Journal of Korean Ophthalmic Optics Society (한국안광학회지)

The Korean Ophthalmic Optics Society (한국안광학회)
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One Year Follow-up for Successfully Treated Children with Accommodative Dysfunction

조절이상이 성공적으로 치료된 어린이에 대한 1년 후의 추적검사

  • Shin, Hoy Sun (Department of Ophthalmic Optics, Kaya University) ;
  • Youk, Do Jin (Department of Ophthalmic Optics, Daegu Polytechnic College) ;
  • Sung, Duk Yong (Department of Ophthalmic Optics, Daegu Polytechnic College) ;
  • Park, Sang Chul (Department of Ophthalmic Optics, Busan College of Information Technology) ;
  • Lee, Sun Haeng (Department of Ophthalmic Optics, Gimhae College)
  • 신효순 (가야대학교 안경광학과) ;
  • 육도진 (대구산업정보대학 안경광학과) ;
  • 성덕용 (대구산업정보대학 안경광학과) ;
  • 박상철 (부산정보대학 안경광학과) ;
  • 이선행 (김해대학 안경광학과)
  • Received : 2010.02.01
  • Accepted : 2010.06.19
  • Published : 2010.06.30
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Abstract

Purpose: The purpose of this study is to evaluate the long-term stability of the improved symptoms and accommodative functions after completion of accommodative therapy. Methods: Seven children (mean age${\pm}$SD: $12{\pm}1.41$ years) who were successfully treated with a vision therapy program for either accommodative insufficiency or infacility were followed for 1 year. The visual symptoms of the subjects were measured by the College of Optometrists in Vision Development Quality of Life (COVD-QOL) checklist, and this was followed by measurement of the monocular and binocular accommodative facility with ${\pm}2.00$ D flipper lens. Results: The mean visual symptoms at the 1 year follow-up examination ($15.14{\pm}8.59$) showed a small increase, but there was no significant difference (p=0.446) from post-therapy ($11.86{\pm}7.22$). There was small regression in the monocular (left eye, $13.86{\pm}3.93cpm$) and binocular ($11.14{\pm}3.13cpm$) accommodative facility at the 1 year follow-up examination, but there were no significant different from the monocular ($15.86{\pm}4.14cpm$, p=0.147) and binocular ($13.21{\pm}3.76cpm$, p=0.066) accommodative facility measurements at post-therapy. Also, every subject met the normative values of ${\geq}7$ cpm for monocular accommodative facility and ${\geq}5$ cpm for binocular accommodative facility in the long-term. Conclusions: There was long-term maintenance of the improved visual symptoms and accommodative functions, and so it is clear that the positive therapeutic effects persist with accommodative therapy.

목적: 조절이상에 대한 치료가 완료된 어린이에 대해 장기간의 추적 관찰을 함으로써 치료직후에 향상된 눈증상과 조절기능이 지속되는지의 여부를 확인하고자 하였다. 방법: 조절부족이나 조절난이가 있는 조절이상자에 대해 12주 동안 비전세라피 프로그램을 실시한 결과 치료가 성공적으로 이루어진 남여 7명(평균 나이 ${\pm}SD$, $12{\pm}1.41$세)을 대상으로 1년이 경과한 후에 설문지를 사용하여 눈증상을 평가한 후 ${\pm}2.00$ D 플리퍼 렌즈로 단안 및 양안의 조절 용이를 측정하였다. 결과: 치료 프로그램이 완료되고 1년이 경과한 다음 College of Optometrists in Vision Development Quality of Life(COVD-QOL)로 평가한 평균 눈증상은 $15.14{\pm}8.53$점으로 치료 직후의 $11.86{\pm}7.60$점 보다 작은 증가를 보였으나 유의하지 않았다(p=0.176). 그리고 단안(왼쪽 눈) 및 양안의 평균 조절용이 측정값도 각각 $13.86{\pm}3.93cpm$과 $11.14{\pm}3.13cpm$ 으로 치료 직후의 $15.86{\pm}4.14cpm$(p=0.147)과 $13.21{\pm}3.76cpm$(p=0.066)보다 작게 감소하였으나 유의하지는 않았으며, 대상자 모두에서 단안 및 양안 조절용이의 정상값인 7 cpm 이상과 5 cpm 이상을 각각 만족하였다. 결론: 장기간의 추적검사를 통해 치료 프로그램 직후에 향상된 눈증상과 조절기능이 여전히 지속되는 것을 볼 수 있었고, 따라서 조절이상에 대한 비전세라피의 치료효과가 장기적임을 확인하였다.

Keywords

References

  1. 손성은, "조절 부족과 조절 용이성 환자의 임상 사례", 대한시과학회지 , 2(2): 169-175(2000).
  2. 신효순, 박상철, 박천만, "눈의 조절부족이 있는 어린이를 대상으로한시치료의 효과",한국모자보건학회지, 14(1): 48-56(2010).
  3. Cooper J., Feldman J., Selenow A., Fair R., Buccerio F., MacDonald D., and Levy M., "Reduction of asthenopia after accommodative facility training", Am. J. Optom. Physiol. Opt., 64(6):430-436(1987). https://doi.org/10.1097/00006324-198706000-00008
  4. Daum K. M., "Accommodative dysfunction", Doc. Ophthalmol., 55(3):177-198(1983). https://doi.org/10.1007/BF00140808
  5. Duckman R. H., "Accommodation in cerebral palsy: Function and remediation", J. Am. Optom. Assoc., 55(4):281-283(1984).
  6. Hoffman L., Cohen A. H., and Feuer G., "Effectiveness of non-strabismic optometric vision training in a private practice", Am. J. Optom. & Arch. Am. Acad. Optom., 50(10):813-816(1973). https://doi.org/10.1097/00006324-197310000-00008
  7. Cited in Rouse M. W., "Management of binocular anomalies: Efficacy of vision therapy in the treatment of accommodative deficiencies", Am. J. Optom. Physiol. Opt., 64(6):415-420(1987). https://doi.org/10.1097/00006324-198706000-00006
  8. Wold R. M., Pierce J. R., and Keddington J., "Effectiveness of optometric vision therapy", J. Am. Optom. Assoc., 49(9):1047-1054(1978).
  9. 박현주, "조절용이성부족의 임상사례", 한국안광학회 추계학술대회 논문집, pp. 60-62(2007).
  10. 신효순, "증상올 호소하는 조절난이 어린이를 대상으로 한 비전세라피의 효과", 한국안광학회지, 14(3):75-81(2009).
  11. Bobier W. R., and Sivak J. G.,, "Orthoptic treatment of subjects showing slow accommodative responses", Am. J. Optom. Physiol. Opt., 60(8):678-687(1983). https://doi.org/10.1097/00006324-198308000-00006
  12. Liu J. S., Lee M., Jang J., Ciuffreda K. J., Wong J. H., Grisham D., and Stark L., "Objective assessment of accommodation orthoptics. I. Dynamic insufficiency", Am. J. Optom. Physiol. Opt., 56(5):285-294(1979). https://doi.org/10.1097/00006324-197905000-00002
  13. Ciuffreda K. J., "The scientific basis for and efficacy of optometric vision therapy in nonstrabismic accommodative and vergence disorders", Optometry, 73(12):735-762(2002).
  14. Sterner B., Abrahamsson M., and Sjstrm A., "The effects of accommodative facility training on a group of children with impaired relative accommodation: A comparison between dioptric treatment and sham treatment", Ophthal. Physiol. Opt. 21(6):470-476(2002).
  15. Hung G. K., Ciuffreda K. J., and Semmlow J. L., "Static vergence and accommodation: Population norms and orthoptics effect", Doc. Ophthalmol., 62(2):165-179(1986). https://doi.org/10.1007/BF00229128
  16. Sterner B., Gellerstedt M., and Sjstrm A., "Accommodative facility training with a long term follow up in a sample of school aged children showing accommodative dysfunction", Doc. Ophthalmol., 99(1):93-101(1999). https://doi.org/10.1023/A:1002623107251
  17. Harris P., and Gormley L., "Changes in scores on the COVD quality of life assesment before and after vision therapy", J. Behav. Optom., 18(2):43-47(2007).
  18. Maples W. C., and Bither M., "Efficacy of vision therapy as assessed by the COVD Quality of Life checklist", Optometry, 73(8):492-497(2002).
  19. Maples W. C., "Test-retest reliability of the college of optometrists in vision development quality of life out¬comes assessment", Optometry, 71(9):579-584(2000).
  20. Scheiman M., and Wick B., "Clinical management of binocular vision: Heterophoric, accommodative and eye movement disorders", 2nd Ed., Lippincott Williams and Wilkins, Philadelphia, USA, pp. 19-24(2002).
  21. Rouse M. W., "Management of binocular anomalies: Efficacy of vision therapy in the treatment of accommodative deficiencies", Am. J. Optom. Physiol. Opt., 64(6):415-420(1987). https://doi.org/10.1097/00006324-198706000-00006