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Purpose: To report retinal nerve fiber layer thickness (RNFLT) in eyes with amblyopia compared with contralateral healthy eyes. Methods: In this cross-sectional study, we included patients with anisometropic amblyopia, strabismic amblyopia, and mixed amblyopia. All subjects underwent complete ophthalmic examination, including RNFLT measurement with time-domain OCT (Stratus OCT) and scanning laser polarimeter (GDX VCC). A paired “t” test was used to compare average and quadrant-wise RNFL thickness between the amblyopic and contralateral normal eyes. In addition, an analysis of variance test was used to compare various RNFL thickness parameters between the three groups. Results: A total of 33 eyes of 33 subjects with anisometropic amblyopia, 20 eyes of 20 subjects with strabismic amblyopia, and 38 eyes of 38 subjects with mixed amblyopia were included. In the anisometropic amblyopia group, the average RNFLT in the amblyopic eye was 98.2 ?m and 99.8 ?m in the fellow normal eye (P = 0.5), the total foveal thickness was 152.82 ?m (26.78) in the anisometropic eye and 150.42 ?m (23.84) in the fellow eye (P = 0.38). The difference between amblyopic and contralateral normal eye for RNFL and macular parameters was statistically insignificant in all three groups. The RNFL thickness in four quadrants was similar in the amblyopic and non-amblyopic eye between all three groups and statistically non-significant. Conclusion: Our study showed that RNFL thickness was similar in amblyopic and non-amblyopic eyes between all three amblyopia groups
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Purpose: To study the efficacy of supplemental occlu?pad therapy with partial occlusion in children with refractive anisometropic amblyopia. Methods: Thirty?one children who did not improve after partial occlusion of 6 h for 6 months were supplemented with the use of occlu?pad for 1 h per day and three such sessions in a week. Results: The mean age was 6.8+/?1.4 years (range 5�years). A significant improvement of 3.2+/?1.3 lines in visual acuity was noticed at the end of 3 months of starting this supplemental therapy in children. Out of 31 children, 26 children improved at least 2 lines or more at the end of 3 months. All children (n = 9) having anisohyperopic amblyopia improved at the end of 3 months. Conclusion: Occlu?pad is useful in supplementing occlusion therapy in cases of refractive amblyopia and is more effective in anisohyperopic amblyopia
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Purpose: To compare the ocular higher order aberrations (HOAs) for the physiologic pupil size in amblyopic and non-amblyopic eyes of patients with anisometropic amblyopia in pediatric age group. Methods: Children between 5 and 15 years age having treatment naïve anisometropic amblyopia; after a detailed examination by a pediatric ophthalmologist; underwent assessment of wavefront aberrations for both amblyopic and non-amblyopic eyes at their physiologic pupil sizes using i-Trace ray tracing wavefront aberrometer. The axial lengths were also measured using IOL Master 500. The RMS values of the total ocular higher order aberrations (HOAs) and those arising from internal and corneal components of the two eyes were tabulated and compared to look for differences. Comparison of total ocular aberrations for pre-determined refractive error groups was also done for amblyopic and non-amblyopic eyes separately. Results: Eighty-eight eyes of 44 subjects were included for analysis. Mean pupil size was comparable in between amblyopic and non-amblyopic eyes (3.98 mm vs. 4.07 mm, P = 0.346). The mean axial lengths of the two eyes were comparable (amblyopic eyes 23.13 mm vs. non-amblyopic eyes 22.88 mm, P = 0.419). Significant differences in total HOAs and those arising from the internal optics (except spherical aberrations) of the eye were noted between the two eyes. There were no differences in the corneal HOAs. The total HOAs were comparable amongst the various refractive error groups for amblyopic and non-amblyopic eyes individually. Conclusion: There are significant differences in ocular HOAs between amblyopic and non-amblyopic eyes in children with anisometropic amblyopia.
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Objective@#To evaluate the effect of atropine penalization for treatment of moderate and severe anisometropic amblyopia.@*Methods@#Retrospective cohort study was performed.Eighty moderate and severe anisometropic amblyopia pediatric patients aged 4-7 years old were enrolled from December 2011 to November 2017 in Tianjin Eye Hospital and Beijing Children's Hospital.The subjects were divided into atropine penalization group and patching group according to the treatment, with 25 cases of moderate amblyopia and 15 cases of severe amblyopia in each group.The best corrected visual acuity (BCVA) of amblyopia in atropine penalization group and patching group before treatment, 2 months, 4 months, 6 months and 8 months after treatment were compared.The binocular visual function of each group was compared before and after treatment.The compliance and complications were also recorded.This study adhered to the Declaration of Helsinki, and was approved by the Ethics Committee of Tianjin Eye Hospital (2016-42) and Beijing Children's Hospital (2019-k-33).@*Results@#There were significant differences in BVCA between the two groups before and after treatment in cases with moderate amblyopia (Fgroup=3.104, P=0.032; Ftime=4.342, P=0.013); The BCVA of atropine penalization group was better than that of patching group at 2, 4, 6 and 8 months after treatment, the differences were statistically significant (all at P<0.05). There were significant differences in BCVA between the two groups before and after treatment in cases with severe amblyopia (Fgroup=3.149, P=0.016; Ftime=5.094, P=0.024); The BCVA of atropine penalization group was better than that of patching group at 2, 4, 6 and 8 months after treatment, the differences were statistically significant (all at P<0.05). The effective rates of stereopsis reconstruction in atropine penalization group were significantly higher than those in patching group in both moderate and severe amblyopia cases, and the differences were statistically significant (both at P<0.05). The compliance rate of moderate amblyopia in atropine penalization group was 96% (24/25), which was significantly higher than 76% (19/25) in patching group, the difference was statistically significant (χ2=4.153, P=0.042). The compliance rate of severe amblyopia in atropine penalization group was 100% (15/15), which was also significantly higher than 67% (10/15) in patching group, the difference was statistically significant (χ2=6.000, P=0.014). During the follow-up period, there were 4 cases with photophobia in the atropine penalization group.No adverse reaction was observed in the patching group.@*Conclusions@#Compared with patching, atropine penalization is an effective method in treatment of moderate and severe amblyopia, with the advantage in rapid improvement of visual acuity, stereopsis recovery and compliance of treatment.Atropine penalization is worthy for clinical application.
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@#AIM: To study the therapeutic effect of visual perception learning combined with occlusion on visual acuity and stereoscopic function in patients with anisometropic amblyopia, and to compare the differences in visual acuity and stereoscopic visual function enhancement.<p>METHODS: A total of 47 patients with monocular anisometropic amblyopia who were treated in our hospital from June 2016 to December 2017 were enrolled. The visual acuity learning system combined with occlusion for amblyopia treatment was used to observe the best corrected visual acuity of 47 patients before and after treatment, and the result of random point dynamic 2nd order rough stereoscopic view, random point dynamic 1st order stereoscopic view between fine and rough, random point static 0-order near, far fine stereoscopic view, and to compare the difference between visual acuity improvement and stereo vision improvement.<p>RESULTS: After treatment, the visual acuity improvement degree was significantly different from that of dynamic 2nd order rough stereoscopic vision of random points, dynamic 1st order fine stereoscopic vision of random points, static 0 order near and far fine stereoscopic vision of random points,and the degree of improvement is obviously inconsistent. The difference was statistically significant.<p>CONCLUSION: The degree of visual acuity in patients with anisometropic amblyopia is not synchronized with the improvement of stereopsis. The stereoscopic function of patients with basically curedvisual acuity is not basically normal. Therefore, the training and establishment of stereoscopic function in patients with anisometropic amblyopia should be concerned. The measurement of stereopsis may become a new classification method and treatment standard for amblyopia.
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PURPOSE: To compare the thickness of superior, temporal, inferior, and nasal macula and foveal thickness and volume in patients with anisometropic amblyopia prior to and after successful occlusion therapy using optical coherence tomography (OCT) measurement. METHODS: Data were collected prospectively on 30 patients with unilateral anisometropic amblyopia from December 2006 to August 2007. All patients had anisometropia of 2.0 diopters or more. OCT scans were obtained for all patients at diagnosis. Occlusion therapy was then prescribed and OCT scans were obtained again at the time of successful occlusion therapy (defined as interocular difference of 0.05). However, mean foveal volume prior to occlusion therapy (0.15 ± 0.02 mm3) decreased after occlusion (0.14 ± 0.01 mm3) with statistical significance (Wilcoxon signed rank test, p = 0.025). CONCLUSIONS: There was a meaningful decrease in foveal volume in patients with anisometropic amblyopia after successful occlusion therapy. Whether this decrease relates to visual improvement of the amblyopic eye remains to be determined.
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Humans , Amblyopia , Anisometropia , Diagnosis , Prospective Studies , Tomography, Optical Coherence , Visual AcuityABSTRACT
AIM: To evaluate the effect of stereoscopic 3D (S3D) technology as a visual training system in children with amblyopia. METHODS:Totally 30 children,aged 4-16 years old,18 with ametropic amblyopia ( AMA ), and 12 with anisometropic amblyopia(ANA) were recruited in this study. A binocular 3D shutter glasses technology visual training system was used for training trials. Each training time lasted 1h,and the number of training trials totaled 33 (mean士SD:32士8) times on average,per-person. Before and after each training trial, the best corrected visual acuity ( BCVA) of each eye, range of fusion by synoptophore, as well as near and distance stereopsis acuity by Yan Shaoming random - dot test and synoptophore respectively was measured. RESULTS: A significant difference was found pre- and post treatment in BCVA in both kinds of amblyopia studied. Significant improvement was also found in fusion range and stereopsis acuity. The improvement of fusion range and stereopsis recovery could be seen in ANA than in AMA patients. The near stereopsis acuity recovery in ANA group might more easily to regain stereoacuity at near than in AMA group. CONCLUSION: S3D display vision training systems are indicated for the recovery of stereoacuity in children with amblyopia.
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AIM: To observe the long - term effect of visual perceptual learning to correct anisometropic amblyopia in children.?METHODS: The clinical data of 200 children (200 eyes) with anisometropic amblyopia were retrospectively analyzed, which were divided into 2 groups according to therapeutic methods, and 82 children treated with traditional integrative therapy were distributed to the control group, while 118 children treated with visual perceptual learning were distributed to the observation group. After 1 year's treatment, the corrected vision, contrast sensitivity and stereo sharpness of patients were compared between groups.?RESULTS:After 1 year's treatment, the effective rate of the observation group was higher than the controls (90. 7％ vs 75. 6％, P<0. 05), and after 1 year's follow up, there was 92. 5％ patients maintained stabilization in the observation group, while that in the control group was 80. 6％, and the observation group was higher than the controls too, the difference between groups had statistical significance (P<0. 05). Before treatment, there was no significant difference in contrast sensitivity between groups (P>0. 05). After 6 and 12 months' treatment, the contrast sensitivity of both groups increased(P<0. 05), and the observation group was higher than the controls after 12 months' treatment, the difference between groups had statistical significance (P<0. 05). Before treatment, there was no significant difference in stereopsis acuity between groups ( P > 0. 05 ). After treatment, the stereopsis acuity of the observation group was better than the controls, and the difference between groups had statistical significance (P<0. 05).?CONCLUSION: The long-term curative effect of visual perception learning to correct children's refractive aberration is better than traditional comprehensive therapy.
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AIM: To investigate curative effects of excimer laser corneal refractive surgery for adults or older adolescent with hyperopic anisometropic amblyopia.METHODS: From March 2014 to March 2016, we selected 26 cases 26 eyes of adults or older adolescent with hyperopic anisometropic amblyopia in our hospital.All eyes underwent laser in situ keratomileusis, observed for the uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), diopter and stereopsis.RESULTS: At the end of the follow-up, the patient`s spherical equivalent and anisometropia were 1.47±0.51D and 1.15±0.22D, were significantly lower than that before operation (P<0.05).At the end of the follow-up, the distance and near UCVA and BCVA were 0.26±0.13 and 0.23±0.09, 0.42±0.09 and 0.31±0.16, which were significantly higher than those before operation (P<0.05).At the end of follow-up, the visual function of the patients was significantly improved (P<0.05), the rate of postoperative visual function < 100 eyes was 23%.CONCLUSION: In adult or older adolescent with hyperopic anisometropic amblyopia, excimer laser corneal refractive surgery has a certain effect.
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AIM:To analyze relevancy between the changes of the retinal thicknesses of children's anisometropic amblyopic macular at Area A1 before and at the end of amplyopia cure and amplyopia cure effect. METHODS: Through randomly selecting 30 cases ( 60 eyes) of anisometropic amblyopic children as test group and 29 cases ( 58 eyes ) of children with normal vision after the vision correction as control group, the changes of the retinal thicknesses of macular of the test group and the control group at Area A1 by OCT-3 was observed dynamically and analyzed. RESULTS: Compared with first diagnosis, the comparative difference of retinal thicknesses of macular at Area A1 in control group at 3, 6mo has statistical significance. The test group was divided into amblyopia group and non-amblyopia group. There has statistical significance for the comparative difference between the retinal thicknesses of macular centre at 3, 6mo and the first diagnosis in the non - amblyopia group, the amblyopia group was divided into the invalid cure group, progress group and the cured group according to amblyopic cure effect. Compared with first diagnosis, there is no statistical significance of macular at Area A1 in invalid cure group and progress group at 3, 6mo, and in the cured group at 3mo, but in the cured group at 6mo has statistical significance. CONCLUSION: There is a certain relationship between the changes of retinal thicknesses of macular of children with anisometropic amblyopic at Area A1 before and at the end of amblyopia treatment and amblyopia cure effect. OCT is a kind of objective auxiliary test method and provides new clues for amblyopia research.
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Background The characteristics of anisometropic amblyopia in ocular morphology are becoming a hot topic in amblyopia field.And the interocular difference in corneal parameters of anisometropic amblyopia is to be understood here.Corneal topography is a non-invasive method for in vivo corneal examination and applied in our study.Objective This study was to investigate the interocular difference of corneal topography in anisometropic amblyopic patients Methods This was a serial cases observation.Thirty anisometropic amblyopes were selected in Center for Optometry and Visual Science,People's Hospital of Guangxi Zhuang Autonomous Region.The patients were divided into amblyopic eye group and fellow eye group based on the best corrected distance visual acuity.Corneal topography was examined with Orbscan Ⅱ z,and corneal morphological parameters such as Diff values of the anterior and posterior corneal surface,Sim K 's astigmatism,Kmax,angle kappa and central corneal thickness (CCT) were measured.The interocular differences in these parameters were evaluated by paired t test,and the correlations in these parameters between the amblyopic eyes and the fellow eyes were analyzed by Pearson linear correlation and simple regression analysis.Results The Diff values of the anterior corneal surface were (0.011±0.006)mm and (0.011±0.017)mm,and those in the posterior corneal surface were (0.031 ±0.012)mm and (0.026 ±0.008)mm in the amblyopic eye group and the fellow eye group,respectively.In addition,Sim K's astigmatism were (1.8± 1.1)D and (1.1 ±0.6) D,JCC were (77±80) °and (100±80) °,J0 values were (-0.17±0.72) D and (0.02±0.41) D,J45 values were (-0.16±0.79) D and (0.13 ±0.48) D,CCT values were (551 ±37) μm and (551 ±31) μm,angle kappa values were (6.4± 1.4) ° and (4.9 ± 1.2) ° in the amblyopic eye group and the fellow eye group,respectively.Significant differences were found in the Diff values of the anterior and posterior corneal surface,Sim K's astigmatism and angle kappa between the two groups (t=-3.041,P=0.005 ;t=-4.317,P=0.000 ;t=-4.571,P=0.000).Pearson's linear correlation test demonstrated significant interocular positive correlations in parameters such as the anterior corneal surface Diff values (r =0.444),J0 (r =0.383),posterior Diff values (r =0.600),and Sim K 's astigmatism (r =0.479),and CCT (r =0.948,P＜0.05).The linear regression equation between the two groups was Y =-0.005 +1.392X (R2 =0.197,F=6.858,P=0.014) in the Diff values in the anterior corneal surface,Y =-0.013+0.421X (R2=0.360,F=15.761,P=0.000) in the Diff values in the posterior corneal surface,Y =0.616+0.27X (R2=0.230,F=8.348,P=0.007) in the Sim K's astigmatism,Y=0.060+0.219X (R2 =0.147,F=4.814,P=0.037) in theJo and Y=i08.289+0.804X (R2 =0.899,F=250.293,P=0.000) in CCT.Conclusions Corneal morphological interocular differences exist significantly in anisometropic amblyopic patients.
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PURPOSE: To evaluate the change in multifocal visual evoked potential (mfVEP) in unilateral anisometropic amblyopia before and after occlusion treatment. METHODS: The mfVEP was performed using RETIscan(R) (Roland,Brandenburg, Germany) for patients with unilateral anisometropic amblyopia before and after occlusion treatment. Amplitude and latency values of mfVEP were analyzed according to the field divided by 6 rings or 4 sectors. RESULTS: The each amplitude of values of all 6 rings were not significantly different before treatment (p = 0.077) in amblyopic eyes. However, the value of ring 1 (p = 0.00) was significantly higher than the value of other rings after treatment. In fellow eyes, the values of ring 1 was consistently significantly higher than the value of other rings before (p = 0.014) and after (p = 0.049) occlusion treatment. Additionally, the amplitudes of ring 1 (p = 0.005) and ring 3 (p = 0.007) were significantly increased in amblyopic eyes after occlusion treatment. In fellow eyes, the values of all rings did not change significantly. The analysis of amplitudes with 4 sectors revealed no significant result. The analysis of latencies with 6 rings and 4 sectors revealed no significant result. CONCLUSIONS: The change in amplitude on the central field (ring 1) in amblyopic eyes can be a useful objective monitoring method observing the improvement progress in visual acuity.
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Humans , Amblyopia , Evoked Potentials, Visual , Eye , Visual AcuityABSTRACT
PURPOSE: To evaluate the change in multifocal visual evoked potential (mfVEP) in unilateral anisometropic amblyopia before and after occlusion treatment. METHODS: The mfVEP was performed using RETIscan(R) (Roland,Brandenburg, Germany) for patients with unilateral anisometropic amblyopia before and after occlusion treatment. Amplitude and latency values of mfVEP were analyzed according to the field divided by 6 rings or 4 sectors. RESULTS: The each amplitude of values of all 6 rings were not significantly different before treatment (p = 0.077) in amblyopic eyes. However, the value of ring 1 (p = 0.00) was significantly higher than the value of other rings after treatment. In fellow eyes, the values of ring 1 was consistently significantly higher than the value of other rings before (p = 0.014) and after (p = 0.049) occlusion treatment. Additionally, the amplitudes of ring 1 (p = 0.005) and ring 3 (p = 0.007) were significantly increased in amblyopic eyes after occlusion treatment. In fellow eyes, the values of all rings did not change significantly. The analysis of amplitudes with 4 sectors revealed no significant result. The analysis of latencies with 6 rings and 4 sectors revealed no significant result. CONCLUSIONS: The change in amplitude on the central field (ring 1) in amblyopic eyes can be a useful objective monitoring method observing the improvement progress in visual acuity.
Subject(s)
Humans , Amblyopia , Evoked Potentials, Visual , Eye , Visual AcuityABSTRACT
Background: To compare binocular functions in amblyopic and non-amblyopic anisometropes and to investigate the possible associated factors for amblyopia development such as type of refractive error and initial age of refractive error correction. Materials and Methods: Prospectively anisometropic subjects with (n=42) and without amblyopia (n=33) were included in the study. Full ophthalmological examination including binocularity and motility was performed. Results: There was no statistically significant difference between the ages at the time of initial refractive error correction ( P =0.946). All of the anisometropes (100%) had fusion with Worth 4-dot test and Bagolini glasses. However 81% of amblyopic subjects had fusion with Worth 4 dot test and 88.1% had normal response with Bagolini glasses. Median stereopsis was 60 sec of arc in anisometropic subjects and 400 sec of arc in amblyopes. Conclusion: Our data support that, binocular functions are well developed in anisometropes without amblyopia and initial age at correction of refractive error has no primary effect on development of amblyopia.
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PURPOSE: To identify the efficacy of spectacle wearing for 4 months before amblyopia treatment in children with anisometropic amblyopia. METHODS: The patients with anisometropic amblyopia without strabismus were selected for the present study. The patients were divided into 2 groups; patients who began amblyopia treatment while simultaneously wearing glasses (Group A, 16 patients) and patients who began amblyopia treatment after wearing spectacles for 4 months (Group B, 17 patients). Intermittent atropine penalization or part-time occlusion was provided for amblyopia treatment. Age and best-corrected visual acuity at the start and cessation of treatment, type of amblyopia, treatment method and duration of treatment were analyzed. RESULTS: There were no statistical differences among age, best-corrected visual acuity of the amblyopic and better eyes, type of amblyopia, or treatment method between the 2 groups. In Group B, visual acuity of the amblyopic and better eyes improved after 4 months of spectacle wearing. At the last visit, there were no statistical differences of visual acuity in the amblyopic eye between the 2 groups. In children with resolution of amblyopia, the treatment duration of Group A (15 patients) was 17.3 months, longer than the 4.7 months in Group B (13 patients) (p = 0.003). CONCLUSIONS: Wearing spectacles for 4 months prior to amblyopia treatment may be an effective method of shortening the treatment duration.
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Child , Humans , Amblyopia , Atropine , Eye , Eyeglasses , Glass , Strabismus , Visual Acuity , Withholding TreatmentABSTRACT
PURPOSE: To compare the effects of full-time and part-time occlusion therapy in patients who had been diagnosed with anisometropic amblyopia after age eight and have begun treatment. METHODS: We included patients eight years old or older who had been diagnosed with anisometropic amblyopia. They were treated with full-time or part-time occlusion therapy and followed up for at least six months. Treatment was considered successful when visual acuity was increased by two lines or more. RESULTS: There were 26 total patients. There were 14 part-time and 12 full-time occlusion therapy patients in the respective groups. Visual acuity for the amblyopic eyes was significantly improved while the non-amblyopic eyes did not show any significant differences after the treatment. The changes in the visual acuity were significantly larger for the full-time treatment group compared to the part-time treatment group. The full-time occlusion group showed a significant difference in visual acuity of the amblyopic eyes after treatment. Lower visual acuity of an amblyopic eye at the first visit led to a greater improvement in visual acuity after the treatment. CONCLUSIONS: With good compliance, occlusion therapy for anisometropic amblyopia can be successful even if it is initiated after eight years of age.
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Aged , Humans , Amblyopia , Compliance , Eye , Visual AcuityABSTRACT
PURPOSE: To report the clinical outcome of children with unilateral high myopic anisometropic amblyopia who were treated with contact lenses (CL). METHODS: Patients who had myopic anisometropia greater than -7 diopters and was treated with contact lenses combined with occlusion therapy during the period between 1998 and 2007 were retrospectively reviewed. Twenty-seven patients who were followed up for more than 1 year after treatment were included in the study. Initial and final best corrected visual acuities (BCVA) were compared and factors which influence the visual outcome were analyzed. RESULTS: A total of 10 out of 27 patients (37%) acquired visual improvement of more than 2 lines. At the final examination, 6 patients (22.2%) had BCVA better than logMAR 0.3 and 10 patients (37.0%) had BCVA better than logMAR 0.7. Medullated nerve fiber and strabismus were the most commonly associated ocular pathologies among the patients. Patients without strabismus or medullated nerve fiber acquired greater visual improvement than patients with these comorbidities. Patients with lower initial refractive error (spherical equivalent) in the amblyopic eye acquired a better final vision. Poor compliance to CL wearing or occlusion therapy adversely affected the final vision. CONCLUSIONS: In the present study of children with unilateral severe myopic anisometropic amblyopia treated with CL combined with occlusion therapy, a third of the patients acquired visual improvement of more than 2 lines. The absence of medullated nerve fiber or strabismus was determined to be a good prognostic factor.
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Child , Humans , Amblyopia , Anisometropia , Comorbidity , Compliance , Contact Lenses , Eye , Nerve Fibers , Refractive Errors , Retrospective Studies , Strabismus , Vision, Ocular , Visual AcuityABSTRACT
PURPOSE: We measured the macular and peripapillary retinal nerve fiber layer (RNFL) thickness in patients with hyperopic anisometropic amblyopia using optical coherence tomography (OCT) to determine the relationship between final visual acuity after occlusion therapy and these OCT parameters. METHODS: This prospective study comprised 41 patients with unilateral hyperopic anisometropic amblyopia treated from April 2004 to August 2005. According to the final visual acuity after occlusion therapy, we divided our patients into two groups and compared the macular and peripapillary RNFL thicknesses between normal and amblyopic eyes. RESULTS: The mean refractive error was +4.3 diopters (D) in amblyopic eyes, and +1.3 D in normal eyes. The mean macular thickness of group A (patients with final visual acuity equal to or better than 20/25) and group B (patients with final visual acuity worse than 20/25) was 256.8+/-17.7 micrometer and 259.3+/-14.5 micrometer in amblyopic eyes, and 253.8+/-17.3 micrometer and 254.6+/-16.7 micrometer in normal eyes respectively. The mean peripapillary RNFL thickness of group A and group B was 118.6+/-12.9 micrometer and 111.5+/-9.0 micrometer in amblyopic eyes, and 112.9+/-9.2 micrometer and 108.3+/-6.5 micrometer in normal eyes respectively. In group A, there was a significant difference in peripapillary RNFL thickness between amblyopic and normal eyes (P=0.0003, 0.04). However, the RNFLestimated integral of both groups after correction of refractive error and axial length showed no significant difference (P=0.34, 0.45). CONCLUSIONS: There was no significant relationship between OCT parameters and final visual acuity after occlusion therapy in hyperopic anisometropic amblyopia.
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Humans , Amblyopia , Nerve Fibers , Prospective Studies , Refractive Errors , Retinaldehyde , Tomography, Optical Coherence , Visual AcuityABSTRACT
PURPOSE: This study was undertaken to evaluate the effect of L-dopa in amblyopic children for whom occlusion treatment failed. METHODS: We studied nine amblyopic children (11 eyes) for whom part-time occlusion (4~8 hours/day) treatment for a minimum period of 6 months had failed. The types of amblyopia included: anisometropic (1 patient, 1 eye), stimulus deprivation (4 patients, 6 eyes) and mixed (anisometropic and strabismic: 2 patients, 2 eyes; anisometropic and organic: 2 patients, 2 eyes). Best corrected visual acuity before treatment was between 0.05 and 0.5. They received, with full informed consent of the parent, levodopa (2~4 mg/kg) for 8 weeks combined with part-time occlusion. RESULTS: The children were between 4 and 11 years old (mean 5.8+/-2.05). Of the subjects, 45.5% (4 patients, 5 eyes) had improved visual acuity after 8 weeks of treatment. In one patient with anisometropic, two patients with mixed (anisometropic and strabismic), and one patient with stimulus deprivation (ametropic) amblyopia, visual acuity improved by one to five lines. CONCLUSIONS: In anisometropic, strabismic amblyopes and mild deprivational amblyopes for whom occlusion treatment failed, L-dopa improved visual acuity. L-dopa may be an additional option for treatment of amblyopic patients with a guarded visual prognosis.
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Child , Humans , Amblyopia , Informed Consent , Levodopa , Parents , Prognosis , Visual AcuityABSTRACT
PURPOSE: To determine the outcome of part-time occlusion therapy in children with anisometropic amblyopia detected after they were 8 years of age. METHODS: We analyzed 29 eyes with anisometropic amblyopia in children 8 years of age and older. The mean age was 8.79+/-0.98 (range 8~12) years old. The subjects whose best-corrected visual acuity (BCVA) did not improve by two lines or better within 2 weeks of wearing glasses full-time were prescribed occlusion therapy for 6 hours a day outside of school hours, along with the instruction to wear glasses full-time. Subjects who complied with occlusion for more than 3 hours a day were considered to comply well. RESULTS: The major component of the anisometropia was hyperopia in 51.7% of the subjects, and hyperopia plus astigmatism was found in 24.1%. The mean pretreatment BCVA score was 0.51+/-0.23 (LogMAR). Compliance was 89.66%. The mean posttreatment BCVA was 0.03+/-0.01 (LogMAR), and the success rate, based on a posttreatment BCVA of 0.1 (LogMAR) and better, was 96.43%. It took an average of 4.79+/-3.35 months to reach the desired posttreatment BCVA. The mean posttreatment stereopsis was 79.78+/-37.61 seconds of arc. The recurrence rate was 8%. The visual improvement was related to the degree of compliance (p=0.000). The time taken to reach the posttreatment BCVA was shorter in subjects with a better pretreatment BCVA (p=0.019), but it did not relate to the compliance (p=0.366). CONCLUSIONS: The most common component of anisometropia detected after 8 years of age was hyperopia. The part-time occlusion therapy, which had been carried out after school hours, was successful in most cases.