达到了临床成功标准。
结论
在这项针对儿童症状性集合不足治疗的前瞻性研究中，同时使用临床和客观眼动测量来评估治疗结果，发现症状性集合不足的儿童在完成OBVAT后，症状以及视差性聚散的临床和客观测量指标均有显著变化。
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