Relationships among Clinical Factors and Patient-reported Outcome Measures in Adults with Convergence Insufficiency

Ingryd J. Lorenzana; David A. Leske; Sarah R. Hatt; Trevano W. Dean; Erin C. Jenewein; Linda R. Dagi; Casey J. Beal; Yi Pang; Dashaini V. Retnasothie; Christina A. Esposito; S. A. Erzurum; Amy E. Aldrich; Eric R. Crouch; Zhuokai Li; Raymond T. Kraker; Jonathan M. Holmes; Susan A. Cotter; Ingryd J. Lorenzana; Angelyque L. Lorenzana; Silvia Han; Catherine L. Heyman; Reena A. Patel; Dashaini V. Retnasothie; Sue M. Parker; Yi Pang; Huizi Yin; Elyse Nylin; Marie I. Bodack; Karen A. Kehbein; Randy C. Brafford; Erin C. Jenewein; Ruth Y. Shoge; Karen E. Pollack; Yin C. Tea; Cristina L. Law; Julie A. Tyler; Felicia Jean Timmermann; Ida X. Chung; Chunming Liu; Kimberly R. Walker; Jennifer Baker; Darren L. Hoover; Pamela A. Huston; Jonathan M. Holmes; Suzanne M. Wernimont; Christina A. Esposito; Alicia E. Feis; Tracy A. Bland; Paula A. Handford; Caitlin C. Miller; S. Ayse Erzurum; Alysa Christiansen; Amy E. Aldrich; Lauri A. Atencio; Swati Agarwal-Sinha; Casey J. Beal; Shannon Hampton; Michael X. Repka; Xiaonong Liu; Courtney Kraus; Catherine S. Choi; Michael C. Dixon; Scott A. Larson; Xiaoyan Shan; Pavlina S. Kemp; Michael F. Gallaway; Debbie L. Killion; Donny W. Suh; Carolyn X. Chamberlain; David B. Petersen; Beth A. Morrell; Aaron M. Miller; Carole L. Gray; Eric Crouch; Earl R. Crouch; Gaylord G. Ventura; Tara H. Cronin; Andrew J. Levada; Susan H. Heaton; Lisa Bohra; Susan Nicole Perzyk

doi:10.1097/OPX.0000000000001929

Relationships among Clinical Factors and Patient-reported Outcome Measures in Adults with Convergence Insufficiency

Ingryd J. Lorenzana, David A. Leske, Sarah R. Hatt, Trevano W. Dean, Erin C. Jenewein, Linda R. Dagi, Casey J. Beal, Yi Pang, Dashaini V. Retnasothie, Christina A. Esposito, S. A. Erzurum, Amy E. Aldrich, Eric R. Crouch, Zhuokai Li, Raymond T. Kraker, Jonathan M. Holmes, Susan A. Cotter, Ingryd J. Lorenzana, Angelyque L. Lorenzana, Silvia HanCatherine L. Heyman, Reena A. Patel, Dashaini V. Retnasothie, Sue M. Parker, Yi Pang, Huizi Yin, Elyse Nylin, Marie I. Bodack, Karen A. Kehbein, Randy C. Brafford, Erin C. Jenewein, Ruth Y. Shoge, Karen E. Pollack, Yin C. Tea, Cristina L. Law, Julie A. Tyler, Felicia Jean Timmermann, Ida X. Chung, Chunming Liu, Kimberly R. Walker, Jennifer Baker, Darren L. Hoover, Pamela A. Huston, Jonathan M. Holmes, Suzanne M. Wernimont, Christina A. Esposito, Alicia E. Feis, Tracy A. Bland, Paula A. Handford, Caitlin C. Miller, S. Ayse Erzurum, Alysa Christiansen, Amy E. Aldrich, Lauri A. Atencio, Swati Agarwal-Sinha, Casey J. Beal, Shannon Hampton, Michael X. Repka, Xiaonong Liu, Courtney Kraus, Catherine S. Choi, Michael C. Dixon, Scott A. Larson, Xiaoyan Shan, Pavlina S. Kemp, Michael F. Gallaway, Debbie L. Killion, Donny W. Suh, Carolyn X. Chamberlain, David B. Petersen, Beth A. Morrell, Aaron M. Miller, Carole L. Gray, Eric Crouch, Earl R. Crouch, Gaylord G. Ventura, Tara H. Cronin, Andrew J. Levada, Susan H. Heaton, Lisa Bohra, Susan Nicole Perzyk

Research output: Contribution to journal › Article › peer-review

Abstract

SIGNIFICANCE When exploring relationships among clinical measures and patient-reported outcome measures in adults with convergence insufficiency, worse symptoms (Convergence Insufficiency Symptom Survey [CISS] score) seemed to be correlated with worse reading function domain score (Adult Strabismus-20 quality-of-life questionnaire). After treatment, improved symptoms were associated with improved reading function quality of life. PURPOSE This study aimed to explore relationships between clinical measures and patient-reported outcome measures in adults undergoing treatment for symptomatic convergence insufficiency. METHODS In a prospective multicenter observational study, we evaluated adults with symptomatic convergence insufficiency (i.e., clinical measures of near exodeviation, receded near point of convergence, reduced near positive fusional vergence; CISS score ≥21). Fifty-seven participants treated with vision therapy/exercises (n = 35) or base-in prism (n = 22) were analyzed. Spearman correlation coefficients (R) were used to assess associations among the three clinical measures and patient-reported outcome measures (CISS, Diplopia Questionnaire, four Adult Strabismus-20 quality-of-life domains) before treatment (baseline) and after 10 weeks and 1 year. Associations were interpreted to be present when the lower limit of the 95% confidence interval (CI) was moderate to strong (R ≥ 0.4). RESULTS Among multiple exploratory analyses, the only moderate to strong baseline correlation was between worse CISS and worse Adult Strabismus-20 reading function scores (R = 0.62; 95% CI, 0.43 to 0.76). Regarding change in measures with treatment, the only moderate to strong correlations were between improved CISS and improved Adult Strabismus-20 reading function scores for prism at 10 weeks (R = 0.78; 95% CI, 0.52 to 0.91) and 1 year (R = 0.85; 95% CI, 0.65 to 0.94) and for vision therapy/exercises at 1 year (R = 0.78; 95% CI, 0.57 to 0.89). CONCLUSIONS In exploratory analyses, we found positive correlations between CISS symptom scores and reading function quality-of-life scores. The absence of correlations between symptoms and individual clinical measures is consistent with clinical experience that, in convergence insufficiency, symptoms and clinical findings can be discordant.

Original language	English (US)
Pages (from-to)	692-701
Number of pages	10
Journal	Optometry and Vision Science
Volume	99
Issue number	9
DOIs	https://doi.org/10.1097/OPX.0000000000001929
State	Published - Sep 1 2022

ASJC Scopus subject areas

Ophthalmology
Optometry

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10.1097/OPX.0000000000001929

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Lorenzana, I. J., Leske, D. A., Hatt, S. R., Dean, T. W., Jenewein, E. C., Dagi, L. R., Beal, C. J., Pang, Y., Retnasothie, D. V., Esposito, C. A., Erzurum, S. A., Aldrich, A. E., Crouch, E. R., Li, Z., Kraker, R. T., Holmes, J. M., Cotter, S. A., Lorenzana, I. J., Lorenzana, A. L., ... Perzyk, S. N. (2022). Relationships among Clinical Factors and Patient-reported Outcome Measures in Adults with Convergence Insufficiency. Optometry and Vision Science, 99(9), 692-701. https://doi.org/10.1097/OPX.0000000000001929

Lorenzana, IJ, Leske, DA, Hatt, SR, Dean, TW, Jenewein, EC, Dagi, LR, Beal, CJ, Pang, Y, Retnasothie, DV, Esposito, CA, Erzurum, SA, Aldrich, AE, Crouch, ER, Li, Z, Kraker, RT, Holmes, JM, Cotter, SA, Lorenzana, IJ, Lorenzana, AL, Han, S, Heyman, CL, Patel, RA, Retnasothie, DV, Parker, SM, Pang, Y, Yin, H, Nylin, E, Bodack, MI, Kehbein, KA, Brafford, RC, Jenewein, EC, Shoge, RY, Pollack, KE, Tea, YC, Law, CL, Tyler, JA, Timmermann, FJ, Chung, IX, Liu, C, Walker, KR, Baker, J, Hoover, DL, Huston, PA, Holmes, JM, Wernimont, SM, Esposito, CA, Feis, AE, Bland, TA, Handford, PA, Miller, CC, Erzurum, SA, Christiansen, A, Aldrich, AE, Atencio, LA, Agarwal-Sinha, S, Beal, CJ, Hampton, S, Repka, MX, Liu, X, Kraus, C, Choi, CS, Dixon, MC, Larson, SA, Shan, X, Kemp, PS, Gallaway, MF, Killion, DL, Suh, DW, Chamberlain, CX, Petersen, DB, Morrell, BA, Miller, AM, Gray, CL, Crouch, E, Crouch, ER, Ventura, GG, Cronin, TH, Levada, AJ, Heaton, SH, Bohra, L & Perzyk, SN 2022, 'Relationships among Clinical Factors and Patient-reported Outcome Measures in Adults with Convergence Insufficiency', Optometry and Vision Science, vol. 99, no. 9, pp. 692-701. https://doi.org/10.1097/OPX.0000000000001929

@article{ed40e6e5f1724a7a84ca7f7b4a0537f6,

title = "Relationships among Clinical Factors and Patient-reported Outcome Measures in Adults with Convergence Insufficiency",

abstract = "SIGNIFICANCE When exploring relationships among clinical measures and patient-reported outcome measures in adults with convergence insufficiency, worse symptoms (Convergence Insufficiency Symptom Survey [CISS] score) seemed to be correlated with worse reading function domain score (Adult Strabismus-20 quality-of-life questionnaire). After treatment, improved symptoms were associated with improved reading function quality of life. PURPOSE This study aimed to explore relationships between clinical measures and patient-reported outcome measures in adults undergoing treatment for symptomatic convergence insufficiency. METHODS In a prospective multicenter observational study, we evaluated adults with symptomatic convergence insufficiency (i.e., clinical measures of near exodeviation, receded near point of convergence, reduced near positive fusional vergence; CISS score ≥21). Fifty-seven participants treated with vision therapy/exercises (n = 35) or base-in prism (n = 22) were analyzed. Spearman correlation coefficients (R) were used to assess associations among the three clinical measures and patient-reported outcome measures (CISS, Diplopia Questionnaire, four Adult Strabismus-20 quality-of-life domains) before treatment (baseline) and after 10 weeks and 1 year. Associations were interpreted to be present when the lower limit of the 95% confidence interval (CI) was moderate to strong (R ≥ 0.4). RESULTS Among multiple exploratory analyses, the only moderate to strong baseline correlation was between worse CISS and worse Adult Strabismus-20 reading function scores (R = 0.62; 95% CI, 0.43 to 0.76). Regarding change in measures with treatment, the only moderate to strong correlations were between improved CISS and improved Adult Strabismus-20 reading function scores for prism at 10 weeks (R = 0.78; 95% CI, 0.52 to 0.91) and 1 year (R = 0.85; 95% CI, 0.65 to 0.94) and for vision therapy/exercises at 1 year (R = 0.78; 95% CI, 0.57 to 0.89). CONCLUSIONS In exploratory analyses, we found positive correlations between CISS symptom scores and reading function quality-of-life scores. The absence of correlations between symptoms and individual clinical measures is consistent with clinical experience that, in convergence insufficiency, symptoms and clinical findings can be discordant.",

author = "Lorenzana, {Ingryd J.} and Leske, {David A.} and Hatt, {Sarah R.} and Dean, {Trevano W.} and Jenewein, {Erin C.} and Dagi, {Linda R.} and Beal, {Casey J.} and Yi Pang and Retnasothie, {Dashaini V.} and Esposito, {Christina A.} and Erzurum, {S. A.} and Aldrich, {Amy E.} and Crouch, {Eric R.} and Zhuokai Li and Kraker, {Raymond T.} and Holmes, {Jonathan M.} and Cotter, {Susan A.} and Lorenzana, {Ingryd J.} and Lorenzana, {Angelyque L.} and Silvia Han and Heyman, {Catherine L.} and Patel, {Reena A.} and Retnasothie, {Dashaini V.} and Parker, {Sue M.} and Yi Pang and Huizi Yin and Elyse Nylin and Bodack, {Marie I.} and Kehbein, {Karen A.} and Brafford, {Randy C.} and Jenewein, {Erin C.} and Shoge, {Ruth Y.} and Pollack, {Karen E.} and Tea, {Yin C.} and Law, {Cristina L.} and Tyler, {Julie A.} and Timmermann, {Felicia Jean} and Chung, {Ida X.} and Chunming Liu and Walker, {Kimberly R.} and Jennifer Baker and Hoover, {Darren L.} and Huston, {Pamela A.} and Holmes, {Jonathan M.} and Wernimont, {Suzanne M.} and Esposito, {Christina A.} and Feis, {Alicia E.} and Bland, {Tracy A.} and Handford, {Paula A.} and Miller, {Caitlin C.} and Erzurum, {S. Ayse} and Alysa Christiansen and Aldrich, {Amy E.} and Atencio, {Lauri A.} and Swati Agarwal-Sinha and Beal, {Casey J.} and Shannon Hampton and Repka, {Michael X.} and Xiaonong Liu and Courtney Kraus and Choi, {Catherine S.} and Dixon, {Michael C.} and Larson, {Scott A.} and Xiaoyan Shan and Kemp, {Pavlina S.} and Gallaway, {Michael F.} and Killion, {Debbie L.} and Suh, {Donny W.} and Chamberlain, {Carolyn X.} and Petersen, {David B.} and Morrell, {Beth A.} and Miller, {Aaron M.} and Gray, {Carole L.} and Eric Crouch and Crouch, {Earl R.} and Ventura, {Gaylord G.} and Cronin, {Tara H.} and Levada, {Andrew J.} and Heaton, {Susan H.} and Lisa Bohra and Perzyk, {Susan Nicole}",

note = "Publisher Copyright: {\textcopyright} Lippincott Williams & Wilkins.",

year = "2022",

month = sep,

day = "1",

doi = "10.1097/OPX.0000000000001929",

language = "English (US)",

volume = "99",

pages = "692--701",

journal = "Optometry and Vision Science",

issn = "1040-5488",

publisher = "Lippincott Williams and Wilkins",

number = "9",

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TY - JOUR

T1 - Relationships among Clinical Factors and Patient-reported Outcome Measures in Adults with Convergence Insufficiency

AU - Lorenzana, Ingryd J.

AU - Leske, David A.

AU - Hatt, Sarah R.

AU - Dean, Trevano W.

AU - Jenewein, Erin C.

AU - Dagi, Linda R.

AU - Beal, Casey J.

AU - Pang, Yi

AU - Retnasothie, Dashaini V.

AU - Esposito, Christina A.

AU - Erzurum, S. A.

AU - Aldrich, Amy E.

AU - Crouch, Eric R.

AU - Li, Zhuokai

AU - Kraker, Raymond T.

AU - Holmes, Jonathan M.

AU - Cotter, Susan A.

AU - Lorenzana, Ingryd J.

AU - Lorenzana, Angelyque L.

AU - Han, Silvia

AU - Heyman, Catherine L.

AU - Patel, Reena A.

AU - Retnasothie, Dashaini V.

AU - Parker, Sue M.

AU - Pang, Yi

AU - Yin, Huizi

AU - Nylin, Elyse

AU - Bodack, Marie I.

AU - Kehbein, Karen A.

AU - Brafford, Randy C.

AU - Jenewein, Erin C.

AU - Shoge, Ruth Y.

AU - Pollack, Karen E.

AU - Tea, Yin C.

AU - Law, Cristina L.

AU - Tyler, Julie A.

AU - Timmermann, Felicia Jean

AU - Chung, Ida X.

AU - Liu, Chunming

AU - Walker, Kimberly R.

AU - Baker, Jennifer

AU - Hoover, Darren L.

AU - Huston, Pamela A.

AU - Holmes, Jonathan M.

AU - Wernimont, Suzanne M.

AU - Esposito, Christina A.

AU - Feis, Alicia E.

AU - Bland, Tracy A.

AU - Handford, Paula A.

AU - Miller, Caitlin C.

AU - Erzurum, S. Ayse

AU - Christiansen, Alysa

AU - Aldrich, Amy E.

AU - Atencio, Lauri A.

AU - Agarwal-Sinha, Swati

AU - Beal, Casey J.

AU - Hampton, Shannon

AU - Repka, Michael X.

AU - Liu, Xiaonong

AU - Kraus, Courtney

AU - Choi, Catherine S.

AU - Dixon, Michael C.

AU - Larson, Scott A.

AU - Shan, Xiaoyan

AU - Kemp, Pavlina S.

AU - Gallaway, Michael F.

AU - Killion, Debbie L.

AU - Suh, Donny W.

AU - Chamberlain, Carolyn X.

AU - Petersen, David B.

AU - Morrell, Beth A.

AU - Miller, Aaron M.

AU - Gray, Carole L.

AU - Crouch, Eric

AU - Crouch, Earl R.

AU - Ventura, Gaylord G.

AU - Cronin, Tara H.

AU - Levada, Andrew J.

AU - Heaton, Susan H.

AU - Bohra, Lisa

AU - Perzyk, Susan Nicole

PY - 2022/9/1

Y1 - 2022/9/1

N2 - SIGNIFICANCE When exploring relationships among clinical measures and patient-reported outcome measures in adults with convergence insufficiency, worse symptoms (Convergence Insufficiency Symptom Survey [CISS] score) seemed to be correlated with worse reading function domain score (Adult Strabismus-20 quality-of-life questionnaire). After treatment, improved symptoms were associated with improved reading function quality of life. PURPOSE This study aimed to explore relationships between clinical measures and patient-reported outcome measures in adults undergoing treatment for symptomatic convergence insufficiency. METHODS In a prospective multicenter observational study, we evaluated adults with symptomatic convergence insufficiency (i.e., clinical measures of near exodeviation, receded near point of convergence, reduced near positive fusional vergence; CISS score ≥21). Fifty-seven participants treated with vision therapy/exercises (n = 35) or base-in prism (n = 22) were analyzed. Spearman correlation coefficients (R) were used to assess associations among the three clinical measures and patient-reported outcome measures (CISS, Diplopia Questionnaire, four Adult Strabismus-20 quality-of-life domains) before treatment (baseline) and after 10 weeks and 1 year. Associations were interpreted to be present when the lower limit of the 95% confidence interval (CI) was moderate to strong (R ≥ 0.4). RESULTS Among multiple exploratory analyses, the only moderate to strong baseline correlation was between worse CISS and worse Adult Strabismus-20 reading function scores (R = 0.62; 95% CI, 0.43 to 0.76). Regarding change in measures with treatment, the only moderate to strong correlations were between improved CISS and improved Adult Strabismus-20 reading function scores for prism at 10 weeks (R = 0.78; 95% CI, 0.52 to 0.91) and 1 year (R = 0.85; 95% CI, 0.65 to 0.94) and for vision therapy/exercises at 1 year (R = 0.78; 95% CI, 0.57 to 0.89). CONCLUSIONS In exploratory analyses, we found positive correlations between CISS symptom scores and reading function quality-of-life scores. The absence of correlations between symptoms and individual clinical measures is consistent with clinical experience that, in convergence insufficiency, symptoms and clinical findings can be discordant.

AB - SIGNIFICANCE When exploring relationships among clinical measures and patient-reported outcome measures in adults with convergence insufficiency, worse symptoms (Convergence Insufficiency Symptom Survey [CISS] score) seemed to be correlated with worse reading function domain score (Adult Strabismus-20 quality-of-life questionnaire). After treatment, improved symptoms were associated with improved reading function quality of life. PURPOSE This study aimed to explore relationships between clinical measures and patient-reported outcome measures in adults undergoing treatment for symptomatic convergence insufficiency. METHODS In a prospective multicenter observational study, we evaluated adults with symptomatic convergence insufficiency (i.e., clinical measures of near exodeviation, receded near point of convergence, reduced near positive fusional vergence; CISS score ≥21). Fifty-seven participants treated with vision therapy/exercises (n = 35) or base-in prism (n = 22) were analyzed. Spearman correlation coefficients (R) were used to assess associations among the three clinical measures and patient-reported outcome measures (CISS, Diplopia Questionnaire, four Adult Strabismus-20 quality-of-life domains) before treatment (baseline) and after 10 weeks and 1 year. Associations were interpreted to be present when the lower limit of the 95% confidence interval (CI) was moderate to strong (R ≥ 0.4). RESULTS Among multiple exploratory analyses, the only moderate to strong baseline correlation was between worse CISS and worse Adult Strabismus-20 reading function scores (R = 0.62; 95% CI, 0.43 to 0.76). Regarding change in measures with treatment, the only moderate to strong correlations were between improved CISS and improved Adult Strabismus-20 reading function scores for prism at 10 weeks (R = 0.78; 95% CI, 0.52 to 0.91) and 1 year (R = 0.85; 95% CI, 0.65 to 0.94) and for vision therapy/exercises at 1 year (R = 0.78; 95% CI, 0.57 to 0.89). CONCLUSIONS In exploratory analyses, we found positive correlations between CISS symptom scores and reading function quality-of-life scores. The absence of correlations between symptoms and individual clinical measures is consistent with clinical experience that, in convergence insufficiency, symptoms and clinical findings can be discordant.

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UR - http://www.scopus.com/inward/citedby.url?scp=85138125765&partnerID=8YFLogxK

U2 - 10.1097/OPX.0000000000001929

DO - 10.1097/OPX.0000000000001929

M3 - Article

C2 - 35914096

AN - SCOPUS:85138125765

SN - 1040-5488

VL - 99

SP - 692

EP - 701

JO - Optometry and Vision Science

JF - Optometry and Vision Science

IS - 9

ER -

Relationships among Clinical Factors and Patient-reported Outcome Measures in Adults with Convergence Insufficiency

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