Vision In Preschoolers - Hyperopia in Children (VIP-HIP)

学龄前儿童视力 - 儿童远视 (VIP-HIP)

• 批准号: 8265250
• 负责人: MARJEAN T KULP
• 金额: $ 73.37万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-06-01 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8265250
• 关键词: Amblyopia; Asthenopia; Attention; Behavior; Child; Clinical Practice Guideline; Development; Epidemiologic Studies; Evaluation; Glass; Goals; Guidelines; Headache; Hyperopia; Investigation; Link; Nursery Schools; Ophthalmic examination and evaluation; Outcome Measure; Parents; Performance; Policies; Preschool Child; Randomized Clinical Trials; Reading; Refractive Errors; Schools; Strabismus; Testing; Vision; Vision Screening; Visual Acuity; early childhood; improved; literacy; primary outcome; response

Our prior NEI multicenter Vision In Preschoolers (VIP) studies identified the most effective tests for preschool vision screening, and federal initiatives are currently underway to increase the number of preschool children receiving vision screening and eye examinations. Clinical practice guidelines for children detected with amblyopia or strabismus are clear, but no evidencebased management guidelines are available for managing the many more children detected who have moderate to large hyperopic refractive errors without amblyopia or strabismus. The requirement for accommodation in the uncorrected hyperope may result in eyestrain, headache, intermittent blur and difficulty attending at near, leading to subsequent reading and school performance problems. Several studies have linked hyperopia and reading ability, but largescale investigations have not been conducted in preschool children. Thus, the benefit of detecting children with moderate to large hyperopic refractive errors via vision screening and examining them for prescription of glasses is controversial. The proposed Vision In Preschoolers - Hyperopia In Preschoolers (VIP - HIP) cross- sectional multi-center epidemiological study will answer the following question: Do uncorrected hyperopic (e3D to <6D) 4 or 5yearold children without strabismus or amblyopia perform worse on a battery of educational tests than do comparable emmetropic children? The primary outcome measure will be performance on an assessment of literacy, the Test of Preschool Early Literacy (TOPEL). Results on literacy will be supplemented with results on assessments of attention (LeiterR sustained attention subtest), visualmotor integration (BeeryBuktenica Developmental Test of VisualMotor Integration, 5th Edition [BEERY" VMI]), and behavior and development as provided by parental assessment (Connors Early Childhood [Connors EC] and the Parents' Evaluation of Development Status [PEDS]). The relation between moderate hyperopia and early educational performance will be further investigated by 1) evaluating the association of hyperopia and visual function (visual acuity at distance and near, ocular alignment, stereoacuity), and 2) evaluating accommodative response as a mechanism responsible for any relations found between hyperopia and academic performance. The proposed VIPHIP study will have substantial impact on the understanding of any effects of uncorrected hyperopia on early educational performance and visual function. The results of the study will determine the need for and relevance of a fullscale randomized clinical trial (RCT) to determine whether refractive correction in preschool improves any deficit in performance on early educational tests. The results will also have implications for vision screening policy and prescribing guidelines for glasses.

我们之前的 NEI 多中心学龄前儿童视力 (VIP) 研究确定了 最有效的学前视力筛查测试和联邦举措是 目前正在增加接受视力的学龄前儿童的数量 筛查和眼科检查。儿童临床实践指南 检测出弱视或斜视是明确的，但没有证据依据 管理指南可用于管理更多的孩子 检测出患有中度至重度远视屈光不正的人 弱视或斜视。住宿要求 未经矫正的远视可能会导致眼睛疲劳、头痛、间歇性模糊和 就近上课困难，导致后续阅读和上学 性能问题。多项研究将远视与阅读联系起来 能力，但尚未在学前班进行大规模调查 孩子们。因此，检测患有中度至重度远视的儿童的好处 通过视力筛查和检查屈光不正的处方 眼镜是有争议的。 拟议的学龄前儿童视力 - 学龄前儿童远视 (VIP - HIP) 交叉 分段多中心流行病学研究将回答以下问题： 未矫正远视（e3D 至 <6D）4 岁或 5 岁儿童，无斜视或 弱视在一系列教育测试中的表现比同类弱视表现更差 正视儿童？主要结果指标将是绩效 读写能力评估，学前早期读写能力测试（TOPEL）。结果于 读写能力将得到注意力评估结果的补充（LeiterR 持续注意力子测试）、视觉运动整合（BeeryBuktenica Developmental VisualMotor 集成测试，第 5 版 [BEERY" VMI]）以及行为和 父母评估提供的发展（Connors Early Childhood [Connors EC]和家长对发育状况的评估[PEDS]）。 中度远视与早期教育表现之间的关系为 通过 1) 评估远视与视觉功能的关联进行进一步研究 （远视和近视敏锐度、眼位对准、立体视度），以及 2) 评估 适应性反应作为一种机制，负责发现之间的任何关系 远视和学习成绩。 拟议的 VIPHIP 研究将对任何人的理解产生重大影响 未矫正的远视对早期教育表现和视觉功能的影响。 研究结果将决定全面研究的必要性和相关性 随机临床试验（RCT）以确定学龄前屈光矫正是否有效 改善早期教育测试中的任何表现缺陷。结果也将 对视力筛查政策和眼镜处方指南产生影响。