Abstract：
BACKGROUND: Visual function deficits have been reported in adolescents following concussion. We compared vergence and accommodation deficits in paediatric and adolescent patients at a tertiary medical centre in the sub-acute (15 days to 12 weeks) and chronic (12 weeks to 1 year) phases of concussion recovery.
METHODS: The study included patients aged 7 to <18 years seen between 2014 and 2021, who had a binocular vision (BV) examination conducted within 15 days and 1 year of their concussion injury. Included patients had to have 0.10 logMAR monocular best-corrected vision or better in both eyes and be wearing a habitual refractive correction. BV examinations at near included measurements of near point of convergence, convergence and divergence amplitudes, vergence facility, monocular accommodative amplitude and monocular accommodative facility. Vergence and accommodation deficits were diagnosed using established clinical criteria. Group differences were assessed using nonparametric statistics and ANCOVA modelling.
RESULTS: A total of 259 patients were included with 111 in the sub-acute phase and 148 in the chronic phase of concussion recovery. There was no significant difference in the rates of vergence deficits between the two phases of concussion recovery (sub-acute = 48.6%; chronic = 49.3%). There was also no significant difference in the rates of accommodation deficits between the two phases of concussion recovery (sub-acute = 82.0%; chronic = 77.0%).
CONCLUSIONS: Patients in both the sub-acute and chronic phases of concussion recovery exhibited a high frequency of vergence and accommodation deficits, with no significant differences between groups. Results indicate that patients exhibiting vision deficits in the sub-acute phase may not resolve without intervention, though a prospective, longitudinal study is required to test the hypothesis.
METHODS: The study included patients aged 7 to <18 years seen between 2014 and 2021, who had a binocular vision (BV) examination conducted within 15 days and 1 year of their concussion injury. Included patients had to have 0.10 logMAR monocular best-corrected vision or better in both eyes and be wearing a habitual refractive correction. BV examinations at near included measurements of near point of convergence, convergence and divergence amplitudes, vergence facility, monocular accommodative amplitude and monocular accommodative facility. Vergence and accommodation deficits were diagnosed using established clinical criteria. Group differences were assessed using nonparametric statistics and ANCOVA modelling.
RESULTS: A total of 259 patients were included with 111 in the sub-acute phase and 148 in the chronic phase of concussion recovery. There was no significant difference in the rates of vergence deficits between the two phases of concussion recovery (sub-acute = 48.6%; chronic = 49.3%). There was also no significant difference in the rates of accommodation deficits between the two phases of concussion recovery (sub-acute = 82.0%; chronic = 77.0%).
CONCLUSIONS: Patients in both the sub-acute and chronic phases of concussion recovery exhibited a high frequency of vergence and accommodation deficits, with no significant differences between groups. Results indicate that patients exhibiting vision deficits in the sub-acute phase may not resolve without intervention, though a prospective, longitudinal study is required to test the hypothesis.
摘要：
背景：已报道青少年脑震荡后出现视觉功能缺陷。我们比较了三级医疗中心的小儿和青少年患者在脑震荡恢复的亚急性（15天至12周）和慢性（12周至1年）阶段的收敛度和适应性缺陷。
方法：该研究包括2014年至2021年期间观察到的7至<18岁的患者，这些患者在脑震荡损伤后15天和1年内进行了双眼视觉（BV）检查。纳入的患者必须具有0.10logMAR单眼最佳矫正视力或双眼更好，并且习惯性屈光矫正。近处的BV检查包括近收敛点的测量，收敛和发散幅度，vergencefacility,单眼调节幅度和单眼调节设施。使用既定的临床标准来诊断聚散度和适应性缺陷。使用非参数统计和ANCOVA建模评估组差异。
结果：共有259例患者纳入，其中111例处于亚急性期，148例处于脑震荡恢复的慢性期。脑震荡恢复的两个阶段之间的收敛缺陷率没有显着差异（亚急性=48.6％；慢性=49.3％）。脑震荡恢复的两个阶段之间的调节缺陷率也没有显着差异（亚急性=82.0％；慢性=77.0％）。
结论：在脑震荡恢复的亚急性和慢性阶段的患者表现出高频率的聚散和调节缺陷，组间无显著差异。结果表明，在亚急性期表现出视力障碍的患者如果没有干预，可能无法解决。虽然有前景，需要纵向研究来检验这一假设。
方法：该研究包括2014年至2021年期间观察到的7至<18岁的患者，这些患者在脑震荡损伤后15天和1年内进行了双眼视觉（BV）检查。纳入的患者必须具有0.10logMAR单眼最佳矫正视力或双眼更好，并且习惯性屈光矫正。近处的BV检查包括近收敛点的测量，收敛和发散幅度，vergencefacility,单眼调节幅度和单眼调节设施。使用既定的临床标准来诊断聚散度和适应性缺陷。使用非参数统计和ANCOVA建模评估组差异。
结果：共有259例患者纳入，其中111例处于亚急性期，148例处于脑震荡恢复的慢性期。脑震荡恢复的两个阶段之间的收敛缺陷率没有显着差异（亚急性=48.6％；慢性=49.3％）。脑震荡恢复的两个阶段之间的调节缺陷率也没有显着差异（亚急性=82.0％；慢性=77.0％）。
结论：在脑震荡恢复的亚急性和慢性阶段的患者表现出高频率的聚散和调节缺陷，组间无显著差异。结果表明，在亚急性期表现出视力障碍的患者如果没有干预，可能无法解决。虽然有前景，需要纵向研究来检验这一假设。
