Fixation instability, astigmatism, and lack of stereopsis as factors impeding recovery of binocular balance in amblyopia following binocular therapy.

Dichoptic therapy is a promising method for improving vision in pediatric and adult patients with amblyopia. However, a systematic understanding about changes in specific visual functions and substantial variation of effect among patients is lacking. Utilizing a novel stereoscopic augmented-reality based training program, 24 pediatric and 18 adult patients were trained for 20 h along a three-month time course with a one-month post-training follow-up for pediatric patients. Changes in stereopsis, distance and near visual acuity, and contrast sensitivity for amblyopic and fellow eyes were measured, and interocular differences were analyzed. To reveal what contributes to successful dichoptic therapy, ANCOVA models were used to analyze progress, considering clinical baseline parameters as covariates that are potential requirements for amblyopic recovery. Significant and lasting improvements have been achieved in stereoacuity, interocular near visual acuity, and interocular contrast sensitivity. Importantly, astigmatism, fixation instability, and lack of stereopsis were major limiting factors for visual acuity, stereoacuity, and contrast sensitivity recovery, respectively. The results demonstrate the feasibility of treatment-efficacy prediction in certain aspects of dichoptic amblyopia therapy. Furthermore, our findings may aid in developing personalized therapeutic protocols, capable of considering individual clinical status, to help clinicians in tailoring therapy to patient profiles for better outcome.

Optic disc morphology in unilateral branch retinal vein occlusion using spectral domain optical coherence tomography.

BACKGROUND: The aim of this study was to evaluate the association between optic nerve head (ONH) parameters and branch retinal vein occlusion (BRVO) using spectral domain optical coherence tomography (SD-OCT). METHODS: Both eyes of 40 patients with unilateral BRVO (mean age: 67.4 ± 11.4 years, male: female - 18:22) were enrolled in this study. Control group consisted of randomly selected single healthy eyes of 40 age and gender matched volunteers (mean age: 64.7 ± 15.4 years, male: female - 16:24). ONH parameters (including optic disc area, optic cup area, neuroretinal rim area, cup volume, rim volume, cup-disc area ratio, horizontal and vertical cup-disc ratio, average retinal nerve fiber layer) were measured by SD-OCT. Axial length (AL) of the eyes was measured by non-contact optical low coherence reflectometry. The ONH parameters of eyes with BRVO were compared with those of fellow eyes using mixed model, one-way between-groups analysis of covariance was conducted to compare the ONH parameters of affected and unaffected fellow eyes in BRVO patients with those of the control eyes keeping confounding factors, including AL, age and gender under control in the statistical analysis. RESULTS: None of the investigated ONH parameters of affected BRVO eyes, unaffected fellow eyes and control eyes were statistically different after controlling for AL, age and gender. CONCLUSION: Optic disc morphology might not be a potential anatomical predisposing factor for development of BRVO.