Does coexisting accommodative dysfunction impact clinical convergence measures, symptoms and treatment success for symptomatic convergence insufficiency in children?
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| Title: | Does coexisting accommodative dysfunction impact clinical convergence measures, symptoms and treatment success for symptomatic convergence insufficiency in children? |
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| Authors: | Kulp, Marjean T (AUTHOR), Sinnott, Loraine T (AUTHOR), Cotter, Susan A (AUTHOR), Borsting, Eric (AUTHOR), Toole, Andrew J (AUTHOR), Chen, Angela M (AUTHOR), Jenewein, Erin C (AUTHOR), Morrison, Ann M (AUTHOR), Plaumann, Maureen D (AUTHOR), Jones‐Jordan, Lisa (AUTHOR), Mitchell, G Lynn (AUTHOR), Tea, Yin C (AUTHOR), Scheiman, Mitchell M (AUTHOR), Cooper, Jeffrey (AUTHOR), Schulman, Erica (AUTHOR), Hamian, Kimberly (AUTHOR), Iacono, Danielle (AUTHOR), Larson, Steven (AUTHOR), Leung, Valerie (AUTHOR), Meeder, Sara (AUTHOR) |
| Source: | Ophthalmic & Physiological Optics. Jan2022, Vol. 42 Issue 1, p59-70. 12p. 6 Charts. |
| Subjects: | Symptoms, Secondary analysis, Analysis of variance, Logistic regression analysis |
| Abstract: | Purpose: To determine whether coexisting accommodative dysfunction in children with symptomatic convergence insufficiency (CI) impacts presenting clinical convergence measures, symptoms and treatment success for CI. Methods: Secondary data analyses of monocular accommodative amplitude (AA; push‐up method), monocular accommodative facility (AF; ±2.00 D lens flippers) and symptoms (CI Symptom Survey [CISS]) in children with symptomatic CI from the Convergence Insufficiency Treatment Trial (N = 218) and CITT‐Attention and Reading Trial (N = 302) were conducted. Decreased AA was defined as more than 2D below the minimum expected amplitude for age (15 – ¼ age); those with AA < 5 D were excluded. Decreased AF was defined as <6 cycles per minute. Mean near point of convergence (NPC), near positive fusional vergence (PFV) and symptoms (CISS) were compared between those with and without accommodative dysfunction using analysis of variance and independent samples t‐testing. Logistic regression was used to compare the effect of baseline accommodative function on treatment success [defined using a composite of improvements in: (1) clinical convergence measures and symptoms (NPC, PFV and CISS scores) or (2) solely convergence measures (NPC and PFV)]. Results: Accommodative dysfunction was common in children with symptomatic CI (55% had decreased AA; 34% had decreased AF). NPC was significantly worse in those with decreased AA (mean difference = 6.1 cm; p < 0.001). Mean baseline CISS scores were slightly worse in children with coexisting accommodative dysfunction (decreased AA or AF) (30.2 points) than those with normal accommodation (26.9 points) (mean difference = 3.3 points; p < 0.001). Neither baseline accommodative function (p ≥ 0.12 for all) nor interaction of baseline accommodative function and treatment (p ≥ 0.50) were related to treatment success based on the two composite outcomes. Conclusions: A coexisting accommodative dysfunction in children with symptomatic CI is associated with worse NPC, but it does not impact the severity of symptoms in a clinically meaningful way. Concurrent accommodative dysfunction does not impact treatment response for CI. [ABSTRACT FROM AUTHOR] |
| Copyright of Ophthalmic & Physiological Optics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 153951738 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Does coexisting accommodative dysfunction impact clinical convergence measures, symptoms and treatment success for symptomatic convergence insufficiency in children? – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Kulp%2C+Marjean+T%22">Kulp, Marjean T</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sinnott%2C+Loraine+T%22">Sinnott, Loraine T</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cotter%2C+Susan+A%22">Cotter, Susan A</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Borsting%2C+Eric%22">Borsting, Eric</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Toole%2C+Andrew J%22">Toole, Andrew J</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chen%2C+Angela+M%22">Chen, Angela M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jenewein%2C+Erin+C%22">Jenewein, Erin C</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Morrison%2C+Ann+M%22">Morrison, Ann M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Plaumann%2C+Maureen D%22">Plaumann, Maureen D</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jones‐Jordan%2C+Lisa%22">Jones‐Jordan, Lisa</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mitchell%2C+G+Lynn%22">Mitchell, G Lynn</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tea%2C+Yin+C%22">Tea, Yin C</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Scheiman%2C+Mitchell+M%22">Scheiman, Mitchell M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cooper%2C+Jeffrey%22">Cooper, Jeffrey</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Schulman%2C+Erica%22">Schulman, Erica</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hamian%2C+Kimberly%22">Hamian, Kimberly</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Iacono%2C+Danielle%22">Iacono, Danielle</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Larson%2C+Steven%22">Larson, Steven</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Leung%2C+Valerie%22">Leung, Valerie</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Meeder%2C+Sara%22">Meeder, Sara</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Ophthalmic+%26+Physiological+Optics%22">Ophthalmic & Physiological Optics</searchLink>. Jan2022, Vol. 42 Issue 1, p59-70. 12p. 6 Charts. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Symptoms%22">Symptoms</searchLink><br /><searchLink fieldCode="DE" term="%22Secondary+analysis%22">Secondary analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Analysis+of+variance%22">Analysis of variance</searchLink><br /><searchLink fieldCode="DE" term="%22Logistic+regression+analysis%22">Logistic regression analysis</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Purpose: To determine whether coexisting accommodative dysfunction in children with symptomatic convergence insufficiency (CI) impacts presenting clinical convergence measures, symptoms and treatment success for CI. Methods: Secondary data analyses of monocular accommodative amplitude (AA; push‐up method), monocular accommodative facility (AF; ±2.00 D lens flippers) and symptoms (CI Symptom Survey [CISS]) in children with symptomatic CI from the Convergence Insufficiency Treatment Trial (N = 218) and CITT‐Attention and Reading Trial (N = 302) were conducted. Decreased AA was defined as more than 2D below the minimum expected amplitude for age (15 – ¼ age); those with AA < 5 D were excluded. Decreased AF was defined as <6 cycles per minute. Mean near point of convergence (NPC), near positive fusional vergence (PFV) and symptoms (CISS) were compared between those with and without accommodative dysfunction using analysis of variance and independent samples t‐testing. Logistic regression was used to compare the effect of baseline accommodative function on treatment success [defined using a composite of improvements in: (1) clinical convergence measures and symptoms (NPC, PFV and CISS scores) or (2) solely convergence measures (NPC and PFV)]. Results: Accommodative dysfunction was common in children with symptomatic CI (55% had decreased AA; 34% had decreased AF). NPC was significantly worse in those with decreased AA (mean difference = 6.1 cm; p < 0.001). Mean baseline CISS scores were slightly worse in children with coexisting accommodative dysfunction (decreased AA or AF) (30.2 points) than those with normal accommodation (26.9 points) (mean difference = 3.3 points; p < 0.001). Neither baseline accommodative function (p ≥ 0.12 for all) nor interaction of baseline accommodative function and treatment (p ≥ 0.50) were related to treatment success based on the two composite outcomes. Conclusions: A coexisting accommodative dysfunction in children with symptomatic CI is associated with worse NPC, but it does not impact the severity of symptoms in a clinically meaningful way. Concurrent accommodative dysfunction does not impact treatment response for CI. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Ophthalmic & Physiological Optics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/opo.12911 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 12 StartPage: 59 Subjects: – SubjectFull: Symptoms Type: general – SubjectFull: Secondary analysis Type: general – SubjectFull: Analysis of variance Type: general – SubjectFull: Logistic regression analysis Type: general Titles: – TitleFull: Does coexisting accommodative dysfunction impact clinical convergence measures, symptoms and treatment success for symptomatic convergence insufficiency in children? Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Kulp, Marjean T – PersonEntity: Name: NameFull: Sinnott, Loraine T – PersonEntity: Name: NameFull: Cotter, Susan A – PersonEntity: Name: NameFull: Borsting, Eric – PersonEntity: Name: NameFull: Toole, Andrew J – PersonEntity: Name: NameFull: Chen, Angela M – PersonEntity: Name: NameFull: Jenewein, Erin C – PersonEntity: Name: NameFull: Morrison, Ann M – PersonEntity: Name: NameFull: Plaumann, Maureen D – PersonEntity: Name: NameFull: Jones‐Jordan, Lisa – PersonEntity: Name: NameFull: Mitchell, G Lynn – PersonEntity: Name: NameFull: Tea, Yin C – PersonEntity: Name: NameFull: Scheiman, Mitchell M – PersonEntity: Name: NameFull: Cooper, Jeffrey – PersonEntity: Name: NameFull: Schulman, Erica – PersonEntity: Name: NameFull: Hamian, Kimberly – PersonEntity: Name: NameFull: Iacono, Danielle – PersonEntity: Name: NameFull: Larson, Steven – PersonEntity: Name: NameFull: Leung, Valerie – PersonEntity: Name: NameFull: Meeder, Sara IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 01 Text: Jan2022 Type: published Y: 2022 Identifiers: – Type: issn-print Value: 02755408 Numbering: – Type: volume Value: 42 – Type: issue Value: 1 Titles: – TitleFull: Ophthalmic & Physiological Optics Type: main |
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