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KMID : 1159320180200010059
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Korean Journal of Vision Science
2018 Volume.20 No. 1 p.59 ~ p.67
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The Analysis of Convergence Insufficiency using the CISS Questionnaire in Those Non-strabismic Horizontal Misalignment
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Kim Jin-Yeong
Lee Koon-Ja
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Abstract
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Subjects: To analyze the correlation between the degree of distance and near phoria and convergence insufficiency using the CISS (convergence insufficiency symptom survey) questionnaire in those with non-strabismic horizontal misalignment.
Methods: A total of 94 college students (36 males and 58 females, mean age: 22.56 ± 3.72 years) in Gimhae, Gyeongnam province were enrolled. The refractive error of the subject was spherical power below ± 6.00 D and cylinder power below ± 2.00 D. Those with systemic and ocular diseases and more than 2 D difference between the two eyes were excluded from this study. Associated phoria and dissociated phoria tests were performed using the Maddox rod and the Wesson fixation disparity card, respectively. According to the results of the CISS questionnaire, the subjects were divided into two groups as being symptomatic and asymptomatic. Statistical analysis was performed using SPSS 22.0, A Mann-Whitney U test was applied to compare the mean values according to the degree of phoria between CISS symptomatic and asymptomatic group. The sensitivity, specificity and AUC (area under an ROC curve) of the phoria tests are compared using statistical program Medcalc version 17.5.5 (Medcalc Software, Mariakerke), and the significance level was p<0.05.
Results: In the distance exophoria group (n=62), the number of CI (convergence insufficiency) symptomatic group was 36 (43.4%) and CI asymptomatic group was 26 (31.3%) and in the distance esophoria group (n=21) CI symptomatic group was 12 (14.5%), and CI asymptomatic group was 9 (10.8%). There was no significant difference between CI symptomatic and asymptomatic group in the associated phoria group at distance (χ2 =0.131, p=0.937). In the near exophoria group (n=64) CI symptomatic and asymptomatic groups were 37 (39.4%) and 27 (28.7%), respectively, and in the near esophoria group (n=18), CI symptomatic and asymptomatic groups were 12 (12.8%) 6 (6.4%), respectively. There was no significant difference between CI symptomatic and CI asymptomatic groups according to the associated phoria at near (χ2 =0.424, p=0.809). In exo-deviation group(n=61), thirty-six (38.3%) were CI symptomatic and twenty-five (26.6%) were CI asymptomatic, p and in the eso-deviation group (n=10), six (10.7%) were CI symptomatic and four (10.5%) were CI asymptomatic. There was no significant difference between CI symptomatic and asymptomatic groups in the dissociated phoria test (χ2 =2.474, p=0.290). In the associated phoria test, the ROC curve showed a sensitivity, specificity and AUC of 41.3% and 75.2%, 0.524 at distance and 69.7%, 53.1% and 0.560 at near, respectively. In the dissociated phoria test, the ROC curve showed a sensitivity of 87.2% and a specificity of 2.4% and AUC of 0.541, showing that there was no significant difference among phoria tests.
Conclusions: There was no significant difference in the ratio of the CI symptomatic and asymptomatic groups using the CISS questionnaire according to the associated phoria tests at distance and near. There was no correlation between the fixation disparity and CI symptomatic and asymptomatic groups.
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KEYWORD
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Associated phoria, Dissociated phoria, Convergence insufficiency, CISS, ROC curve
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