目的:评估使用基于办公室的聚散度/调节疗法治疗的症状性会聚功能不全儿童的临床会聚措施改善的时间过程。
方法:我们评估了205,9至14岁有症状的收敛功能不全儿童的收敛功能,这些儿童在收敛功能不全治疗试验-注意力和阅读试验(CITT-ART)中被随机分配到基于办公室的收敛/调节治疗。在基线和治疗4、8、12和16周后测量近收敛点(NPC)和近正融合聚散度(PFV);使用重复测量方差分析比较了这些时间点之间NPC和PFV的平均变化。计算从(1)基线到4周和(2)4-16周的NPC和PFV的变化率。对于每个时间点,首次达到NPC正常标准(<6cm)的参与者比例,计算PFV模糊(如果没有模糊,则中断;>15Δ和>2倍的外差)和会聚复合(NPC和PFV均正常)。
结果:NPC和PFV的变化最大(7.6cm和12.7Δ),NPC和PFV的改善速度最快(1.9cm/周和3.2Δ/周,分别)都是在治疗的前4周发现的,在随后的12周内,两者都有所放缓。治疗12周后,NPC,PFV和收敛复合材料在93.2%正常,91.7%和87.8%的参与者,分别,并在4.4%的患者中再治疗4周恢复正常,2.0%和4.4%的参与者,分别。
结论:尽管NPC和PFV的最大改善发生在治疗的前4周,大多数参与者在随后的12周治疗中每周都有改善.虽然大多数患有会聚不足的儿童在治疗12周后获得了正常的会聚,额外4周的聚散度/调节治疗可能对一些参与者有益.
To evaluate the time course of improvements in clinical convergence measures for children with symptomatic convergence insufficiency treated with office-based vergence/accommodative therapy.
We evaluated convergence measures from 205, 9- to 14-year-old children with symptomatic convergence insufficiency randomised to office-based vergence/accommodative therapy in the Convergence Insufficiency Treatment Trial - Attention and Reading Trial (CITT-ART). Near-point of convergence (NPC) and near-positive fusional vergence (PFV) were measured at baseline and after 4, 8, 12 and 16 weeks of therapy; mean change in NPC and PFV between these time points were compared using repeated measures analysis of variance. Rates of change in NPC and PFV from: (1) baseline to 4 weeks and (2) 4-16 weeks were calculated. For each time point, the proportion of participants to first meet the normal criterion for NPC (<6 cm), PFV blur (break if no blur; >15Δ and >2 times the exodeviation) and convergence composite (NPC and PFV both normal) were calculated.
The greatest change in NPC and PFV (7.6 cm and 12.7 Δ) and the fastest rate of improvement in NPC and PFV (1.9 cm/week and 3.2 Δ/week, respectively) were both found during the first 4 weeks of therapy, with both slowing over the subsequent 12 weeks. After 12 weeks of therapy, the NPC, PFV and convergence composite were normal in 93.2%, 91.7% and 87.8% of participants, respectively, and normalised with another 4 weeks of therapy in 4.4%, 2.0% and 4.4% of participants, respectively.
Although the greatest improvements in NPC and PFV occurred in the first 4 weeks of therapy, most participants had weekly improvements over the subsequent 12 weeks of treatment. While most children with convergence insufficiency obtained normal convergence following 12 weeks of therapy, an additional 4 weeks of vergence/accommodative therapy may be beneficial for some participants.