One‐year follow‐up of clinical convergence measures in children enrolled in the Convergence Insufficiency Treatment Trial—Attention and Reading Trial

Abstract

AbstractPurposeTo assess the long‐term stability of clinical measures of convergence (near point of convergence [NPC] and positive fusional vergence [PFV]) in participants enrolled in the Convergence Insufficiency Treatment Trial‐Attention and Reading Trial (CITT‐ART) who received 16 weeks of office‐based vergence/accommodative therapy.MethodsA total of 310 children, 9–14 years old, with symptomatic convergence insufficiency were enrolled in CITT‐ART. Some 270 completed both their 16‐week primary outcome visit followed by a 1‐year follow‐up visit. Of those 270, 181 (67%) were randomised to the vergence/accommodative therapy. Of the 181 in the vergence/accommodative group, 121 (67%) reported not receiving any additional treatment after the 16‐week primary outcome visit. The mean change in NPC, PFV and percentages of children classified by the predetermined success criteria of convergence (normal NPC [<6 cm] and/or improved by ≥4 cm; normal PFV [passing Sheard's criterion and base‐out break >15Δ] and/or improved by ≥10Δ) were compared at the 16‐week primary outcome visit and 1 year later.ResultsOf the 121 who returned for their 1‐year follow‐up visit, there was no significant change in mean adjusted NPC (reduction of −0.2 cm; 95% CI: −1.0 to 0.5 cm) at 1 year. There was a statistically significant decrease in mean‐adjusted PFV (−4.7∆; 95% CI: −6.5 to −2.8Δ) at 1 year. There were similar percentages of participants classified as ‘normal’ (p = 0.30), ‘normal and/or improved’ (p > 0.50) and ‘normal and improved’ (p > 0.14) based on NPC and PFV at the 1‐year visit compared with the 16‐week primary outcome visit.ConclusionThe improvements in NPC and PFV following 16 weeks of vergence/accommodative therapy (with no reported additional treatment thereafter) in children with symptomatic convergence insufficiency persisted 1‐year post‐treatment.