Literature DB >> 31640452

The Convergence Insufficiency Neuro-mechanism in Adult Population Study (CINAPS) Randomized Clinical Trial: Design, Methods, and Clinical Data.

Tara L Alvarez1, Mitchell Scheiman2, Elio M Santos1, Cristian Morales1, Chang Yaramothu1, John Vito D'Antonio-Bertagnolli1, Bharat B Biswal1, Suril Gohel3, Xiaobo Li1.   

Abstract

Purpose: To describe the design and methodology of the Convergence Insufficiency Neuro-mechanism in Adult Population Study (CINAPS), the first randomized clinical trial (RCT) studying young adults with symptomatic convergence insufficiency (CI) using a combination of traditional clinical tests, objective eye movement recordings, and functional brain activities as outcome measures.
Methods: In this double-masked RCT, binocularly normal controls (BNC) (N = 50) and CI patients (N = 50) are randomized into office-based vergence/accommodative therapy (OBVAT) or office-based placebo therapy (OBPT). Outcome measures included clinical signs and symptoms, phoria adaptation, forced fixation disparity curves, binocular rivalry, vergence and saccadic objective eye movements, and task-induced functional brain activities. This study is registered on ClinicalTrials.gov NCT03593031.
Results: No significant baseline differences are observed between the BNC (p > .4) or CI (p > .3) participants assigned to OBVAT or OBPT for age, near point of convergence (NPC), positive fusional vergence (PFV), phoria at distance and near, amplitude of accommodation, or the Convergence Insufficiency Symptom Survey (CISS). Significant differences are observed between the CI and BNC cohorts at baseline measurements for NPC, PFV, difference in phoria from far to near, amplitude of accommodation, and CISS (p < .001). For the CI patients, 26% had a comorbidity of accommodation insufficiency, and 16% self-reported ADHD.
Conclusion: Features of the study design include the following: standardized diagnostic and office-based therapeutic intervention, placebo treatment arm, masked clinical outcome examinations, objective eye movement recordings, functional imaging, phoria adaptation, fixation disparity curves and binocular rivalry measurements.

Entities:  

Keywords:  Convergence insufficiency; eye movement; functional MRI; randomized clinical trial; vergence

Mesh:

Year:  2019        PMID: 31640452      PMCID: PMC6944764          DOI: 10.1080/09286586.2019.1679192

Source DB:  PubMed          Journal:  Ophthalmic Epidemiol        ISSN: 0928-6586            Impact factor:   1.648


  99 in total

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2.  Distance vergence adaptation is abnormal in subjects with convergence insufficiency.

Authors:  R L Brautaset; J A M Jennings
Journal:  Ophthalmic Physiol Opt       Date:  2005-05       Impact factor: 3.117

3.  Segregation of frontoparietal and cerebellar components within saccade and vergence networks using hierarchical independent component analysis of fMRI.

Authors:  Yelda Alkan; Bharat B Biswal; Paul A Taylor; Tara L Alvarez
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4.  Frequency limitations of the two-point central difference differentiation algorithm.

Authors:  A T Bahill; J S Kallman; J E Lieberman
Journal:  Biol Cybern       Date:  1982       Impact factor: 2.086

5.  Actual measurement of fixation disparity and its use in diagnosis and treatment.

Authors:  J E Sheedy
Journal:  J Am Optom Assoc       Date:  1980-12

6.  Long-term effectiveness of treatments for symptomatic convergence insufficiency in children.

Authors: 
Journal:  Optom Vis Sci       Date:  2009-09       Impact factor: 1.973

7.  Treatment of accommodative dysfunction in children: results from a randomized clinical trial.

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Journal:  Optom Vis Sci       Date:  2011-11       Impact factor: 1.973

8.  Measuring ADHD behaviors in children with symptomatic accommodative dysfunction or convergence insufficiency: a preliminary study.

Authors:  Eric Borsting; Michael Rouse; Ray Chu
Journal:  Optometry       Date:  2005-10

9.  Objective Assessment of Vergence after Treatment of Concussion-Related CI: A Pilot Study.

Authors:  Mitchell M Scheiman; Henry Talasan; G Lynn Mitchell; Tara L Alvarez
Journal:  Optom Vis Sci       Date:  2017-01       Impact factor: 1.973

10.  Convergence Insufficiency, Accommodative Insufficiency, Visual Symptoms, and Astigmatism in Tohono O'odham Students.

Authors:  Amy L Davis; Erin M Harvey; J Daniel Twelker; Joseph M Miller; Tina Leonard-Green; Irene Campus
Journal:  J Ophthalmol       Date:  2016-07-20       Impact factor: 1.909

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2.  Disparity vergence differences between typically occurring and concussion-related convergence insufficiency pediatric patients.

Authors:  Tara L Alvarez; Chang Yaramothu; Mitchell Scheiman; Arlene Goodman; Susan A Cotter; Kristine Huang; Angela M Chen; Matthew Grady; Anne E Mozel; Olivia E Podolak; Chris G Koutures; Christina L Master
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3.  Convergence Insufficiency Neuro-mechanism in Adult Population Study Randomized Clinical Trial: Clinical Outcome Results.

Authors:  Tara L Alvarez; Mitchell Scheiman; Elio M Santos; Chang Yaramothu; John Vito d'Antonio-Bertagnolli
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4.  Underlying neurological mechanisms associated with symptomatic convergence insufficiency.

Authors:  Tara L Alvarez; Mitchell Scheiman; Cristian Morales; Suril Gohel; Ayushi Sangoi; Elio M Santos; Chang Yaramothu; John Vito d'Antonio-Bertagnolli; Xiaobo Li; Bharat B Biswal
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5.  Test-retest of a phoria adaptation stimulus-induced functional MRI experiment.

Authors:  Cristian Morales; Suril Gohel; Mitchell Scheiman; Xiaobo Li; Elio M Santos; Ayushi Sangoi; Tara L Alvarez
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  5 in total

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