Abdi Saeid, Kangari Haleh, Rahmani Saeed, Akbarzadeh Baghban Alireza, Kamary Rad Zahra
Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Proteomics Research Center, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
BMC Ophthalmol. 2025 Jan 17;25(1):28. doi: 10.1186/s12886-025-03857-8.
The psychometric properties of the Convergence Insufficiency Symptom Survey (CISS) have been previously determined across the younger adult population. This study investigated the psychometric properties of the CISS in presbyopic adults via classical and Rasch analysis.
A total of 100 presbyopic individuals (40-60 years) were selected with far and near acuity of 20/20 with their habitual spectacles; 50 had convergence insufficiency and 50 had normal binocular vision. Refraction, cover test, near point of convergence, and positive fusional ranges were examined. The Persian translated CISS was administered twice, once in the first session and 7 to 14 days later. Classical and Rasch analyses were conducted.
The mean ages and gender ratios in the CI group and normal group were 49.70 ± 5.96 and 49.82 ± 5.64 years with a 50% female distribution among individuals. The mean CISS scores for presbyopes with CI and normal groups were 19.24 ± 5.33 and 13.26 ± 3.53 respectively (p < 0.001). Effective discrimination was achieved with a score greater than 15, yielding a sensitivity of 72%, a specificity of 69%, and an Area Under the Curve (AUC) of 0.813. For internal consistency, Cronbach's α coefficient was 0.82. For test-retest reliability in CISS scores, ICC was 0.91 (confidence interval 0.88-0.93) with the 95% limits of agreement in CI group being - 3.91 to 2.59. The Rasch analysis demonstrated a satisfactory model fit, as all items had infit and outfit mean square values ranging between 0.6 and 1.4. The measurement precision was good, with a person separation value of 2.30. Additionally, the first contrast eigenvalue of 2.34 and a raw variance of less than 50% indicated multidimensionality. The CI group reported headaches (item 3) more frequently than the normal binocular vision group did. However, eye discomfort scores (item 10) were similar for both groups.
The CISS is a valid and reliable tool for assessing the symptoms in presbyopic adults. However, due to this survey's multidimensionality, we recommend additional objective examinations in presbyopic adults with CI.
先前已确定集合不足症状调查（CISS）在年轻成人中的心理测量特性。本研究通过经典分析和Rasch分析调查了CISS在老花眼成人中的心理测量特性。
共选取100名年龄在40 - 60岁的老花眼个体，他们佩戴习惯眼镜时的远视力和近视力均为20/20；其中50人有集合不足，50人双眼视觉正常。检查了屈光、遮盖试验、集合近点和正融合范围。波斯语翻译版的CISS进行了两次施测，一次在第一次会话时，7至14天后再次施测。进行了经典分析和Rasch分析。
集合不足组和正常组的平均年龄和性别比例分别为49.70±5.96岁和49.82±5.64岁，两组中女性比例均为50%。集合不足的老花眼组和正常组的CISS平均得分分别为19.24±5.33和13.26±3.53（p < 0.001）。得分大于15时可实现有效区分，灵敏度为72%，特异度为69%，曲线下面积（AUC）为0.813。内部一致性方面，Cronbach's α系数为0.82。CISS得分的重测信度方面，组内相关系数（ICC）为0.91（置信区间0.88 - 0.93），集合不足组的95%一致性界限为 - 3.91至2.59。Rasch分析显示模型拟合良好，所有项目的内拟合和外拟合均方值在0.6至1.4之间。测量精度良好，个人分离值为2.30。此外，第一个对比特征值为2.34，原始方差小于50%，表明存在多维性。集合不足组比双眼视觉正常组更频繁地报告头痛（第3项）。然而，两组的眼部不适得分（第10项）相似。
CISS是评估老花眼成人症状的有效且可靠的工具。然而，由于该调查具有多维性，我们建议对有集合不足的老花眼成人进行额外的客观检查。
