Long-term effectiveness of treatments for symptomatic convergence insufficiency in children
Convergence Insufficiency Treatment Trial Study Group, Mitchell Scheiman, Marjean Kulp, Susan Cotter, Gladys Lynn Mitchell, Michael Rouse, Richard Hertle, Jeffrey Cooper, Rachel Coulter, Michael Gallaway, Kristine Hopkins, Brian G Mohney, Susanna Tamkins, Sussanna Tamkins, Hilda Capo, Mark Dunbar, Craig McKeown, Arlanna Moshfeghi, Kathryn Nelson, Vicky Fischer, Adam Perlman, Ronda Singh, Eva Olivares, Ana Rosa, Nidia Rosado, Elias Silverman, Jeffrey Cooper, Audra Steiner, Marta Brunelli, Stacy Friedman, Steven Ritter, Lily Zhu, Lyndon Wong, Ida Chung, Kaity Colon, Kristine Hopkins, Marcela Frazier, Janene Sims, Marsha Swanson, Katherine Weise, Adrienne Broadfoot, Michelle Anderson, Catherine Baldwin, Rachel Coulter, Deborah Amster, Gregory Fecho, Tanya Mahaphon, Jacqueline Rodena, Mary Bartuccio, Yin Tea, Annette Bade, Michael Gallaway, Brandy Scombordi, Mark Boas, Tomohiko Yamada, Ryan Langan, Ruth Shoge, Lily Zhu, Marjean Kulp, Michelle Buckland, Michael Earley, Gina Gabriel, Aaron Zimmerman, Kathleen Reuter, Andrew Toole, Molly Biddle, Nancy Stevens, Susan Cotter, Eric Borsting, Michael Rouse, Carmen Barnhardt, Raymond Chu, Susan Parker, Rebecca Bridgeford, Jamie Morris, Javier Villalobos, David Granet, Lara Hustana, Shira Robbins, Erica Castro, Cintia Gomi, Brian G Mohney, Jonathan Holmes, Melissa Rice, Virginia Karlsson, Becky Nielsen, Jan Sease, Tracee Shevlin, Mitchell Scheiman, Karen Pollack, Susan Cotter, Richard Hertle, Michael Rouse, Gladys Lynn Mitchell, Tracy Kitts, Melanie Bacher, Linda Barrett, Loraine Sinnott, Kelly Watson, Pam Wessel, Maryann Redford, Mitchell Scheiman, Lynn Mitchell, Susan Cotter, Richard Hertle, Marjean Kulp, Maryann Redford, Michael Rouse, Marie Diener-West, Andrew Costello, William V Good, Ron D Hays, Argye Hillis, Ruth Manny, Convergence Insufficiency Treatment Trial Study Group, Mitchell Scheiman, Marjean Kulp, Susan Cotter, Gladys Lynn Mitchell, Michael Rouse, Richard Hertle, Jeffrey Cooper, Rachel Coulter, Michael Gallaway, Kristine Hopkins, Brian G Mohney, Susanna Tamkins, Sussanna Tamkins, Hilda Capo, Mark Dunbar, Craig McKeown, Arlanna Moshfeghi, Kathryn Nelson, Vicky Fischer, Adam Perlman, Ronda Singh, Eva Olivares, Ana Rosa, Nidia Rosado, Elias Silverman, Jeffrey Cooper, Audra Steiner, Marta Brunelli, Stacy Friedman, Steven Ritter, Lily Zhu, Lyndon Wong, Ida Chung, Kaity Colon, Kristine Hopkins, Marcela Frazier, Janene Sims, Marsha Swanson, Katherine Weise, Adrienne Broadfoot, Michelle Anderson, Catherine Baldwin, Rachel Coulter, Deborah Amster, Gregory Fecho, Tanya Mahaphon, Jacqueline Rodena, Mary Bartuccio, Yin Tea, Annette Bade, Michael Gallaway, Brandy Scombordi, Mark Boas, Tomohiko Yamada, Ryan Langan, Ruth Shoge, Lily Zhu, Marjean Kulp, Michelle Buckland, Michael Earley, Gina Gabriel, Aaron Zimmerman, Kathleen Reuter, Andrew Toole, Molly Biddle, Nancy Stevens, Susan Cotter, Eric Borsting, Michael Rouse, Carmen Barnhardt, Raymond Chu, Susan Parker, Rebecca Bridgeford, Jamie Morris, Javier Villalobos, David Granet, Lara Hustana, Shira Robbins, Erica Castro, Cintia Gomi, Brian G Mohney, Jonathan Holmes, Melissa Rice, Virginia Karlsson, Becky Nielsen, Jan Sease, Tracee Shevlin, Mitchell Scheiman, Karen Pollack, Susan Cotter, Richard Hertle, Michael Rouse, Gladys Lynn Mitchell, Tracy Kitts, Melanie Bacher, Linda Barrett, Loraine Sinnott, Kelly Watson, Pam Wessel, Maryann Redford, Mitchell Scheiman, Lynn Mitchell, Susan Cotter, Richard Hertle, Marjean Kulp, Maryann Redford, Michael Rouse, Marie Diener-West, Andrew Costello, William V Good, Ron D Hays, Argye Hillis, Ruth Manny
Abstract
Purpose: To assess the long-term stability of improvements in symptoms and signs in 9- to 17-year-old children enrolled in the Convergence Insufficiency Treatment Trial who were asymptomatic after treatment for convergence insufficiency.
Methods: Seventy-nine patients who were asymptomatic after a 12-week therapy program for convergence insufficiency were followed for 1 year [33/60 in office-based vergence/accommodative therapy (OBVAT), 18/54 in home-based pencil push-ups (HBPP), 12/57 in home-based computer vergence/accommodative therapy and pencil push-ups (HBCVAT+), and 16/54 in office-based placebo therapy (OBPT)]. Symptoms and clinical signs were measured 6 months and 1 year after completion of the 12-week therapy program. The primary outcome measure was the mean change on the Convergence Insufficiency Symptom Survey (CISS). Secondary outcome measures were near point of convergence, positive fusional vergence at near, and proportions of patients who remained asymptomatic or who were classified as successful or improved based on a composite measure of CISS, near point of convergence, and positive fusional vergence.
Results: One-year follow-up visit completion rate was 89% with no significant differences between groups (p = 0.26). There were no significant changes in the CISS in any treatment group during the 1-year follow-up. The percentage who remained asymptomatic in each group was 84.4% (27/32) for OBVAT, 66.7% (10/15) for HBPP, 80% (8/10) for HBCVAT+, and 76.9% (10/13) for OBPT. The percentage who remained either successful or improved 1-year posttreatment was 87.5% (28/32) for OBVAT, 66.6% (10/15) for HBPP, 80% (8/10) for HBCVAT+, and 69.3% (9/13) for OBPT.
Conclusions: Most children aged 9 to 17 years who were asymptomatic after a 12-week treatment program of OBVAT for convergence insufficiency maintained their improvements in symptoms and signs for at least 1 year after discontinuing treatment. Although the sample sizes for the home-based and placebo groups were small, our data suggest that a similar outcome can be expected for children who were asymptomatic after treatment with HBPP or HBCVAT+.
Trial registration: ClinicalTrials.gov NCT00338611.
Figures
Source: PubMed