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Correlations between clinical measures and symptoms: Report 1: Stereoacuity with accommodative, vergence measures, and symptoms.

ABSTRACT: AIM:The aim of this study was to explore associations between reduced stereoacuity and clinical measures of accommodation, vergences, and symptoms which could facilitate the development of quick and reliable screening tools. METHODS:Using a multi-stage random cluster sampling, 1211 high school students (481 males and 730 females) between 13 and 18 years of age, were selected and examined. Visual acuity, stereoacuity and suppression, refractive errors, near point of convergence, heterophoria and fusional vergences, as well as, amplitude of accommodation, accommodative response, facility and relative accommodation were evaluated. Correlations among variables and the validity of Randot stereoacuity to distinguish between children with and without defective clinical measures as well as symptomatic versus asymptomatic children were characterized by the sensitivity and specificity of the tests. RESULTS:The overall mean stereoacuity was 43.9?±?25.23?s arc, and 18.9% [95% Confidence Interval, 16.6-21.4%)] of the participants had reduced stereoacuity (defined as ?60). Stereoacuity values and symptoms scores were worse in children with defective clinical measures. The Receiver Operation Curve showed that maximum sensitivity and specificity was obtained with near point of convergence break (?10?cm) of (0.70 95% confidence interval: 0.63-0.77) with Randot stereoacuity test (defined as ?60?s arc). The correlations between reduced stereoacuity and symptoms scores was moderately strong and statistically significant (Pearson's, r?=?0.507, p?=?0.01). The Receiver Operation Curve showed that maximum sensitivity and specificity obtained with the Convergence Insufficiency Symptoms Survey was 0.57 (95% Confidence interval?=?0.53-0.62, p?=?0.001), sensitivity of 90.26%, and specificity 15.26% with the Randot stereoacuity test. CONCLUSION:Reduced stereoacuity, defective clinical measures and symptoms of asthenopia were prevalent among sample of school children studied. Randot stereoacuity test could fairly distinguish between defective and normal clinical measures; though the accuracy to differentiate between symptomatic and asymptomatic school children is poor. These findings highlight the need for validation of a simple and fast screening tool in school settings. Further studies to confirm above findings will be needed.

SUBMITTER: Wajuihian SO

PROVIDER: S-EPMC7301208 | biostudies-literature | 2020 Jul - Sep

REPOSITORIES: biostudies-literature

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Correlations between clinical measures and symptoms: Report 1: Stereoacuity with accommodative, vergence measures, and symptoms.

Wajuihian Samuel Otabor SO

Journal of optometry 20200529 3

<h4>Aim</h4>The aim of this study was to explore associations between reduced stereoacuity and clinical measures of accommodation, vergences, and symptoms which could facilitate the development of quick and reliable screening tools.<h4>Methods</h4>Using a multi-stage random cluster sampling, 1211 high school students (481 males and 730 females) between 13 and 18 years of age, were selected and examined. Visual acuity, stereoacuity and suppression, refractive errors, near point of convergence, he ...[more]

PMID: 32475793

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Project description:PurposeTo determine whether coexisting accommodative dysfunction in children with symptomatic convergence insufficiency (CI) impacts presenting clinical convergence measures, symptoms and treatment success for CI.MethodsSecondary 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)].ResultsAccommodative 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.ConclusionsA 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.

Dataset Information

Correlations between clinical measures and symptoms: Report 1: Stereoacuity with accommodative, vergence measures, and symptoms.

Publications

Correlations between clinical measures and symptoms: Report 1: Stereoacuity with accommodative, vergence measures, and symptoms.

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