The Ohio State University College of Optometry, Columbus, Ohio, USA.
Southern California College of Optometry at Marshall B. Ketchum University, Fullerton, California, USA.
Ophthalmic Physiol Opt. 2024 Nov;44(7):1346-1353. doi: 10.1111/opo.13378. Epub 2024 Aug 14.
To assess the long-term stability of clinical measures of convergence (near point of convergence [NPC] and positive fusional vergence [PFV]) in participants enrolled in the Convergence Insufficiency Treatment Trial-Attention and Reading Trial (CITT-ART) who received 16 weeks of office-based vergence/accommodative therapy.
A total of 310 children, 9-14 years old, with symptomatic convergence insufficiency were enrolled in CITT-ART. Some 270 completed both their 16-week primary outcome visit followed by a 1-year follow-up visit. Of those 270, 181 (67%) were randomised to the vergence/accommodative therapy. Of the 181 in the vergence/accommodative group, 121 (67%) reported not receiving any additional treatment after the 16-week primary outcome visit. The mean change in NPC, PFV and percentages of children classified by the predetermined success criteria of convergence (normal NPC [<6 cm] and/or improved by ≥4 cm; normal PFV [passing Sheard's criterion and base-out break >15Δ] and/or improved by ≥10Δ) were compared at the 16-week primary outcome visit and 1 year later.
Of the 121 who returned for their 1-year follow-up visit, there was no significant change in mean adjusted NPC (reduction of -0.2 cm; 95% CI: -1.0 to 0.5 cm) at 1 year. There was a statistically significant decrease in mean-adjusted PFV (-4.7∆; 95% CI: -6.5 to -2.8Δ) at 1 year. There were similar percentages of participants classified as 'normal' (p = 0.30), 'normal and/or improved' (p > 0.50) and 'normal and improved' (p > 0.14) based on NPC and PFV at the 1-year visit compared with the 16-week primary outcome visit.
The improvements in NPC and PFV following 16 weeks of vergence/accommodative therapy (with no reported additional treatment thereafter) in children with symptomatic convergence insufficiency persisted 1-year post-treatment.
评估参加会聚不足治疗试验-注意力和阅读试验（CITT-ART）的参与者中接受 16 周基于办公室的会聚/调节治疗后的临床会聚（近点会聚[NPC]和正融合性会聚[PFV]）测量的长期稳定性。
共有 310 名 9-14 岁有症状性会聚不足的儿童参加了 CITT-ART。其中 270 人完成了 16 周的主要结局访问，随后进行了 1 年的随访。在这 270 人中，有 181 人（67%）随机接受了会聚/调节治疗。在会聚/调节组的 181 人中，有 121 人（67%）在 16 周的主要结局访问后没有接受任何额外的治疗。在 16 周的主要结局访问和 1 年后，比较 NPC、PFV 的平均变化以及根据预定的成功标准分类的儿童百分比（正常 NPC [<6cm] 和/或改善≥4cm；正常 PFV [通过 Sheard 标准和基底外分离>15Δ]和/或改善≥10Δ）。
在返回进行 1 年随访的 121 人中，1 年后 NPC 的平均调整值（减少 0.2cm；95%CI：-1.0 至 0.5cm）无显著变化。1 年后 PFV 的平均调整值显著下降（-4.7∆；95%CI：-6.5 至-2.8∆）。与 16 周的主要结局访问相比，根据 NPC 和 PFV，1 年后有类似百分比的参与者被归类为“正常”（p=0.30）、“正常和/或改善”（p>0.50）和“正常和改善”（p>0.14）。
在儿童有症状性会聚不足的情况下，接受 16 周的会聚/调节治疗（此后没有报告额外的治疗）后，NPC 和 PFV 的改善在治疗后 1 年仍持续存在。
