Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey.
Pennsylvania College of Optometry, Salus University, Philadelphia, Pennsylvania.
Optom Vis Sci. 2020 Dec;97(12):1061-1069. doi: 10.1097/OPX.0000000000001606.
These data confirm the effectiveness of office-based vergence/accommodative therapy for improving the near point of convergence and positive fusional vergence in young adults with symptomatic convergence insufficiency within a double-masked longitudinal randomized clinical trial.
This study aimed to report changes in clinical signs and symptoms of convergence insufficiency from a randomized clinical trial evaluating the effectiveness of office-based vergence/accommodative therapy for young adults with symptomatic convergence insufficiency.
In this double-masked, randomized clinical trial, convergence insufficiency patients (n = 50; average age, 21 ± 3 years; range, 18 to 32 years) were randomized to either office-based vergence/accommodative therapy or office-based placebo therapy. Improvements in (1) near point of convergence, (2) positive fusional vergence, and (3) self-reported symptoms (Convergence Insufficiency Symptom Survey [CISS] score) were evaluated after twelve 1-hour sessions of treatment within the office comparing the results from the vergence/accommodative therapy and the placebo therapy groups.
The mean near point of convergence improved by 6.0 and 3.1 cm in the vergence/accommodative and placebo therapy groups, respectively (mean difference of -2.9 cm; 95% confidence interval [CI], -4.6 to -1.0 cm; P < .01). The mean positive fusional vergence increased by 17.3 and 7.4Δ in the vergence/accommodative and placebo therapy groups, respectively (mean difference of 9.9Δ; 95% CI, 4.9 to 16.0Δ; P < .001). The mean CISS score improved by 12.4 and 10.1 points in the vergence/accommodative and placebo therapy groups, respectively (mean difference of 2.3 points; 95% CI, -8.3 to +4.6 points; P = .56).
Our results demonstrate that office-based vergence/accommodative therapy is effective for improving the near point of convergence and positive fusional vergence in young adults with symptomatic convergence insufficiency. However, given that both treatment groups had a similar reduction in self-reported symptoms, we recommend that the CISS be revised if it is to be used as an outcome measure in future studies of convergence insufficiency.
这些数据证实了基于办公室的聚散和调节治疗在年轻成年人有症状的集合不足中的有效性，可改善近点的收敛和积极融合收敛在一个双盲纵向随机临床试验。
本研究旨在报告从评价基于办公室的聚散和调节治疗对年轻成年人有症状的集合不足的有效性的随机临床试验中，集合不足的临床体征和症状的变化。
在这项双盲、随机临床试验中，集合不足的患者（n = 50；平均年龄 21 ± 3 岁；范围 18 至 32 岁）被随机分配到基于办公室的聚散和调节治疗或基于办公室的安慰剂治疗。在办公室内进行十二次 1 小时的治疗后，评估（1）近点的收敛，（2）积极融合收敛，（3）自我报告的症状（集合不足症状调查[CISS]评分），比较聚散和调节治疗组和安慰剂治疗组的结果。
在聚散和调节治疗组和安慰剂治疗组中，平均近点的收敛分别改善了 6.0 和 3.1cm（平均差异-2.9cm；95%置信区间[CI]，-4.6 至-1.0cm；P <.01）。在聚散和调节治疗组和安慰剂治疗组中，平均积极融合收敛分别增加了 17.3 和 7.4Δ（平均差异 9.9Δ；95%置信区间，4.9 至 16.0Δ；P <.001）。在聚散和调节治疗组和安慰剂治疗组中，平均 CISS 评分分别改善了 12.4 和 10.1 分（平均差异 2.3 分；95%置信区间，-8.3 至+4.6 分；P =.56）。
我们的结果表明，基于办公室的聚散和调节治疗对改善年轻成年人有症状的集合不足的近点收敛和积极融合收敛是有效的。然而，鉴于两组治疗的自我报告症状都有类似的减轻，我们建议，如果 CISS 要在未来的集合不足研究中作为一种结果衡量标准，那么就需要对其进行修订。
