Symptoms in children with convergence insufficiency: before and after treatment.
Symptoms in children with convergence insufficiency: before and after treatment.
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DOI：
10.1097/opx.0b013e318269c8f9
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发表时间：
2012-10
期刊：
影响因子：
--
通讯作者：
CITT Study Group
中科院分区：
文献类型：
--
作者：
Barnhardt C;Cotter SA;Mitchell GL;Scheiman M;Kulp MT;CITT Study Group
探讨症状性集合功能不全（CI）儿童治疗前后的症状模式，并评估患者特征与症状严重程度之间的关系。在一项随机临床试验中，对221名9至<18岁的症状性CI儿童在治疗前后进行了会聚不足症状调查（CISS）。在基线时确定症状类型的频率，比较治疗应答者的体能相关与眼部相关症状的平均变化，并确定整个队列基线时和治疗应答者治疗后患者特征与症状严重程度之间的关系。在基线时，无论年龄、性别、种族/民族或是否存在父母报告的ADHD，表现相关症状的评分均大于眼睛相关症状的评分（平均反应为2.3 vs. 1.8，p<0.001）。总体和眼部相关子量表评分的症状严重程度均随年龄增加（分别为p=0.048，p=0.022）。父母报告的ADHD儿童比没有父母报告的ADHD儿童更有症状（p=0.005），因为他们的表现相关得分更高（p<0.001）。在治疗反应者中发现了与表现相关和与眼睛相关的症状的显著和相等的改善（p<0.01）。女孩的表现相关症状显著低于男孩（p=0.014），非洲裔美国儿童的眼部相关症状少于白色儿童（p=0.022）。与父母报告的ADHD儿童相比，没有父母报告的ADHD儿童的总体症状和眼部相关症状明显较少（分别为p=0.019，p=0.011）。由于高频率的性能和眼睛相关的症状，临床医生应该进行有针对性的历史，解决这两种类型的症状，以帮助确定儿童与症状CI。未来的研究CI和症状的关系及其对ADHD，阅读表现和注意力的潜在影响是必要的。
To investigate symptom patterns and evaluate the relationship between patient characteristics and symptom severity before and after treatment for symptomatic children with convergence insufficiency (CI). In a randomized clinical trial, the Convergence Insufficiency Symptom Survey (CISS) was administered pre- and post-treatment to 221 children 9 to <18 years with symptomatic CI. Frequency of symptom type was determined at baseline, mean change in performance-related versus eye-related symptoms for treatment responders was compared, and the relationship between patient characteristics and symptom severity at baseline for the entire cohort and after treatment for those who responded to treatment, was determined. At baseline, the score for performance-related symptoms was greater than that for eye-related symptoms (mean response of 2.3 vs. 1.8, p<0.001) regardless age, sex, race/ethnicity, or presence of parent-reported ADHD. Symptom severity increased with age for both the overall and eye-related subscale scores (p=0.048, p=0.022, respectively). Children with parent-reported ADHD were more symptomatic (p=0.005) than those without parent-reported ADHD because of a higher performance-related score (p<0.001). A significant and equal improvement (p<0.01) for the performance-related and eye-related symptoms was found in treatment responders. Girls had significantly lower performance-related symptoms than boys (p=0.014) and African-American children reported less eye-related symptoms than White children (p=0.022). Children without parent-reported ADHD had significantly less symptoms overall and less eye-related symptoms than children with parent-reported ADHD (p=0.019, p=0.011, respectively). Because of a high frequency of both performance- and eye-related symptoms, clinicians should perform a targeted history that addresses both types of symptoms to help identify children with symptomatic CI. Future study regarding the relationship of CI and symptoms and their potential influence on ADHD, reading performance, and attention is warranted.