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Abstract：
OBJECTIVE: To report the change in the magnitude of near exodeviation in children with symptomatic convergence insufficiency successfully treated with office-based vergence/accommodative therapy in the Convergence Insufficiency Treatment Trial-Attention and Reading Trial.
METHODS: A total of 131 children 9-14 years of age with symptomatic convergence insufficiency classified as successfully treated with office-based vergence/accommodative therapy at the 16-week outcome visit were included. Masked examiners measured the near ocular deviation by the prism and alternate cover test at baseline, primary outcome and 1-year post-treatment. The mean change in near deviation was calculated from baseline to primary outcome, from primary outcome to 1-year post-treatment and from baseline to 1-year post-treatment.
RESULTS: Of the 131 participants successfully treated with vergence/accommodative therapy, 120 completed the 1-year post-treatment visit. A significant change in near exodeviation was observed at baseline to primary outcome (2.6Δ less exo, p < 0.001, moderate effect size d = 0.61) and at baseline to 1-year post-treatment (2.0Δ less exo; p < 0.001, small effect size d = 0.45). The change from primary outcome to 1-year post-treatment (0.6Δ more exo; p = 0.06, small effect size d = 0.11) was not significant. Forty per cent (48/120) of participants had a decrease in near exodeviation >3.5∆ (expected test/retest variability) between baseline and the primary outcome examination. Of the 120 participants, one (1.0%) was esophoric at the primary outcome and was subsequently exophoric at 1-year post-treatment. Four participants (3.3%) who were orthophoric or exophoric at the primary outcome were esophoric (all ≤3∆) at the 1-year post-treatment visit.
CONCLUSIONS: On average, the near exodeviation was smaller in size immediately after the discontinuation of vergence/accommodative therapy (2.6∆, moderate effect size) and 1 year post vergence/accommodative therapy (2.0∆, small effect size) in children with convergence insufficiency who were successfully treated; 40% had a clinically meaningful decrease in exophoria. The development of near esophoria was rare.
METHODS: A total of 131 children 9-14 years of age with symptomatic convergence insufficiency classified as successfully treated with office-based vergence/accommodative therapy at the 16-week outcome visit were included. Masked examiners measured the near ocular deviation by the prism and alternate cover test at baseline, primary outcome and 1-year post-treatment. The mean change in near deviation was calculated from baseline to primary outcome, from primary outcome to 1-year post-treatment and from baseline to 1-year post-treatment.
RESULTS: Of the 131 participants successfully treated with vergence/accommodative therapy, 120 completed the 1-year post-treatment visit. A significant change in near exodeviation was observed at baseline to primary outcome (2.6Δ less exo, p < 0.001, moderate effect size d = 0.61) and at baseline to 1-year post-treatment (2.0Δ less exo; p < 0.001, small effect size d = 0.45). The change from primary outcome to 1-year post-treatment (0.6Δ more exo; p = 0.06, small effect size d = 0.11) was not significant. Forty per cent (48/120) of participants had a decrease in near exodeviation >3.5∆ (expected test/retest variability) between baseline and the primary outcome examination. Of the 120 participants, one (1.0%) was esophoric at the primary outcome and was subsequently exophoric at 1-year post-treatment. Four participants (3.3%) who were orthophoric or exophoric at the primary outcome were esophoric (all ≤3∆) at the 1-year post-treatment visit.
CONCLUSIONS: On average, the near exodeviation was smaller in size immediately after the discontinuation of vergence/accommodative therapy (2.6∆, moderate effect size) and 1 year post vergence/accommodative therapy (2.0∆, small effect size) in children with convergence insufficiency who were successfully treated; 40% had a clinically meaningful decrease in exophoria. The development of near esophoria was rare.
摘要：
目的：报告在收敛功能不全治疗试验-注意力和阅读试验中成功使用基于办公室的收敛/调节疗法治疗的症状性收敛功能不全儿童的近偏离程度的变化。
方法：共纳入131名9-14岁有症状的收敛功能不全患儿，这些患儿在16周的结局访视时被分类为通过基于办公室的收敛度/调节疗法成功治疗。蒙面检查者通过棱镜测量近眼偏差，并在基线处进行交替覆盖测试。主要结局和治疗后1年。计算从基线到主要结局的近偏差的平均变化，从主要结局到治疗后1年以及从基线到治疗后1年.
结果：在131名参与者中，通过聚散/调节疗法成功治疗，120人完成了治疗后1年的访视。在基线到主要结果时观察到接近外向偏差的显著变化(2.6Δ减少外向,p<0.001，中等效应大小d=0.61）和基线至治疗后1年（外型较少2.0Δ；p<0.001，小效应大小d=0.45）。从主要结果到治疗后1年的变化（exo增加0.6Δ；p=0.06，小效应大小d=0.11）不显著。40％（48/120）的参与者在基线和主要结局检查之间的近外偏差减少>3.5Δ（预期测试/重测变异性）。在120名参与者中，1例(1.0%)在主要结局时出现内隐,随后在治疗后1年出现外隐.在治疗后1年的随访中，有四名（3.3％）在主要结果为正骨或外倒骨的参与者（均≤3Δ）。
结论：平均而言，在停止聚散度/调节治疗后，近外向的大小较小(2.6，Δ中等效应大小)和聚散度/调节治疗后1年(2.0Δ，效果大小较小）在成功治疗的会聚功能不全儿童中；40％的外吐有临床意义的减少。近esophoria的发展很少。
方法：共纳入131名9-14岁有症状的收敛功能不全患儿，这些患儿在16周的结局访视时被分类为通过基于办公室的收敛度/调节疗法成功治疗。蒙面检查者通过棱镜测量近眼偏差，并在基线处进行交替覆盖测试。主要结局和治疗后1年。计算从基线到主要结局的近偏差的平均变化，从主要结局到治疗后1年以及从基线到治疗后1年.
结果：在131名参与者中，通过聚散/调节疗法成功治疗，120人完成了治疗后1年的访视。在基线到主要结果时观察到接近外向偏差的显著变化(2.6Δ减少外向,p<0.001，中等效应大小d=0.61）和基线至治疗后1年（外型较少2.0Δ；p<0.001，小效应大小d=0.45）。从主要结果到治疗后1年的变化（exo增加0.6Δ；p=0.06，小效应大小d=0.11）不显著。40％（48/120）的参与者在基线和主要结局检查之间的近外偏差减少>3.5Δ（预期测试/重测变异性）。在120名参与者中，1例(1.0%)在主要结局时出现内隐,随后在治疗后1年出现外隐.在治疗后1年的随访中，有四名（3.3％）在主要结果为正骨或外倒骨的参与者（均≤3Δ）。
结论：平均而言，在停止聚散度/调节治疗后，近外向的大小较小(2.6，Δ中等效应大小)和聚散度/调节治疗后1年(2.0Δ，效果大小较小）在成功治疗的会聚功能不全儿童中；40％的外吐有临床意义的减少。近esophoria的发展很少。
