Vision In Preschoolers - Hyperopia in Children (VIP-HIP)

学龄前儿童视力 - 儿童远视 (VIP-HIP)

• 批准号: 8026170
• 负责人: MARJEAN T KULP
• 金额: $ 78.86万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-06-01 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8026170
• 关键词: Amblyopia; Asthenopia; Attention; Behavior; Child; Clinical Practice Guideline; Development; Epidemiologic Studies; Evaluation; Glass; Goals; Guidelines; Headache; Hyperopia; Investigation; Link; Nursery Schools; Ophthalmic examination and evaluation; Outcome Measure; Parents; Performance; Policies; Preschool Child; Randomized Clinical Trials; Reading; Refractive Errors; Schools; Strabismus; Testing; Vision; Vision Screening; Visual Acuity; early childhood; evidence base; improved; literacy; primary outcome; response; visual-motor integration

DESCRIPTION (provided by applicant): Our prior NEI multicenter Vision in Preschoolers (VIP) studies identified the most effective tests for preschool vision screening, and federal initiatives are currently underway to increase the number of preschool children receiving vision screening and eye examinations. Clinical practice guidelines for children detected with amblyopia or strabismus are clear, but no evidence-based management guidelines are available for managing the many more children detected who have moderate to large hyperopic refractive errors without amblyopia or strabismus. The requirement for accommodation in the uncorrected hyperope may result in eyestrain, headache, intermittent blur and difficulty attending at near, leading to subsequent reading and school performance problems. Several studies have linked hyperopia and reading ability, but large-scale investigations have not been conducted in preschool children. Thus, the benefit of detecting children with moderate to large hyperopic refractive errors via vision screening and examining them for prescription of glasses is controversial. The proposed Vision In Preschoolers - Hyperopia In Preschoolers (VIP - HIP) cross- sectional multi-center epidemiological study will answer the following question: Do uncorrected hyperopic (e3D to <6D) 4 or 5yearold children without strabismus or amblyopia perform worse on a battery of educational tests than do comparable emmetropic children? The primary outcome measure will be performance on an assessment of literacy, the Test of Preschool Early Literacy (TOPEL). Results on literacy will be supplemented with results on assessments of attention (LeiterR sustained attention subtest), visual motor integration (Beery-Buktenica Developmental Test of Visual-Motor Integration, 5th Edition [BEERY" VMI]), and behavior and development as provided by parental assessment (Connors Early Childhood [Connors EC] and the Parents' Evaluation of Development Status [PEDS]). The relation between moderate hyperopia and early educational performance will be further investigated by 1) evaluating the association of hyperopia and visual function (visual acuity at distance and near, ocular alignment, stereoacuity), and 2) evaluating accommodative response as a mechanism responsible for any relations found between hyperopia and academic performance. The proposed VIPHIP study will have substantial impact on the understanding of any effects of uncorrected hyperopia on early educational performance and visual function. The results of the study will determine the need for and relevance of a full-scale randomized clinical trial (RCT) to determine whether refractive correction in preschool improves any deficit in performance on early educational tests. The results will also have implications for vision screening policy and prescribing guidelines for glasses. PUBLIC HEALTH RELEVANCE: The proposed Vision in Preschoolers - Hyperopia in Preschoolers (VIP - HIP) cross-sectional multi-center epidemiological study will have substantial impact on the understanding of any effects of uncorrected hyperopia on early educational performance and visual function. The results of the study will determine the need for and relevance of a full-scale randomized clinical trial to determine whether refractive correction in preschool improves any deficit in performance on early educational tests.

描述（由申请人提供）：我们之前的NEI多中心学龄前儿童视力（VIP）研究确定了学龄前视力筛查的最有效测试，联邦计划目前正在进行中，以增加接受视力筛查和眼科检查的学龄前儿童的数量。对于弱视或斜视儿童的临床实践指南是明确的，但没有循证管理指南可用于管理检测到的更多患有中度至重度远视屈光不正但无弱视或斜视的儿童。未矫正的远视眼的调节要求可能导致眼疲劳、头痛、间歇性模糊和近距离注意困难，导致随后的阅读和学习表现问题。一些研究已经将远视和阅读能力联系起来，但尚未在学龄前儿童中进行大规模调查。因此，通过视力筛查检测患有中度至重度远视屈光不正的儿童并检查他们的眼镜处方的益处存在争议。拟议的学龄前儿童视力-学龄前儿童远视（VIP - HIP）横断面多中心流行病学研究将回答以下问题：未矫正的远视（e3 D至<6D）4或5岁无斜视或弱视的儿童在一系列教育测试中的表现是否比可比的正视儿童差？主要的成果衡量标准将是在识字评估方面的表现，即学前早期识字测试。识字结果将补充注意力评估结果（LeiterR持续注意力子测试）、视觉运动整合（Beery-Buktenica视觉运动整合发育测试，第5版[BEERY 'VMI]）以及父母评估提供的行为和发展（Connors幼儿[Connors EC]和父母发育状况评估[PEDS]）。将通过以下方式进一步研究中度远视与早期教育表现之间的关系：1）评价远视与视功能（远视力和近视力、眼球对准、立体视敏度）的相关性，2）评价屈光反应作为远视与学习表现之间存在任何关系的机制。拟议的VIPHIP研究将对理解未矫正的远视对早期教育表现和视觉功能的任何影响产生重大影响。该研究的结果将确定是否需要进行一项全面的随机临床试验（RCT），以确定学龄前屈光矫正是否可以改善早期教育测试中的任何表现缺陷。研究结果也将对视力筛查政策和眼镜处方指南产生影响。 公共卫生关系：拟议的学龄前儿童视力-学龄前儿童远视（VIP - HIP）横断面多中心流行病学研究将对理解未矫正远视对早期教育表现和视功能的任何影响产生重大影响。这项研究的结果将确定一项全面随机临床试验的必要性和相关性，以确定学龄前屈光矫正是否能改善早期教育测试中的任何表现缺陷。