한국안광학회지 (Journal of Korean Ophthalmic Optics Society)

한국안광학회 (The Korean Ophthalmic Optics Society)
권호 표지
DOI QR코드

DOI QR Code

Vision Therapy 프로그램의 양안시기능 개선 효과에 대한 메타분석

Binocular Visual Functions Effect of Vision Therapy Programs : A Meta-Analysis

  • 이정윤 (선린대학교 안경광학과) ;
  • 박천만 (계명대학교 대학원 공중보건학과)
  • Lee, Jeong-Yun (Dept. of Optometry, Sunlin College University) ;
  • Park, Chun Man (Dept. of Public Health, Graduate school, Keimyung University)
  • 투고 : 2015.04.09
  • 심사 : 2015.05.28
  • 발행 : 2015.06.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

목적: Vision therapy 프로그램이 양안시기능 개선에 주는 효과를 통계적으로 종합하기 위하여 전체평균 효과크기, 종속변수별 평균 효과크기 그리고 대상특성과 처치특성에 따른 효과크기를 메타분석 기법을 이용하여 분석하고자 하였다. 방법: 자료의 분석을 위해 vision therapy 프로그램을 적용하고 그 효과를 분석한 국내 선행연구 14편을 선정하여 메타분석하였다. 결과: 전체평균 효과크기는 1.207로 높은 수준의 효과크기를 나타내었다. 양안시이상 유형별 하위영역의 평균 효과크기는 버전스 이상 그룹(2.989)이 가장 높았으며, 조절기능이상 그룹(0.868), 조절기능과 버전스 모두 이상이 있는 그룹(0.692) 순이었다. 대상특성에 따른 효과크기는 중복장애가 없는 양안시이상 그룹(2.509)을 대상으로 실시한 vision therapy가 가장 컸으며, 주당횟수별 평균 효과크기는 주당 7회의 처치 때 2.310으로 가장 큰 효과크기를 나타내었다. 그리고 처치기간에 따른 효과크기는 8주에서 2.019로 양안시기능 개선을 위한 vision therapy가 가장 효과적이었다. 결론: Vision therapy 효과에 대한 각각의 연구결과를 평균 효과크기로 변환하고 이를 객관화하는 방법을 통해 양안시기능 개선을 위한 치료가 효과적임을 증명할 수 있었다.

Purpose: In order to aggregate effect of the improvement of binocular vision function by vision therapy, total mean effect size, mean effect size by dependent variables, and effect size by characteristics of the subjects and characteristics of treatment were analyzed by meta-analysis. Methods: We analyzed data from 14 Korean National primary studies, which reported effects of vision therapy programs, using meta-analysis. Results: The effect size of total mean was 1.207, which showed high effect. The mean effect size according to the subcategory of the binocular dysfunctions was the highest for vergence dysfunctions group (2.989), followed by accommodative dysfunctions group (0.868) and group with both vergence dysfunctions and accommodative dysfunctions (0.692). The effect size according to the characteristics of the subjects was the highest in the vision therapy conducted in the binocular dysfunctions group (2.509) that had no other dysfunctions. The mean effect size according to the number of programs was the highest (2.310) for 7 times a week. Vision therapy for improving the binocular functions was the most effective (2.019) in 8 weeks later from vision therapy start. Conclusions: It can prove that the therapy for the improvement of binocular vision function is effective through that each result of the vision therapy effect is converted to mean effect size, and being objectifying the mean effect size.

키워드

참고문헌

  1. Ciuffreda KJ. The scientific basis for and efficacy of optometric vision therapy in nonstrabismic accommodative and vergence disorders. Optometry. 2002;73(12):735-762.
  2. Sterner B, Abrahamsson M, 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. Ophthalmic Physiol Opt. 2001;21(6):470-476. https://doi.org/10.1046/j.1475-1313.2001.00615.x
  3. Daum KM. Accommodative dysfunction. Documenta Ophthalmologica. 1983;55(3):177-198. https://doi.org/10.1007/BF00140808
  4. Russell GE, Wick B. A prospective study of treatment of accommodative insufficiency. Optom Vis Sci. 1993;70(2):131-135. https://doi.org/10.1097/00006324-199302000-00009
  5. Atzmon D, Nemet P, Ishay A, Karni E. A randomized prospective masked and matched comparative study of orthoptic treatment versus conventional reading tutoring treatment for reading disability in 62 children. Bin Vis Eye Muscle Surg Q. 1993;8(2):91-106.
  6. Sterner B, Abrahamsson M, 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. Ophthalmic Physiol Opt. 2001;21(6):470-476. https://doi.org/10.1046/j.1475-1313.2001.00615.x
  7. Convergence Insufficiency Treatment Trial Study Group. A Randomized clinical trial of treatments for symptomatic convergence insufficiency in children. Arch Ophthalmol. 2008;126(10):1336-1349. https://doi.org/10.1001/archopht.126.10.1336
  8. Scheiman M, Mitchell GL, Cotter S, Cooper J, Kulp M, Rouse M et al. A randomized clinical trial of treatments for convergence insufficiency in children. Arch Ophthalmol. 2005;123(1):14-24. https://doi.org/10.1001/archopht.123.1.14
  9. Harris P. Learning related visual problems in Baltimore city: a long-term program. J Optom Vis Develop. 2002;33:75-115.
  10. Lee SH. The effects of vision therapy on elementary school children with ADHD and binocular dysfunctions. PhD Thesis. Keimyung University, Daegu. 2012;7-63.
  11. Shin HS. The effectiveness of vision therapy for general binocular dysfunctions in primary school children. PhD Thesis. Keimyung University, Daegu. 2009;32-77.
  12. Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Introduction to meta-analysis. West Sussex: John Wiley and Sons. 2009;70-354.
  13. Cooper H. Research Synthesis and Meta-analysis: A Stepby-Step Approach, 4th Ed. Beverly Hills: Sage, 2010;22-252.
  14. Park EY, Shin IS. The effects of transitional education programs on adaptive behavior in students with developmental disabilities; a meta analysis. Dis Employ. 2011;21(2):59-78. https://doi.org/10.15707/disem.2011.21.2.003
  15. Cohen J. Statistical power analysis for the behavioral sciences, 2nd Ed. New York: Academic Press, 1988;125-265.
  16. Hedges LV, Olkin I. Statistical methods for meta-analysis, 1st. San Diego: Academic, 1985;45-175.
  17. Morris SB, Deshon RP. Combining effect size estimates in meta-analysis with repeated measures and independentgroups designs. Psychol Med. 2002;7(1):105-125.
  18. Cochran W. The combination of estimates from different experiments. Biometrics. 1954;10(1):101-129. https://doi.org/10.2307/3001666
  19. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. Br Med J. 2003;327(7414):557-560. https://doi.org/10.1136/bmj.327.7414.557
  20. Jang JU, Kim IS. The study on effects of after vision training for elementary school children in Muan. J Korean Ophthamic Opt Soc. 2013;18(2):137-142. https://doi.org/10.14479/jkoos.2013.18.2.137
  21. Bae EY. A study on the conditions of school children before and after vision training. MA Thesis. Chodang University, Muan. 2012;9-18.
  22. Kim YG. Research on the effect of vision training by using fresnel prism lens. MA Thesis. Konyang University, Daejeon. 2012;24-36.
  23. Lee CS, Kim JK, Shin JH, Kim DN, Lee HM, Kim KH. The change in binocular function and sensory anomaly after vision training on intermittent exotropia and recurrent intermittent exotropia patients after surgical correction. J Korean Ophthalmic Opt Soc. 2011;16(3):345-350.
  24. Cooper J, Feldman J, Selenow A, Fair R, Buccerio F, Mac-Donald D et al. Reduction of asthenopia after accommodative facility training. Am J Optom Physiol Opt. 1987;64(6): 430-436. https://doi.org/10.1097/00006324-198706000-00008
  25. Helveston EM. Visual training: current status in ophthalmology. Am J Ophthalmol. 2005;140(5):903-910. https://doi.org/10.1016/j.ajo.2005.06.003
  26. Lee CS, Son JS, Kim IS, Sung DY, Kim KH. A study for phoria and positive fusion reverse on vision training of convergence insufficiency. J Korean Ophthalmic Opt Soc. 2008;13(1):83-87.
  27. Alvarez TL, Vicci VR, Alkan Y, Kim EH, Gohel S, Barrett AM et al. Vision therapy in adults with convergence insufficiency: Clinical and functional magnetic resonance imaging measures. Optom Vis Sci. 2010;87(12):985-1002. https://doi.org/10.1097/OPX.0b013e3181fef1aa
  28. Brautaset RL, Jennings AJM. Effects of orthoptic treatment on the CA/C and AC/A ratios in convergence insufficiency. Invest Ophthalmol Vis Sci. 2006;47(7):2876-2880. https://doi.org/10.1167/iovs.04-1372
  29. Choi SM, Lee SW. Case study of convergence insufficiency in vision training. Korean J Vis Sci. 2007;9(4):451-458.
  30. Shin HS, Park SC, Park CM. The effectiveness of vision therapy for accommodative insufficiency in children. J Korean Soc Matern Child Health. 2010;14(1):48-56.
  31. Scheiman M, Wick B. Clinical management of binocular vision: heterophoric, accommodative and eye movement disorders. Philadelphia: Lippincott Williams and Wilkins. 2008;75-420.
  32. Mazow ML, France TD, Finkleman S, Frank J, Jenkins P. Acute accommodative and convergence insufficiency. Trans Am Ophthalmol Soc. 1989;87:158-173.
  33. Sterner B, Gellerstedt M, Sjstrm A. Accommodation and the relationship to subjective symptoms with near work for young school children. Ophthalmic Physiol Opt. 2006;26(2):148-155. https://doi.org/10.1111/j.1475-1313.2006.00364.x
  34. Bergqvist UO, Knave BG. Eye discomfort and work with visual display terminals. Scand J Work Environ Health. 1994;20(1):27-33. https://doi.org/10.5271/sjweh.1432
  35. Daum KM. Negative vergence training in humans. Am J Optom Physiol Opt. 1986;63(7):487-496. https://doi.org/10.1097/00006324-198607000-00001
  36. Grisham JD. Visual therapy results for convergence insufficiency: a literature review. Am J Optom Physiol Opt. 1988;65(6):448-454. https://doi.org/10.1097/00006324-198806000-00004
  37. Hong SL. A meta-analysis on the effect of art therapy programs for elementary school students. MA Thesis. Korea National University of Educational, Chung-Buk. 2010;54-84.
  38. Yeon MH, Kang GY. School counseling, Seoul: Yangseowon, 2002;120-325.