在有症状的集合不足儿童中，负融合性聚散是异常的。

Negative Fusional Vergence Is Abnormal in Children with Symptomatic Convergence Insufficiency.

作者信息

Scheiman Mitchell M, Alvarez Tara L, Cotter Susan A, Kulp Marjean T, Sinnott Loraine T, Plaumann Maureen D, Jhajj Jasleen

机构信息

Pennsylvania College of Optometry at Salus University, Elkins Park, Pennsylvania.

Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey.

出版信息

Optom Vis Sci. 2021 Jan 1;98(1):32-40. doi: 10.1097/OPX.0000000000001626.

DOI:10.1097/OPX.0000000000001626

PMID:33394929

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7789288/

Abstract

SIGNIFICANCE

Deficits of disparity divergence found with objective eye movement recordings may not be apparent with standard clinical measures of negative fusional vergence (NFV) in children with symptomatic convergence insufficiency.

PURPOSE

This study aimed to determine whether NFV is normal in untreated children with symptomatic convergence insufficiency and whether NFV improves after vergence/accommodative therapy.

METHODS

This secondary analysis of NFV measures before and after office-based vergence/accommodative therapy reports changes in (1) objective eye movement recording responses to 4° disparity divergence step stimuli from 12 children with symptomatic convergence insufficiency compared with 10 children with normal binocular vision (NBV) and (2) clinical NFV measures in 580 children successfully treated in three Convergence Insufficiency Treatment Trial studies.

RESULTS

At baseline, the Convergence Insufficiency Treatment Trial cohort's mean NFV break (14.6 ± 4.8Δ) and recovery (10.6 ± 4.2Δ) values were significantly greater (P < .001) than normative values. The post-therapy mean improvements for blur, break, and recovery of 5.2, 7.2, and 1.3Δ, respectively, were statistically significant (P < .0001). Mean pre-therapy responses to 4° disparity divergence step stimuli were worse in the convergence insufficiency group compared with the NBV group for peak velocity (P < .001), time to peak velocity (P = .01), and response amplitude (P < .001). After therapy, the convergence insufficiency group showed statistically significant improvements in mean peak velocity (11.63°/s; 95% confidence interval [CI], 6.6 to 16.62°/s), time to peak velocity (-0.12 seconds; 95% CI, -0.19 to -0.05 seconds), and response amplitude (1.47°; 95% CI, 0.83 to 2.11°), with measures no longer statistically different from the NBV cohort (P > .05).

CONCLUSIONS

Despite clinical NFV measurements that seem greater than normal, children with symptomatic convergence insufficiency may have deficient NFV when measured with objective eye movement recordings. Both objective and clinical measures of NFV can be improved with vergence/accommodative therapy.

摘要

意义

对于有症状的集合不足儿童，通过客观眼动记录发现的视差发散缺陷在标准的负融合性聚散（NFV）临床测量中可能并不明显。

目的

本研究旨在确定未经治疗的有症状的集合不足儿童的NFV是否正常，以及在进行聚散/调节治疗后NFV是否改善。

方法

这项对基于门诊的聚散/调节治疗前后NFV测量的二次分析报告了以下变化：（1）与10名双眼视觉正常（NBV）的儿童相比，12名有症状的集合不足儿童对4°视差发散阶梯刺激的客观眼动记录反应；（2）在三项集合不足治疗试验研究中成功治疗的580名儿童的临床NFV测量。

结果

在基线时，集合不足治疗试验队列的平均NFV破裂（14.6±4.8Δ）和恢复（10.6±4.2Δ）值显著高于（P<.001）正常值。治疗后模糊、破裂和恢复的平均改善分别为5.2、7.2和1.3Δ，具有统计学意义（P<.0001）。与NBV组相比，集合不足组在治疗前对4°视差发散阶梯刺激的平均反应在峰值速度（P<.001）、达到峰值速度的时间（P=.01）和反应幅度（P<.001）方面更差。治疗后，集合不足组在平均峰值速度（11.63°/秒；95%置信区间[CI]，6.6至16.62°/秒）、达到峰值速度的时间（−-0.12秒；95%CI，−-0.19至−-0.05秒）和反应幅度（1.47°；95%CI，0.83至2.11°）方面有统计学意义的改善，测量值与NBV队列不再有统计学差异（P>.05）。