Background:To date,compliance to atropine penalization in amblyopic children has only been assessed through self-report.The goal of this pilot study is to measure compliance to atropine penalization objectively.Method...Background:To date,compliance to atropine penalization in amblyopic children has only been assessed through self-report.The goal of this pilot study is to measure compliance to atropine penalization objectively.Methods:Seven amblyopic children(3-8 years;20/40-20/125 in the amblyopic eye) were enrolled.None had been treated with atropine previously.Children were prescribed either a twice per week or daily atropine regimen by their physicians.Compliance was defined as the percentage of days in which the atropine eye drop was taken compared to the number of doses prescribed.We used medication event monitoring system(MEMS) caps to objectively measure compliance.The MEMS caps are designed to electronically record the time and date when the bottle is opened.The parents of the children were provided a calendar log to subjectively report compliance.Participants were scheduled for return visits at 4 and 12 weeks.Weekly compliance was analyzed.Results:At 4 weeks,objective compliance averaged 88%(range,57-100%),while subjective compliance was 98%(range,90-100%).The actual dose in grams and visual acuity(VA) response relationship(r=0.79,P=0.03) was significantly better than the relationship between regimen and response(r=0.41,P>0.05),or the relationship between actual dose in drops and response(r=0.52,P>0.05).Conclusions:Objective compliance to atropine penalization instructions can be monitored with MEMS,which may facilitate our understanding of the dose-response relationship.Objective compliance with atropine penalization decreases over time and varies with regimen.On average,subjective parental reporting of compliance is overestimated.展开更多
Vergence eye movements are the inward and outward rotation of the eyes responsible for binocular coordination.While studies have mapped and investigated the neural substrates of vergence,it is not well understood whet...Vergence eye movements are the inward and outward rotation of the eyes responsible for binocular coordination.While studies have mapped and investigated the neural substrates of vergence,it is not well understood whether vergence eye movements evoke the blood oxygen level-dependent signal reliably in separate experimental visits.The test-retest reliability of stimulus-induced vergence eye movement tasks during a functional magnetic resonance imaging(fMRI)experiment is important for future randomized clinical trials(RCTs).In this study,we established region of interest(ROI)masks for the vergence neural circuit.Twenty-seven binocularly normal young adults participated in two functional imaging sessions measured on different days on the same 3 T Siemens scanner.The fMRI experiments used a block design of sustained visual fixation and rest blocks interleaved between task blocks that stimulated eight or four vergence eye movements.The test-retest reliability of task-activation was assessed using the intraclass correlation coefficient(ICC),and that of spatial extent was assessed using the Dice coefficient.Functional activation during the vergence eye movement task of eight movements compared to rest was repeatable within the primary visual cortex(ICC=0.8),parietal eye fields(ICC=0.6),supplementary eye field(ICC=0.5),frontal eye fields(ICC=0.5),and oculomotor vermis(ICC=0.6).The results demonstrate significant test-retest reliability in the ROIs of the vergence neural substrates for functional activation magnitude and spatial extent using the stimulus protocol of a task block stimulating eight vergence eye movements compared to sustained fixation.These ROIs can be used in future longitudinal RCTs to study patient populations with vergence dysfunctions.展开更多
基金supported by a pilot grant from Indiana Clinical and Translational Sciences Institute Project Development Teams(PDT) to J Wanga Research to Prevent Blindness(RPB) unrestricted grant to the Glick Eye Institute at Indiana University
文摘Background:To date,compliance to atropine penalization in amblyopic children has only been assessed through self-report.The goal of this pilot study is to measure compliance to atropine penalization objectively.Methods:Seven amblyopic children(3-8 years;20/40-20/125 in the amblyopic eye) were enrolled.None had been treated with atropine previously.Children were prescribed either a twice per week or daily atropine regimen by their physicians.Compliance was defined as the percentage of days in which the atropine eye drop was taken compared to the number of doses prescribed.We used medication event monitoring system(MEMS) caps to objectively measure compliance.The MEMS caps are designed to electronically record the time and date when the bottle is opened.The parents of the children were provided a calendar log to subjectively report compliance.Participants were scheduled for return visits at 4 and 12 weeks.Weekly compliance was analyzed.Results:At 4 weeks,objective compliance averaged 88%(range,57-100%),while subjective compliance was 98%(range,90-100%).The actual dose in grams and visual acuity(VA) response relationship(r=0.79,P=0.03) was significantly better than the relationship between regimen and response(r=0.41,P>0.05),or the relationship between actual dose in drops and response(r=0.52,P>0.05).Conclusions:Objective compliance to atropine penalization instructions can be monitored with MEMS,which may facilitate our understanding of the dose-response relationship.Objective compliance with atropine penalization decreases over time and varies with regimen.On average,subjective parental reporting of compliance is overestimated.
基金supported by the National Eye Institute of the National Institutes of Health,Department of Health and Human Services,Bethesda,MD,USA(NEI ROIEY023261 to TLA)。
文摘Vergence eye movements are the inward and outward rotation of the eyes responsible for binocular coordination.While studies have mapped and investigated the neural substrates of vergence,it is not well understood whether vergence eye movements evoke the blood oxygen level-dependent signal reliably in separate experimental visits.The test-retest reliability of stimulus-induced vergence eye movement tasks during a functional magnetic resonance imaging(fMRI)experiment is important for future randomized clinical trials(RCTs).In this study,we established region of interest(ROI)masks for the vergence neural circuit.Twenty-seven binocularly normal young adults participated in two functional imaging sessions measured on different days on the same 3 T Siemens scanner.The fMRI experiments used a block design of sustained visual fixation and rest blocks interleaved between task blocks that stimulated eight or four vergence eye movements.The test-retest reliability of task-activation was assessed using the intraclass correlation coefficient(ICC),and that of spatial extent was assessed using the Dice coefficient.Functional activation during the vergence eye movement task of eight movements compared to rest was repeatable within the primary visual cortex(ICC=0.8),parietal eye fields(ICC=0.6),supplementary eye field(ICC=0.5),frontal eye fields(ICC=0.5),and oculomotor vermis(ICC=0.6).The results demonstrate significant test-retest reliability in the ROIs of the vergence neural substrates for functional activation magnitude and spatial extent using the stimulus protocol of a task block stimulating eight vergence eye movements compared to sustained fixation.These ROIs can be used in future longitudinal RCTs to study patient populations with vergence dysfunctions.
