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Çakır, Burçin, Nilgün Özkan Aksoy, Sedat Özmen, and Özlem Bursalı. "The effect of amblyopia on clinical outcomes of children with astigmatism." Therapeutic Advances in Ophthalmology 13 (January 2021): 251584142110408. http://dx.doi.org/10.1177/25158414211040898.
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Background: Amblyopia is more common in children with high astigmatism, but factors contributing to development of amblyopia and visual outcomes are not fully understood. Objective: To evaluate the effect of amblyopia on the clinical outcomes in children with ⩾1.75 diopter (D) astigmatism. Methods: We reviewed the medical records of children with ⩾1.75 D astigmatism with and without amblyopia (amblyopes group and non-amblyopes group). The mean age, gender, amount and type of ocular deviation, presence of convergence insufficiency (CI), stereopsis, time of initial spectacle use and follow-up time, differences in best-corrected visual acuity (VoD) and spherical equivalent (SE) between eyes were assessed and compared between the groups. Best-corrected visual acuity (BCVA), mean SE, astigmatism measurements were assessed and compared between amblyopic, fellow, and non-amblyopic eyes. Results: The records included 68 eyes of 34 children with amblyopia and 56 eyes of 28 children without amblyopia. The mean age, gender, amount and type of ocular deviation, presence of CI, stereopsis, time of initial spectacle use, follow-up time, and the difference in SE did not differ between groups. In amblyopes, exodeviation was more common and statistically greater in near (33 cm) than at distance (6 m) (p = 0.005). The mean BCVA and astigmatism values were statistically different between amblyopic, fellow, and non-amblyopic eyes. Conclusion: A greater near than distance exodeviation and higher mean astigmatism value were found in amblyopic children with astigmatism.
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Kurent, Alma, and Dragica Kosec. "Amblyopia." Slovenian Medical Journal 88, no. 1-2 (March 4, 2019): 71–76. http://dx.doi.org/10.6016/zdravvestn.2834.
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Amblyopia is a reduction of vision in one or both eyes due to a failure of normal neural development in the immature visual system.Amblyopia occurs due to two basic conditions – abnormal binocular interaction (e.g., strabismus) and blurring or distortion of visual image due to uncorrected refractive errors or media opacities. Best-corrected visual acuities in amblyopic eyes range from mild deficits to severe vision loss.The principle of treating amblyopia involves clearing any image blur and encouraging use of the amblyopic eye with occlusion of the better-seeing eye. Paediatric Eye Disease Investigator Group (PEDIG) studies show that both part-time and full-time occlusions can produce similar results in the eye with severe amblyopia and occlusion can be prescribed initially at 2 hours per day for the moderate amblyope. Studies show that daily atropine and patching for 6 hours/day can be equivalent treatment options and that if pharmacologic blurring is used for treatment, initial treatment can begin with just weekend use of atropine for moderate amblyopia.Amblyopia can lead to permanent loss of vision; therefore vision screening is strongly recommended over the course of childhood to detect amblyopia early enough to allow successful treatment.
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Irsch, Kristina, David L. Guyton, Robert B. Geary, Jing Tian, Boris I. Gramatikov, and Howard S. Ying. "Disconjugacy of Eye Movements during Attempted Fixation: A Sufficient Marker for Amblyopia?" Klinische Monatsblätter für Augenheilkunde 239, no. 10 (October 2022): 1206–12. http://dx.doi.org/10.1055/a-1933-3150.
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Abstract Background To investigate whether detection of disconjugacy of eye movements during attempted fixation, or interocular position instability, may serve as a single sensitive test for amblyopia. Patients/Methods and Material Binocular eye movements were recorded at 500 Hz using the EyeLink 1000 eye tracker (SR Research Ltd., Kanata, Ontario, Canada) and analyzed using EyeLink software and Matlab (MathWorks, Natick, MA, USA). Eight subjects (four amblyopes, one successfully treated amblyope, and three non-amblyopes: 7 – 44 years) were asked to fixate on a stationary cross subtending 0.5° at 57 cm. Interocular position instability was quantified by calculating the minimum area bivariate contour ellipse (BCEA) encompassing 68% of the difference between right and left eye position points during 20-second viewing epochs. For statistical analysis, BCEA values, as well as visual acuity and stereoacuity, were normalized by base-10 logarithm transformation. Results The amblyopic subjects with persistent vision loss (one anisometropic, two strabismic, one deprivation; uncorrected visual acuity range 20/60 – 20/300, corrected stereoacuity range nil-400 arcsec) showed significantly higher interocular position instability (larger 68% BCEAs) than the non-amblyopic subjects (uncorrected visual acuity range 20/20 – 20/800, corrected stereoacuities of 20 arcsec) and the successfully treated strabismic amblyope (to the 20/20 level of visual acuity and 70 arcsec of stereoacuity) during binocular viewing trials; p < 0.01. Interocular position stability was strongly correlated with stereoacuity (in that better stereoacuity was associated with lower 68% BCEAs; r = 0.95), but not with visual acuity (r = 0.20). Conclusion Interocular position instability appears to differentiate amblyopic from non-amblyopic subjects and appears to improve after successful treatment. Interocular position instability may therefore prove to be a single sensitive test for the presence of amblyopia. As a difference measure, it is inherently less susceptible to head motion and calibration error, as well as to conjugate eye motion, and as such is expected to be somewhat immune to latent nystagmus. Interocular position instability may also be useful to guide treatment, especially in preverbal children, and to assess the efficacy of novel treatments. Further research is required to establish optimal interocular position instability thresholds and to determine how specific this measure is to amblyopia.
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KOZMA, PETRA, and LYNNE KIORPES. "Contour integration in amblyopic monkeys." Visual Neuroscience 20, no. 5 (September 2003): 577–88. http://dx.doi.org/10.1017/s0952523803205113.
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Amblyopia is characterized by losses in a variety of aspects of spatial vision, such as acuity and contrast sensitivity. Our goal was to learn whether those basic spatial deficits lead to impaired global perceptual processing in strabismic and anisometropic amblyopia. This question is unresolved by the current human psychophysical literature. We studied contour integration and contrast sensitivity in amblyopic monkeys. We found deficient contour integration in anisometropic as well as strabismic amblyopic monkeys. Some animals showed poor contour integration in the fellow eye as well as in the amblyopic eye. Orientation jitter of the elements in the contour systematically decreased contour-detection ability for control and fellow eyes, but had less effect on amblyopic eyes. The deficits were not clearly related to basic losses in contrast sensitivity and acuity for either type of amblyopia. We conclude that abnormal contour integration in amblyopes reflects disruption of mechanisms that are different from those that determine acuity and contrast sensitivity, and are likely to be central to V1.
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KIORPES, LYNNE, CHAO TANG, and J. ANTHONY MOVSHON. "Sensitivity to visual motion in amblyopic macaque monkeys." Visual Neuroscience 23, no. 2 (March 2006): 247–56. http://dx.doi.org/10.1017/s0952523806232097.
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Amblyopia is usually considered to be a deficit in spatial vision. But there is evidence that amblyopes may also suffer specific deficits in motion sensitivity as opposed to losses that can be explained by the known deficits in spatial vision. We measured sensitivity to visual motion in random dot displays for strabismic and anisometropic amblyopic monkeys. We used a wide range of spatial and temporal offsets and compared the performance of the fellow and amblyopic eye for each monkey. The amblyopes were severely impaired at detecting motion at fine spatial and long temporal offsets, corresponding to fine spatial scale and slow speeds. This impairment was also evident for the untreated fellow eyes of strabismic but not anisometropic amblyopes. Motion sensitivity functions for amblyopic eyes were shifted toward large spatial scales for amblyopic compared to fellow eyes, to a degree that was correlated with the shift in scale of the spatial contrast sensitivity function. Amblyopic losses in motion sensitivity, however, were not correlated with losses in spatial contrast sensitivity. This, combined with the specific impairment for detecting long temporal offsets, reveals a deficit in spatiotemporal integration in amblyopia which cannot be explained by the lower spatial resolution of amblyopic vision.
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Vieira, Maria João, Sandra Viegas Guimarães, Patrício Costa, and Eduardo Silva. "Late Ophthalmologic Referral of Anisometropic Amblyopia: A Retrospective Study of Different Amblyopia Subtypes." Acta Médica Portuguesa 32, no. 3 (March 29, 2019): 179. http://dx.doi.org/10.20344/amp.10623.
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Introduction: Amblyopia requires a timely diagnosis and treatment to attain maximum vision recovery. Specialty literature is lacking on how early amblyopia is referred. We aimed to understand if there are mean age differences at first referral for ophthalmologic tertiary center consultation among non-amblyopic and different types of amblyopia, in a context of lack of population screening.Material and Methods: In this retrospective model, the sample corresponded to all children born in Braga Hospital during 1997 - 2012 (3 - 18 years-old), with an ophthalmologic consultation in 2014. Data was collected from the clinical records and children were divided in a non-amblyopic versus amblyopic group. The amblyopic group was subdivided in strabismic versus refractive (anisometropic/bilateral).Results: The sample had a total of 1665 participants, 1369 (82.2%) without amblyopia and 296 (17.8%) with amblyopia. Among amblyopia: 67.9% (n = 201) refractive, 32.1% (n = 95) strabismic. Within refractive amblyopia: 63.7% (n = 128) anisometropic and 36.3% (n = 73) bilateral. The mean age at first consultation was 6.24 ± 3.90 years-old: 6.39 ± 3.98 for non-amblyopic and 5.76 ± 3.58 for amblyopic. Among amblyopia subgroups, there were significant differences in mean age at first consultation (F3,1250 = 8.45; p < 0.001; η2 = 0.020). Strabismic and bilateral refractive amblyopia were referred earlier, when compared to non-amblyopia or anisometropic amblyopia (p < 0.05). Anisometropic amblyopia had the highest first consultation mean age: 6.92 ± 3.57 years-old.Discussion: Without specific pre-school screening, children with amblyopia were referred to their first ophthalmologic evaluation significantly later than desired, especially anisometropic amblyopia, with a postschool mean age for first consultation.Conclusion: Recognizing high-risk children is essential for earlier referral and helps minimize future visual handicap.
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Acar, Katerina, Lynne Kiorpes, J. Anthony Movshon, and Matthew A. Smith. "Altered functional interactions between neurons in primary visual cortex of macaque monkeys with experimental amblyopia." Journal of Neurophysiology 122, no. 6 (December 1, 2019): 2243–58. http://dx.doi.org/10.1152/jn.00232.2019.
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Amblyopia, a disorder in which vision through one of the eyes is degraded, arises because of defective processing of information by the visual system. Amblyopia often develops in humans after early misalignment of the eyes (strabismus) and can be simulated in macaque monkeys by artificially inducing strabismus. In such amblyopic animals, single-unit responses in primary visual cortex (V1) are appreciably reduced when evoked by the amblyopic eye compared with the other (fellow) eye. However, this degradation in single V1 neuron responsivity is not commensurate with the marked losses in visual sensitivity and resolution measured behaviorally. Here we explored the idea that changes in patterns of coordinated activity across populations of V1 neurons may contribute to degraded visual representations in amblyopia, potentially making it more difficult to read out evoked activity to support perceptual decisions. We studied the visually evoked activity of V1 neuronal populations in three macaques ( Macaca nemestrina) with strabismic amblyopia and in one control animal. Activity driven through the amblyopic eye was diminished, and these responses also showed more interneuronal correlation at all stimulus contrasts than responses driven through the fellow eye or responses in the control animal. A decoding analysis showed that responses driven through the amblyopic eye carried less visual information than other responses. Our results suggest that part of the reduced visual capacity of amblyopes may be due to changes in the patterns of functional interaction among neurons in V1. NEW & NOTEWORTHY Previous work on the neurophysiological basis of amblyopia has largely focused on relating behavioral deficits to changes in visual processing by single neurons in visual cortex. In this study, we recorded simultaneously from populations of primary visual cortical (V1) neurons in macaques with amblyopia. We found changes in the strength and pattern of shared response variability between neurons. These changes in neuronal interactions could impair the visual representations of V1 populations driven by the amblyopic eye.
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Liu, Chun-Hsiu, Sherine Jue Ong, Chung-Ying Huang, Wei-Chi Wu, Ling-Yuh Kao, and Meng-Ling Yang. "Macular Thickness, Foveal Volume, and Choroidal Thickness in Amblyopic Eyes and Their Relationships to the Treatment Outcome." Journal of Ophthalmology 2018 (August 6, 2018): 1–6. http://dx.doi.org/10.1155/2018/1967621.
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Purpose. To assess the correlations between the retinal/choroidal structure and the treatment outcomes of amblyopic children.Methods. This study enrolled eyes with amblyopia resulting from strabismus, anisometropia, or ametropia. All patients underwent detailed eye examinations, including spectral domain optical coherence tomography (SD-OCT) scan. All of the subjects received amblyopic treatment and were divided into 2 groups after 6 months of follow-up: the recovered amblyopic group with a best-corrected visual acuity (BCVA) ≥0.8 and the persistent amblyopic group with a BCVA <0.8 on the Landolt C chart.Results. Forty-four amblyopic children were included, of which 26 were in the recovered amblyopic group after 6 months of follow-up. The patients with strabismic anisometropic amblyopia and severe amblyopia (initial VA ≤ 0.3) were significantly predisposed to developing persistent amblyopia (P=0.049andP<0.001, respectively). After correcting with Littmann’s formula, the thickness and volume of the parafoveal and perifoveal retinal regions in the persistent amblyopia group did not show significant differences with the recovered amblyopia group.Conclusions. The initial severity of amblyopia and the type of amblyopia were the risk factors related to the poor outcome of amblyopic treatment. The foveal thickness, foveal volume, and choroidal thickness were not associated with the treatment outcome.
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Kiorpes, Lynne. "Effect of strabismus on the development of vernier acuity and grating acuity in monkeys." Visual Neuroscience 9, no. 3-4 (October 1992): 253–59. http://dx.doi.org/10.1017/s095252380001066x.
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AbstractThe effect of experimental strabismus on the development of vernier acuity and grating acuity was studied in Macaca nemestrina monkeys. Six monkeys were studied longitudinally beginning near 10 days after birth. Four of the six monkeys developed amblyopia. As is true for human strabismic amblyopes, the deficit in vernier acuity was larger than the deficit in grating acuity in the amblyopic monkeys. The developmental data reveal that this differential disruption of vernier acuity can be understood as a result of a slowed developmental process associated with amblyopia.
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Ghoshal, Rituparna, Dipanwita Ghosh, and Somnath Ghosh. "Dichoptic Vision Therapy in Adults with Anisometropic Amblyopia: A Systematic Review." JULY 2023 19, no. 4 (July 7, 2023): 297–306. http://dx.doi.org/10.47836/mjmhs.19.4.42.
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Introduction: Amblyopia is a condition with reduced best corrected visual acuity in absence of any ocular pathology. Different treatment approaches of amblyopia have been researched for decades. Recent studies on binocular dichoptic therapy using different software and video game based training showed drastic improvement in visual functions in amblyopic adults. Aim of this review is to assess the effect of vision therapy with dichoptic training in adults with anisometropic amblyopes. Method: Review was conducted in articles published within last 25 years from databases like PubMed, research gate, google scholar. Results: Dichoptic therapy has promising results in treatment of adults with anisometropic amblyopia. However, several limitations of these said researches were observed. Conclusion: Further studies particularly RCTs with strict methodology and treatment protocol, larger sample size and longer follow ups are recommended before clinicians could impart dichoptic therapy as a management option of adults with amblyopia into their evidence based practice.
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Kaiti, Raju, Asik Pradhan, and Monica Chaudhry. "Clinical profile of amblyopia and outcome of occlusion therapy in pediatric populations attending a referral hospital." International Eye Research 2, no. 4 (December 28, 2021): 214–22. http://dx.doi.org/10.18240/ier.2021.04.07.
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AIM: To study clinical profile of amblyopia and also the outcomes of occlusion therapy among the amblyopes. METHODS: This was a hospital-based longitudinal study by design. Data were collected from April 2015 to April 2016 in Ophthalmology Department of Dhulikhel Hospital. Presenting visual acuity, chief complaint at presentation, age at presentation, refractive status, binocularity and fixation patterns were assessed in all the children with amblyopia. Improvement in visual acuity was also noted in all the subjects after occlusion therapy, which is a most commonly used modality of treatment for amblyopia. RESULTS: Among 1092 children examined during the study period, 60 (5.49%) were amblyopic. Among them, 35 (58.30%) were females and 25 (41.70%) were males. The mean age at presentation was 8.87±3.29y. Meridional amblyopia was the most prevalent subtype seen in 43.3% (n=26) of children followed by anisohypermetropic amblyopia (20%, n=12). The most common refractive error was astigmatism accounting for 58.30% of the total cases followed by hypermetropia (22.5%) and myopia (7.5%). Compliance with spectacle wear combined with occlusion therapy and active vision therapy was 73.3% (n=44). There was a statistically significant improvement in visual acuity of the amblyopic eyes after the different treatment strategies after 3mo (P=0.002). CONCLUSION: Prevalence of amblyopia and associated visual impairment is still a public health issue in developing countries like Nepal. Lack of awareness and lack of community or preschool vision screening for children lead to late presentation and significant visual impairment associated with the condition. The burden can easily be reduced with screening camps, timely referrals and proper interventions.
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SB, Gupta. "Recent Advances in Management of Amblyopia." Open Access Journal of Ophthalmology 8, no. 1 (January 2, 2023): 1–5. http://dx.doi.org/10.23880/oajo-16000267.
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Amblyopia is the most common cause of monocular vision loss in children. Global incidence is 3.7%. It may be due to early deprivation of vision or defocus in one eye, reflects an imbalance of input from the eyes to visual cortex .Not only monocular vision is reduced but binocular vision is also affected. Fellow Human brain is designed to allow both eyes to work together. If signals from one eye are blurred, brain blocks the visual input from that eye. In the visual pathway, the synapses are broken due to disuse of amblyopic eye. Along with visual coordination deficit, eye to hand and reading can be affected and selfperception may be diminished. A variety of amblyopia therapy options have been developed to treat amblyopia in children and adults. Amblyopia therapy options have traditionally been limited to penalization of non-amblyopic eye with either patching or medicinal penalization. Traditional approaches to diagnose and treatment have limited effectiveness, are uncomfortable for the patients and their families. Recent evidences shows that amblyopes possess binocular cortical mechanisms for both threshold and supra-threshold stimuli. Hence strategy may be based on binocular stimulation methods, aims to stimulate either eye leading to a concomitant improvement in monocular vision with reduction in suppression and strengthening of binocular vision.
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Lee, Sang Wook, and Eun Hye Jung. "Stereoacuity after Successful Occlusion Therapy in Children with Anisometropic Amblyopia." Journal of the Korean Ophthalmological Society 62, no. 11 (November 15, 2021): 1539–46. http://dx.doi.org/10.3341/jkos.2021.62.11.1539.
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Purpose: To compare the stereoacuity between patients with anisometropic amblyopia who were treated and achieved normal visual acuity (VA) and normal children and evaluate the factors associated with stereoacuity.Methods: We retrospectively reviewed the records of 37 pediatric patients with anisometropic amblyopia who recovered to normal VA with glasses and occlusion treatment (amblyopia group) and 34 normal children (control group). The Worth 4-dot test, Lang II test, Titmus test, and TNO test were performed to measure stereoacuity. Clinical characteristics were compared between the two groups, and factors affecting stereoacuity outcomes were also analyzed in the amblyopic group.Results: The mean age at diagnosis of amblyopia was 5.3 ± 1.4 years, and the mean VAs at diagnosis were 0.41 ± 0.24 and 0.06 ± 0.07 in amblyopic and fellow eyes, respectively. The mean duration of occlusion was 19.00 ± 9.44 months, and VA of amblyopic eyes improved to 0.04 ± 0.04 after occlusion treatment. The patient characteristics did not differ significantly between the two groups, except for the final VA of the amblyopic eye. The final mean logarithm of minimal angle of resolution VA of the amblyopic eye in the amblyopia group was significantly worse than that in the control group. The number of patients with normal stereoacuity was significantly lower in the amblyopia group than in the control group on Lang II, Titmus, and TNO tests. Factors associated with poor stereoacuity were severe amblyopia in the Lang II test and poor post-treatment VA of the amblyopic eye in the Titmus test.Conclusions: Stereoacuity was worse in the amblyopia group than in the control group, despite normal visual development. The depth of amblyopia and post-treatment VA were associated with stereoacuity outcomes. Thus, VA improvement should be closely monitored in the amblyopic eye to obtain good stereoacuity.
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Hamidi, Aghdas, Samira Jalalifar, Somayyeh Boomi Quchan Atigh, Azam Darvishi, Nasrin Moghadas Sharif, Hossein Lashkardoost, Negar Sangsefidi, and Javad Heravian Shandiz. "The prevalence of functional amblyopia and its related risk factors in preschool children in North-Eastern Iran." Oman Journal of Ophthalmology 17, no. 1 (2024): 59–64. http://dx.doi.org/10.4103/ojo.ojo_295_22.
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Abstract BACKGROUND: Purpose was to determine the prevalence of amblyopia and its related risk factors in children aged 3–6 years in Bojnurd, north-eastern Iran. MATERIALS AND METHODS In this cross-sectional study, from 12,331 children aged 3–6 in Bojnurd, 6600 children participated in annual amblyopic screening program and among them, around 1100 suspected cases were referred for full ophthalmic examinations. Measurement of visual acuity, cycloplegic refraction, subjective refraction, and cover test were performed for all participants. Amblyopia was defined as CDVA of 0.2 LogMar or less in each eye or 2-line difference or more in best-corrected visual acuity between two eyes. RESULTS: The prevalence of amblyopia was estimated 0.95% (95% confidence interval [CI]: 0.73%–1.2%). There was no relationship between amblyopia with age and genders. Most amblyopic children were hyperopic (61.9%; 95% CI: 48.7–73.8). Strabismus was found in 17.4% of amblyopic patients (95% CI: 9.05%–29.09%). Approximately half of the amblyopic children were anisometropic (55.5%; 95% CI: 42.40%–68.08%). The most common type of amblyopia was anisohyperopic (55.56%; 95% CI: 42.5%–67.5%). The prevalence of bilateral amblyopia was more than unilateral amblyopia. The assessment of data showed that hyperopia, astigmatism, and anisometropia were the most common causes of amblyopia in this study. CONCLUSIONS: The prevalence of amblyopia was estimated about 1% in north-eastern Iran. Our study indicated a valuable information around the effect of refractive error and anisometropia on amblyopia which could be helpful in designing a comprehensive vision screening program for preschool children.
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Kraus, Courtney L., and Susan M. Culican. "New advances in amblyopia therapy I: binocular therapies and pharmacologic augmentation." British Journal of Ophthalmology 102, no. 11 (May 18, 2018): 1492–96. http://dx.doi.org/10.1136/bjophthalmol-2018-312172.
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Amblyopia therapy options have traditionally been limited to penalisation of the non-amblyopic eye with either patching or pharmaceutical penalisation. Solid evidence, mostly from the Pediatric Eye Disease Investigator Group, has validated both number of hours a day of patching and days per week of atropine use. The use of glasses alone has also been established as a good first-line therapy for both anisometropic and strabismic amblyopia. Unfortunately, visual acuity equalisation or even improvement is not always attainable with these methods. Additionally, non-compliance with prescribed therapies contributes to treatment failures, with data supporting difficulty adhering to full treatment sessions. Interest in alternative therapies for amblyopia treatment has long been a topic of interest among researchers and clinicians alike. Incorporating new technology with an understanding of the biological basis of amblyopia has led to enthusiasm for binocular treatment of amblyopia. Early work on perceptual learning as well as more recent enthusiasm for iPad-based dichoptic training have each generated interesting and promising data for vision improvement in amblyopes. Use of pharmaceutical augmentation of traditional therapies has also been investigated. Several different drugs with unique mechanisms of action are thought to be able to neurosensitise the brain and enhance responsiveness to amblyopia therapy. No new treatment has emerged from currently available evidence as superior to the traditional therapies in common practice today. But ongoing investigation into the use of both new technology and the understanding of the neural basis of amblyopia promises alternate or perhaps better cures in the future.
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Totsuka, Satoru, Tomoya Handa, Hitoshi Ishikawa, and Nobuyuki Shoji. "Improvement of Adherence with Occlu-Pad Therapy for Pediatric Patients with Amblyopia." BioMed Research International 2018 (November 22, 2018): 1–5. http://dx.doi.org/10.1155/2018/2394562.
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We aimed to examine visual acuity improvement effect and adherence in amblyopia training using tablet type vision training equipment (Occlu-pad). The subjects were 138 patients with amblyopia (average age of 5.5 ± 1.6 years old); their amblyopic visual acuity at the start of training was logMAR 0.15 to 1.3. Occlu-pad is a device that processes images such that amblyopic eyes can only view the image as it passes through polarized glasses; this is achieved by peeling off the polarizing film layer in the liquid crystal display of an iPad (Apple). Amblyopia training comprised either the instructional training with Occlu-pad or the eye patch (Patching) as a family training, after wearing perfectly corrected glasses. Visual acuity improvement following amblyopia training by Occlu-pad and Patching was significantly different after 6 months in patients with anisometropic amblyopia (p <0.05). In patients with strabismic amblyopia, a significant difference between training methods was observed after 9 months (p <0.05). Use of the Occlu-pad resulted in better adherence for patients with either anisometropic amblyopia or strabismic amblyopia; a significant difference in adherence was observed after 3 months, compared with Patching (p <0.05). Amblyopia training with Occlu-pad supports greater visual acuity improvement and adherence than Patching.
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Thompson, Benjamin, Goro Maehara, Erin Goddard, Reza Farivar, Behzad Mansouri, and Robert F. Hess. "Long-Range Interocular Suppression in Adults with Strabismic Amblyopia: A Pilot fMRI Study." Vision 3, no. 1 (January 8, 2019): 2. http://dx.doi.org/10.3390/vision3010002.
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Interocular suppression plays an important role in the visual deficits experienced by individuals with amblyopia. Most neurophysiological and functional MRI studies of suppression in amblyopia have used dichoptic stimuli that overlap within the visual field. However, suppression of the amblyopic eye also occurs when the dichoptic stimuli do not overlap, a phenomenon we refer to as long-range suppression. We used functional MRI to test the hypothesis that long-range suppression reduces neural activity in V1, V2 and V3 in adults with amblyopia, indicative of an early, active inhibition mechanism. Five adults with amblyopia and five controls viewed monocular and dichoptic quadrant stimuli during fMRI. Three of five participants with amblyopia experienced complete perceptual suppression of the quadrants presented to their amblyopic eye under dichoptic viewing. The blood oxygen level dependant (BOLD) responses within retinotopic regions corresponding to amblyopic and fellow eye stimuli were analyzed for response magnitude, time to peak, effective connectivity and stimulus classification. Dichoptic viewing slightly reduced the BOLD response magnitude in amblyopic eye retinotopic regions in V1 and reduced the time to peak response; however, the same effects were also present in the non-dominant eye of controls. Effective connectivity was unaffected by suppression, and the results of a classification analysis did not differ significantly between the control and amblyopia groups. Overall, we did not observe a neural signature of long-range amblyopic eye suppression in V1, V2 or V3 using functional MRI in this initial study. This type of suppression may involve higher level processing areas within the brain.
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Sapkota, K., A. Pirouzian, and NS Matta. "Prevalence of amblyopia and patterns of refractive error in the amblyopic children of a tertiary eye care center of Nepal." Nepalese Journal of Ophthalmology 5, no. 1 (March 25, 2013): 38–44. http://dx.doi.org/10.3126/nepjoph.v5i1.7820.
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Introduction: Refractive error is a common cause of amblyopia. Objective: To determine prevalence of amblyopia and the pattern and the types of refractive error in children with amblyopia in a tertiary eye hospital of Nepal. Materials and methods: A retrospective chart review of children diagnosed with amblyopia in the Nepal Eye Hospital (NEH) from July 2006 to June 2011 was conducted. Children of age 13+ or who had any ocular pathology were excluded. Cycloplegic refraction and an ophthalmological examination was performed for all children. The pattern of refractive error and the association between types of refractive error and types of amblyopia were determined. Results: Amblyopia was found in 0.7 % (440) of 62,633 children examined in NEH during this period. All the amblyopic eyes of the subjects had refractive error. Fifty-six percent (248) of the patients were male and the mean age was 7.74 ± 2.97 years. Anisometropia was the most common cause of amblyopia (p < 0.001). One third (29 %) of the subjects had bilateral amblyopia due to high ametropia. Forty percent of eyes had severe amblyopia with visual acuity of 20/120 or worse. About twothirds (59.2 %) of the eyes had astigmatism. Conclusion: The prevalence of amblyopia in the Nepal Eye Hospital is 0.7%. Anisometropia is the most common cause of amblyopia. Astigmatism is the most common types of refractive error in amblyopic eyes. Nepal J Ophthalmol 2013; 5(9):38-44 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7820
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Karmacharya, Srijana, Pranisha Singh, Aparna Rizyal, and Aditya Prasad Rijal. "Profile of Amblyopia and Outcome of Occlusion Therapy in Amblyopic Patients Attending Tertiary Care Hospital of Kathmandu." Nepal Medical College Journal 23, no. 2 (July 29, 2021): 94–101. http://dx.doi.org/10.3126/nmcj.v23i2.38505.
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Amblyopia is a common cause of visual impairment in children. The aim of this study was to assess the profile of amblyopia and the outcome of occlusion therapy in amblyopic children attending the eye department of a tertiary care hospital. This was a hospital based prospective interventional study. Sixty-five eyes of 47 patients fulfilling the inclusion criteria were included in the study. Occlusion therapy was started for the diagnosed amblyopic cases after refractive adaptation of 4 weeks. The mean age of presentation was 8.8 ±3.2 years. 29(61.7%) cases had unilateral amblyopia, 18(38.3%) cases had bilateral amblyopia. Ametropic amblyopia (52.3%) was the most common type of amblyopia followed by Anisometropia (23.1%). Refractive error was the most common cause of amblyopia with compound myopic astigmatism seen among 30.8% and hypermetropia among 29.2% of patients. There was no significant association between initial visual acuity with age of presentation and types of amblyopia respectively (P=0.1, P=0.5). The final visual outcome after therapy was better among patients with Ametropic amblyopia than other types (P=0.02). There was significant association between final visual outcome with age, initial visual acuity, type and severity of amblyopia respectively (P<0.001, P<0.001, P=0.02, P=0.02). In conclusion, Ametropia was the most common type of amblyopia. The mean age of presentation was 8.8 years, which was beyond the critical period affecting the outcome of treatment. Uncorrected refractive error was the most common amblyogenic factor. Age of presentation, types and severity of amblyopia are the important contributing factors for the outcome of occlusion therapy. Therefore, early detection and management of amblyopia is important to reduce visual impairment among children.
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TANG, YONG, LINYI CHEN, ZHONGJIAN LIU, CAIYUAN LIU, and YIFENG ZHOU. "Low-level processing deficits underlying poor contrast sensitivity for moving plaids in anisometropic amblyopia." Visual Neuroscience 29, no. 6 (November 2012): 315–23. http://dx.doi.org/10.1017/s095252381200034x.
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AbstractMany studies using random dot kinematograms have indicated a global motion processing deficit originated from extrastriate cortex, specifically middle temporal area (MT) and media superior temporal area (MST), in patients with amblyopia. However, the nature of this deficit remains unclear. To explore whether the ability of motion integration is impaired in amblyopia, contrast sensitivity for moving plaids and their corresponding component gratings were measured over a range of stimulus durations and spatial and temporal frequencies in 10 control subjects and 13 anisometropic amblyopes by using a motion direction discrimination task. The results indicated a significant loss of contrast sensitivity for moving plaids as well as for moving gratings at intermediate and high spatial frequencies in amblyopic eyes (AEs). Additionally, we found that the loss of contrast sensitivity for moving plaids was statistically equivalent to that for moving component gratings in AEs, that is, the former could be almost completely accounted for by the latter. These results suggest that the integration of motion information conveyed by component gratings of moving plaids may be intact in anisometropic amblyopia, and that the apparent deficits in contrast sensitivity for moving plaids in anisometropic amblyopia can be almost completely attributed to those for gratings, that is, low-level processing deficits.
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Storey, Philip P., Hassan A. Aziz, Ghazala A. Datoo O’Keefe, Mark Borchert, Linda A. Lam, Carmen A. Puliafito, and Lisa C. Olmos de Koo. "Decreased severity of age-related macular degeneration in amblyopic eyes." British Journal of Ophthalmology 102, no. 11 (February 6, 2018): 1575–78. http://dx.doi.org/10.1136/bjophthalmol-2017-311671.
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AimTo evaluate whether people with age-related macular degeneration (AMD) and a history of amblyopia have equal severity of AMD in both eyes.MethodsBilling records were used to locate all people with a history of amblyopia and AMD evaluated between 1 January 2003 and 1 June 2015 at a single ophthalmology institute. Two ophthalmic graders blinded to amblyopia status determined the severity of AMD in each eye using fundus photos and a validated grading scale.ResultsA total of 14 people were found to have AMD and a documented history of amblyopia. Average patient age was 77.0 years and average best corrected visual acuity was 20/160 in eyes with a history of amblyopia and 20/40 in fellow eyes without amblyopia. Eyes with a history of amblyopia were found to have a lower AMD severity score (mean lower score: −1.38; paired t-test P=0.019). Of the 11 people with asymmetric disease severity, 10 individuals had worse AMD in the non-amblyopic eye while one person had worse AMD in the amblyopic eye (P=0.0067).ConclusionsOur pilot study suggests that eyes with a history of amblyopia may manifest decreased severity of AMD compared with non-ambylopic eyes in the same patient. Further research is warranted to investigate this clinical observation.
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Reynaud, Alexandre, and Robert F. Hess. "An Unexpected Spontaneous Motion-In-Depth Pulfrich Phenomenon in Amblyopia." Vision 3, no. 4 (October 22, 2019): 54. http://dx.doi.org/10.3390/vision3040054.
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The binocular viewing of a fronto-parallel pendulum with a reduced luminance in one eye results in the illusory tridimensional percept of the pendulum following an elliptical orbit in depth, the so-called Pulfrich phenomenon. A small percentage of mild anisometropic amblyopes who have rudimentary stereo are known to experience a spontaneous Pulfrich phenomenon, which posits a delay in the cortical processing of information involving their amblyopic eye. The purpose of this study is to characterize this spontaneous Pulfrich phenomenon in the mild amblyopic population. In order to assess this posited delay, we used a paradigm where a cylinder rotating in depth, defined by moving Gabor patches at different disparities (i.e., at different interocular phases), generates a strong to ambiguous depth percept. This paradigm allows one to accurately measure a spontaneous Pulfrich phenomenon and to determine how it depends on the spatio-temporal properties of stimulus. We observed a spontaneous Pulfrich phenomenon in anisometropic, strabismic, and mixed amblyopia, which is posited to be due to an interocular delay associated with amblyopic processing. Surprisingly, the posited delay was not always observed in the amblyopic eye, was not a consequence of the reduced contrast sensitivity of the amblyopic eye, and displayed a large variability across amblyopic observers. Increasing the density, decreasing the spatial frequency, or increasing the speed of the stimulus tended to reduce the observed delay. The spontaneous Pulfrich phenomenon seen by some amblyopes was variable and depended on the spatio-temporal properties of the stimulus. We suggest it could involve two conflicting components: an amblyopic delay and a blur-based acceleration.
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Ale Magar, Jit B., and Shaheen P. Shah. "Accommodative Lag Persistence in Treated Anisometropic, Strabismic, and Mixed Amblyopia." Journal of Ophthalmology 2022 (May 10, 2022): 1–6. http://dx.doi.org/10.1155/2022/2133731.
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Background. Amblyopic eyes typically exhibit greater lag of accommodation. Whether this improves after amblyopia treatment is inconclusive. The aim of this study is to report post-treatment accommodative response in amblyopia and to investigate if the lag is associated with visual acuity, treatment duration, and amblyopia type. Methods. Monocular and binocular accommodative responses were measured using Nott’s method of dynamic retinoscopy in amblyopia of anisometropic, strabismic, and combined anisometropic-strabismic types and age-matched controls with normal vision. The results were compared using the nonparametric Wilcoxon signed ranks test. Linear regression analysis was used to examine association of the lag to refractive error, duration of therapy, and visual acuity. Results. Mean ± SD age of 46 amblyopic and 20 control subjects were 6.9 ± 1.8 and 6.9 ± 2.2 years, respectively. At the time of the study, 30 amblyopic subjects were receiving patching therapy and ceased in the remainder. In amblyopic eyes, mean ± SD monocular and binocular lags were 1.2 ± 0.6D and 1.0 ± 0.5D ( p < 0.001 ), respectively, compared to 0.6 ± 0.3D and 0.5 ± 0.2D ( p < 0.005 ), respectively, in nonamblyopic eyes and 0.4 ± 0.2D and 0.3 ± 0.2D ( p = 0.093 ), respectively, in the controls. By types, the monocular lag was significantly higher than the binocular lag ( p = 0.001 ) in mixed amblyopia ( p = 0.004 ); they were similar in anisometropic ( p = 0.283 ) and strabismic ( p = 0.743 ) amblyopia. Monocular lag was significantly correlated to BCVA (r = 0.46; p = 0.001 ) and refraction (r = 0.42; p = 0.001 ) but not to patching duration (r = 0.1; p = 0.280 ). Conclusion. Inadequate accommodative response, a higher lag, persists in amblyopic eyes even after the treatment. Impaired accommodative response is partly determined by posttherapy visual acuity. Further studies investigating the effect of accommodative lag on visual recovery and whether optical correction of the deficiency may improve visual outcome of the treatment are recommended.
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Malik, Noureen, Hannan Masud, Imran Basit, and Palwasha Noor. "FREQUENCY OF REFRACTIVE ERROR AND AMBLYOPIA IN STRABISMUS IN PEDIATRIC AGE GROUP." PAFMJ 71, no. 2 (April 28, 2021): 405–08. http://dx.doi.org/10.51253/pafmj.v71i2.3109.
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Objective: To see the frequency and compare the type of refractive error and strabismus in amblyopic versus non amblyopic children.
Study Design: Comparative cross sectional study.
Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, from Jan to Jul 2019.
Methodology: The sample population comprised of 250 patients of new or previously diagnosed children with refractive error and strabismus presenting at children eye outdoor patient department of armed forces institute of ophthalmology. Strabismus was diagnosed by the consultant eye specialist on the basis of heterotropia at near or distance fixation. Amblyopia and refracttive error was assessed by a trained optometrist. Patients were classified into amblyopia and non- amblyopia groups. The type of squint and refractive error was noted down along with demographic details. Chi square test was used to assess thesignificance of association between various categorical variables.
Results: A total of 250 participants were included with a mean age of 5.00 ± 1.07 years. Out of total, 132 (52.8%) were males while 118 (47.2%) were females. One hundred and fifty (59.5%) patients were suffering from amblyopia while 100 (39.5%) patients were normal with comparable vision in both the eyes. Out of 150 amblyopic patients 134 (89.3%) were suffering from unilateral amblyopia while 16 (10.6%) patients had amblyopia in both the eyes. Out of refractive errors astigmatism was present in 83 (55.3 %) of amblyopia patients while hypermetropia was present in 54 (36%) of the patients. Out of total patients of strabismus, 95 (63.3%) of non-alternating esotropic patients..........
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Kulikova, I. L., and K. A. Aleksandrova. "Comparative analysis of accommodative ability in children with hyperopia, anisometropia, amblyopia after femtolaser-assisted laser intrastromal keratomileusis." POINT OF VIEW. EAST – WEST, no. 3 (September 28, 2021): 44–46. http://dx.doi.org/10.25276/2410-1257-2021-3-44-46.
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Purpose. Analysis of the accommodative ability in children with hyperopic anisometropia, amblyopia of operated amblyopic and paired leading eyes after femtolaser-assisted laser intrastromal keratomileusis (FS-LASIK). Material and methods. In the 1st group were 20 children with hyperopic anisometropia and amblyopia after FS-LASIK. In the 2nd were children receiving conservative treatment. Results. After 6 months, when analyzing the accommodation, the coefficient of the accommodative response (CAR) of amblyopic eye in the 1st group was 0.05±0.07 conv. units, in the 2nd group was -0.1±0.19 conv. units (рm-u=0.03). The microfluctuation coefficient (CMF) of the amblyopic eye was increased, but the CMF of the paired leading eye in children after FS-LASIK approached the norm and amounted to 58.4±5.4 µF / min. In the conservative treatment group CMF remained high and was 60.8±4.44 µF / min (рm-u= 0.08). The objective accommodative response of the amblyopic eye in the 1st group increased by -1.13±0.03 diopters, in the 2nd group – by -0.82±0.48 diopters (рm-u=0.05). Conclusion. FS-LASIK helps to improve the accommodative ability in children with hyperopia, anisometropia and amblyopia. Key words: accommodation, hyperopia, anisometropia, amblyopia, FS-LASIK.
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Khatsenko, I. E., G. I. Rozhkova, M. A. Gracheva, J. M. Salmasi, and L. M. Balashova. "Pathogenesis and descriptions of amblyopia. Part 2. Analysis of definitions." Russian ophthalmology of children, no. 3 (October 10, 2023): 48–54. http://dx.doi.org/10.25276/2307-6658-2023-3-48-54.
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This article describes the definitions of amblyopia appearing in the literature and discusses how exacly they reflect modern ideas about the disease. Based on the results of the analysis, it is recommended not to use the widespread expression “lazy eye” as a synonym for amblyopia, since it distorts the essence of this disease. Two alternative ways of searching for a modern correct definition of amblyopia are proposed. Key words: correct definition of amblyopia, concept of amblyopic component, lazy eye syndrome
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Asensio-Jurado, Laura, Marc Argilés, Lluïsa Quevedo-Junyent, Clara Mestre, and Dennis M. Levi. "Can viewing a 3D movie improve visual function in children with a history of amblyopia and neurotypical children?: A pilot study." PLOS ONE 19, no. 6 (June 25, 2024): e0305401. http://dx.doi.org/10.1371/journal.pone.0305401.
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Purpose The aim of this pilot study was to determine whether viewing an immersive 3D movie with large disparities in a cinema resulted in improved visual acuity (VA), stereoscopic depth perception (ST), and improved eye alignment in residual amblyopic children and children without amblyopia. Methods A total of 24 children aged between 5 and 12 years with a history of anisometropic and/or strabismic amblyopia, that had been previously treated and who currently have residual amblyopia (N = 14), and in children with typical development without amblyopia (N = 10) viewed the movie in 3D Sing 2 in a cinema for 110 minutes. Visual acuity, stereoacuity and ocular deviation were assessed before viewing the movie, and three months later. Stereoacuity and ocular deviation were also measured immediately after viewing the movie. Results We observed an improvement in visual acuity in the non-dominant (amblyopic) eye 3 months after viewing the movie in the amblyopic group (P<0.001). Stereopsis improved immediately after viewing the movie (P = 0.02), and after 3 months by ≈ 40% (P = 0.01). Moreover, improvements in stereopsis were also observed in children without amblyopia (P = 0.04). No significant changes in ocular deviation were observed in either group. Conclusions These pilot results suggest that brief exposure to large disparities by viewing a 3D movie in a cinema can help to improve stereopsis and visual acuity in children aged 5‒12 years with previously treated amblyopia, and provide a rationale for a randomized clinical trial.
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Eslayeh, Asmaa H., Rokiah Omar, and Norliza Md Fadzil. "Refractive amblyopia among children aged 4–12 years in a hospital-based setting in Gaza Strip, Palestine." Medical hypothesis discovery and innovation in ophthalmology 10, no. 3 (November 17, 2021): 107–13. http://dx.doi.org/10.51329/mehdiophthal1428.
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Background: Refractive amblyopia is the most common cause of amblyopia in the Gaza Strip. However, the pattern of this condition has not yet been studied in this region. This study aimed to determine the pattern of refractive amblyopia in Gazan children aged 4?12 years.Methods: This was a hospital-based cross-sectional study using a purposive sampling method. Children aged 4?12 years who attended the Children’s Unit at Gaza Ophthalmic Hospital, Gaza Strip, Palestine from September 2019 to July 2020, were examined. A comprehensive eye test was conducted for all participants. Those who failed the eye examinations and were diagnosed with refractive amblyopia were included in the study. Demographic data and amblyopic refractive error patterns were analyzed accordingly.Results: Of the 107 children, 72.9% were newly diagnosed with refractive amblyopia. The mean ± standard deviation (SD) of age of the children who participated was 7.85 ± 1.55 years. Approximately two-thirds of the patients were female (57.9%). Unilateral amblyopia was predominant in 60.7% of the cases. Moderate amblyopia was common (81.9%). A total of 149 amblyopic eyes were examined in total, with a mean ± SD (range) of best-corrected distance visual acuity and spherical equivalent of 0.45 ± 0.19 (0.2 to 1.3) logarithm of the minimum angle of resolution and + 0.76 ± 4.51 diopters (- 10.25 to + 11.50). Astigmatism was the most common amblyogenic factor (53.7%) among children with amblyopia.Conclusions: The frequency of refractive amblyopia was 72.9%, and meridional amblyopia accounted for the highest percentage. Girls were more commonly affected than boys. The majority were in the 7-year-old age group. Most cases were unilateral with moderate refractive amblyopia. Our study yields insights into the patterns of refractive amblyopia among children in the Gaza Strip.
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Rashad, Mohammad A., Khaled M. Abd Elaziz, Samah Mahmoud Fawzy, Ahmed Abdel Meguid Abdel latif, and Mahmoud Abdel Meguid Abdel latif. "Screening of Primary School Children for Amblyopia and Amblyogenic Factors in Central Cairo, Egypt." Journal of Ophthalmology 2018 (2018): 1–6. http://dx.doi.org/10.1155/2018/8425319.
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Objective. To measure the prevalence of amblyopia and amblyogenic factors among primary school children and to evaluate distance visual acuity (VA) as a screening test to detect amblyopia and define its cutoff value. Subjects and Methods. A cross-sectional study was conducted on primary school children in two schools in Central Cairo. Children underwent assessment of visual acuity using Landolt broken ring. Comprehensive ophthalmologic examination was performed for amblyopia suspects at the Ophthalmology Department of Ain Shams University Hospitals, including reassessment of best-corrected visual acuity (BCVA) using the same chart. Results. A total of 352 children were examined. Reduced screening VA (amblyopia suspect) was detected in 47 subjects (13.35%) proved amblyopia after comprehensive examination was 1.98% (7 cases). Refractive errors (REs) were present in all suspected and proved amblyopia cases (100%) but was only present in 11.6% of nonamblyopic students (P<0.05). The prevalence of hyperopia in the whole sample was 3.6%, and was 27.6% in subjects with RE. Thirty percent of hyperopic eyes were amblyopic. The prevalence of myopia was 9.3% of the whole sample and 70% of students with RE. Only 9% of myopic eyes were amblyopic. Mild to moderate amblyopia (VA better than 0.2log MAR) was 42.9%, while severe amblyopia represented 57.1%. Conclusion. This study emphasizes the importance of school-based eye care system targeting the detection of amblyopia by application of a fast screening distance VA test with a cutoff value of high sensitivity at log MAR 0.539 (Snellen′s VA equivalent 6/18).
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Naumova, Ekaterina, and Elena Titarenko. "Wavefront aberrations in children with different types of amblyopia." Eye 22, no. 129 (March 2020): 14–20. http://dx.doi.org/10.33791/2222-4408-2020-1-14-20.
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Purpose. To quantify and characterize higher-order aberrations in eyes of children with amblyopia caused by different etiology factors; to evaluate the relationship between the wavefront profile and the effectiveness of the amblyopia treatment. Material and methods. This study involved 26 children (52 eyes) from 3 to 9 years old (average age 6.2±3 years) with different types of amblyopia: unilateral amblyopia due to impaired binocular vision and anisometropia, as well as unilateral or bilateral amblyopia caused by hyperopia. Patients were divided into four groups depending on the effectiveness of pleoptic treatment: 14 children (24 eyes) – with positive treatment results, 8 children (12 eyes) – with refractory amblyopia, 4 pre-treatment newly diagnosed patients (6 eyes) without previous history of optical correction, and 10 non-amblyopic contralateral eyes (control group). All patients had central fixation and didn`t have any severe systemic diseases. Higher-order aberrations were measured with iTrace Visual Function Analyzer (Tracey Technologies, Houston, TX) after instillation of 1% cyclopentolate eyedrops. Results and discussion. Wavefront profiles were significantly different in the studied groups. Total spherical aberrations and astigmatism were significantly higher in group with refractory amblyopia (-0.53±1.19 and 2.25±1.07, p=0.02) compared with all the other groups: the group of patients before pleoptic treatment (-0.17±0.23 and 1.79±1.47), group treated with high efficiency (-0.31±0.81 and 1.04±0.13) and with control group (-0.13±0.17 and 1.38±0.11). Total coma-like aberrations didn`t show statistically significant differences in all studied groups (р=0.06). The level of corneal higher-order aberrations (total, coma, spherical) in all three amblyopic groups was higher than in the control group without amblyopia. Conclusion. We revealed statistically significant differences in the wavefront profiles in children with amblyopia of various etiologies in comparison with the control group, including higher-order aberrations. The data obtained indicate that an amblyopic eye with hyperopia has higher level of spherical aberrations and astigmatism due to higher level of internal HOAs, particularly spherical aberrations and astigmatism, which is typical for patients with unsuccessful treatment. Therefore, that type of aberrations is likely to be the main cause of refractory amblyopia.
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Khurana, Mittali, Omna Chawla, Anupam Singh, Prateek Kumar Panda, Indar Kumar Sharawat, Sanjeev Kumar Mittal, and Barun Kumar. "Association of amblyopia and body mass index in children and adolescents." Himalayan Journal of Ophthalmology 18, no. 2 (July 2024): 35–38. http://dx.doi.org/10.4103/hjo.hjo_11_24.
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Abstract Purpose: The purpose of this study is to explore any association between body mass index (BMI) and anthropometric parameters and amblyopia in children and adolescents. Materials and Methods: A total of 82 participants, aged 4–18 years, were included in this cross-sectional, observational study. The anthropometric parameters, which included height, weight, and BMI Z score, were assessed in a subset of amblyopic children and adolescents. We compared these parameters with the healthy age and gender-matched control group. Results: The results revealed that out of all 82 participants, the mean age of 55 amblyopes was 9.11 ± 4.06 years (range, 4–18 years), and that of controls was 8.44 ± 3.69 years (range, 4–17 years). The mean ± standard deviation (SD) of height (cm) and weight (kg) in amblyopia was 129.69 ± 19.01 cm and 29.27 ± 12.01 kg, respectively, and in controls, it was 124.43 ± 13.83 cm (P = 0.159) and 27.01 ± 9.89 kg (P = 0.399). The median (25th–75th percentile) of the BMI Z score in the amblyopia group was -0.27 (-1.365 to 0.885), and in controls was 0.00.01 (-0.85885; P = 0.399). We did not find any clinically or statistically significant difference in the above parameters between cases and controls. Conclusion: This study concludes that amblyopes do not have deranged BMI and anthropometric parameters in the early years of life. Ophthalmologists are the primary healthcare professionals who have a crucial role in prompt identification and intervention to prevent long-term vision impairments in patients with amblyopia. Enhancements in visual acuity are expected to improve their overall quality of life and social well-being, which may reduce the other negative consequences in the form of deranged BMI and other related morbidities in their adulthood.
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Goodyear, Bradley G., David A. Nicolle, G. Keith Humphrey, and Ravi S. Menon. "BOLD fMRI Response of Early Visual Areas to Perceived Contrast in Human Amblyopia." Journal of Neurophysiology 84, no. 4 (October 1, 2000): 1907–13. http://dx.doi.org/10.1152/jn.2000.84.4.1907.
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In this study, we used a temporal two-alternative forced choice psychophysical procedure to measure the observer's perception of a 22% physical contrast grating for each eye as a function of spatial frequency in four subjects with unilateral amblyopia and in six subjects with normal vision. Contrast thresholds were also measured using a standard staircase method. Additionally, blood-oxygenation-level–dependent (BOLD) functional magnetic resonance imaging (fMRI) was used to measure the neuronal response within early visual cortical areas to monocular presentations of the same 22% physical contrast gratings as a function of spatial frequency. For all six subjects with normal vision and for three subjects with amblyopia, the psychophysically measured perception of 22% contrast as a function of spatial frequency was the same for both eyes. Threshold contrast, however, was elevated for the amblyopic eye for all subjects, as expected. The magnitude of the fMRI response to 22% physical contrast within “activated” voxels was the same for each eye as a function of spatial frequency, regardless of the presence of amblyopia. However, there were always fewer “activated” fMRI voxels during amblyopic stimulation than during normal eye stimulation. These results are consistent with the hypotheses that contrast thresholds are elevated in amblyopia because fewer neurons are responsive during amblyopic stimulation, and that the average firing rate of the responsive neurons, which reflects the perception of contrast, is unaffected in amblyopia.
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Bokhary, Kholoud Ahmad, Razan Ibrahim Alsabih, and Gamal Abdelrahman El-Hiti. "Binocular treatment for amblyopic children: a review." Journal of the Pakistan Medical Association 73, no. 3 (February 15, 2023): 627–34. http://dx.doi.org/10.47391/jpma.6216.
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The narrative review was planned to investigate the efficiency of binocular treatment for amblyopic children, and to compare it with the standard methods. Literature search was conducted for articles in English language available on PubMed, Cochrane Library, Embase, Medline and PsycInfo databases as well as through bibliographies of peer-reviewed studies. Studies in the field of binocular treatment for amblyopia were included. Visual outcomes considered were visual acuity, types of amblyopia and stereoacuity. Studies on deprivation amblyopia, animal studies, literature review of amblyopia treatment, case reports, and trials targeting participants in whom previous amblyopia treatment had failed were excluded. Of the 40 studies found, 21(52.5%) met the inclusion criteria. Visual acuity and binocular function improved with binocular treatment for treating amblyopia in children by decreasing suppression depth extent and increasing stereopsis. ---Continue
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Petrovic Pajic, Sanja, Ana Fakin, Maja Sustar Habjan, Martina Jarc-Vidmar, and Marko Hawlina. "Leber Hereditary Optic Neuropathy (LHON) in Patients with Presumed Childhood Monocular Amblyopia." Journal of Clinical Medicine 12, no. 20 (October 22, 2023): 6669. http://dx.doi.org/10.3390/jcm12206669.
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Background: Most Leber hereditary optic neuropathy (LHON) cases are bilateral and sequential; however, there are rare unilateral examples, or those in which the delay of onset of vision loss between one and the other eye is longer. In the case of presumed childhood amblyopia in one eye, vision loss in the good eye may be the only symptom of bilateral disease, which was unnoticed in the previously amblyopic eye, or a preexisting episode of LHON in the “amblyopic” eye. The clinical decision in such cases may be difficult and suggestive of other forms of atypical optic neuropathy until confirmed by genetic testing. Case series: We present three genetically confirmed (MT-ND1:m.3700G>A, MT-ND6:m14484 T>C, and MT-ND4:m.11778G>A) patients with subacute vision loss in the previously good eye, with the other eye believed to be amblyopic from childhood and their features different from what would be expected in true amblyopia. In all, electrophysiology testing showed a bilaterally reduced amplitude of PERG with low VEP P100 wave amplitudes and prolonged peak time in both eyes, also unusual for amblyopia. During follow-up, the pallor of the optic discs progressed in all eyes. Significant thinning of the peripapillary retinal nerve fiber layer (pRNFL; retinal nerve fiber layer around the optic disc) and ganglion cell complex (GCC) in the macular region was present. All three patients had a peculiar history. The first patient was treated for presumed hyperopic amblyopia that did not improve since childhood, experienced visual loss in the good eye at the age of 17, and was negative for the three typical LHON mutations. Extended testing confirmed an atypical pathogenic variant MT-ND1:m.3700G>A in homoplasmy. The second patient with presumed strabismic amblyopia had an unusual presentation of vision loss only at the age of 61, and after the exclusion of other causes, a typical MT-ND4:m.11778G>A pathogenic variant was found in homoplasmy. The third case was peculiar as he had presumed strabismic amblyopia since childhood and had some degree of disc pallor in the amblyopic eye upon presenting with loss of vision in the good eye at the age of 21, and a typical pathogenic variant m14484 T>C, p.Met64Val was subsequently confirmed. However, one year after disease onset, he started to experience significant spontaneous functional improvement in the non-amblyopic up to 1.0 Snellen whilst improvement in the presumed amblyopic eye was modest, suggesting preexisting amblyopia. This interestingly extensive improvement was carefully followed by electrophysiology as well as visual acuity and fields. Conclusions: This report shows three different scenarios of presentation of LHON in patients with presumed uniocular amblyopia from childhood. In such cases, the diagnosis may be difficult, and detailed structural and functional evaluation of the optic nerve head is necessary to assess whether an earlier LHON episode was misdiagnosed as amblyopia or whether LHON presented bilaterally on both eyes whilst only being noticed in the previously good eye.
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Mompart-Martínez, Raquel, Marc Argilés, Genis Cardona, Lluís Cavero-Roig, Lluís González-Sanchís, and Maria Soledad Pighin. "The Relationship between Fixation Stability and Retinal Structural Parameters in Children with Anisometropic, Strabismic and Mixed Amblyopia." Life 13, no. 7 (July 6, 2023): 1517. http://dx.doi.org/10.3390/life13071517.
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(1) Background: Amblyopia is an ocular condition leading to structural and functional changes. The relationship between these changes is complex and remains poorly understood. (2) Methods: Participants included 31 children aged 5 to 9 years with strabismic (n = 9), anisometropic (n = 16) and mixed (n = 6) unilateral amblyopia, and 14 age-matched non-amblyopic children. The 95% and 63% Bivariate Contour Ellipse Area (BCEA), axial length, Foveal Avascular Zone (FAZ) area, center macular thickness and volume were assessed. The relationship between these parameters was explored. (3) Results: Statistically significant differences were found among the four groups in best corrected distance visual acuity (BCVA) (p < 0.001), BCEA 95% (p = 0.002) and BCEA 63% (p = 0.002), but not in the FAZ area, central macular thickness, central macular volume and axial length. Eyes with amblyopia had poorer BCVA and larger fixation instability than controls. Inter-ocular differences were more significant in patients with strabismic amblyopia, particularly in BCVA (p = 0.003), central macular thickness (p < 0.001) and central macular volume (p = 0.002). In amblyopic eyes, BCEA 95% and 63% were correlated with BCVA, but not with the FAZ area. (4) Conclusion: Amblyopia is associated with a reduction in fixation stability and BCVA, although there is a general lack of correlation with structural changes, suggesting a complex interaction between anatomy and function in amblyopia.
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Chen, Wuhe, Frank Thorn, Ruzhi Deng, Xiaoman Li, Jiangtao Lou, Yingjie Wang, and Xinping Yu. "Macular Microvasculature Density Changes in Anisometropic Amblyopic Eyes after Successful Treatment." Journal of Ophthalmology 2020 (November 6, 2020): 1–7. http://dx.doi.org/10.1155/2020/8879175.
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Purpose. To determine if the abnormal macular microvasculature in hyperopic anisometropic amblyopia changes after occlusion therapy, and to discover if the macular microvasculature influences the efficacy of amblyopic treatment. Materials and Methods. Twenty-two children with hyperopic anisometropic amblyopia (median, 8 years old) were enrolled along with 66 healthy controls of similar age and gender distribution. Best-corrected visual acuity (BCVA) was determined, and macular vessel density in the superficial and deep capillary plexuses (SCPs and DCPs, respectively) was measured by optical coherence tomography angiography before and after refractive correction and occlusion therapy. Changes in BCVA and macular SCP and DCP vessel density were measured after amblyopia treatment of 7.5 ± 4.4 months. Results. The amblyopic baseline BCVA, logMAR 0.42 ± 0.27, improved to logMAR 0.18 ± 0.18 in 14 patients (64%) after amblyopia treatment ( P < 0.001 ). In 8 patients (36%), there was no improvement in the BCVA. In amblyopic eyes with improved BCVA, the SCP density tended to increase in each parafoveal quadrant, while it tended to decrease in all quadrants of the fellow eyes. For patients in whom BCVA did not improve, the macular SCP vessel density tended to decrease in all quadrants of the amblyopic and fellow eyes. The posttreatment difference in SCP vessel density between amblyopic and fellow eyes was not significant. Multiple linear regression analysis showed that older age and greater foveal SCP vessel density were negatively correlated with BCVA improvement ( P < 0.018 and P < 0.036 , respectively). Conclusions. Macular vessel density tends to increase in anisometropic amblyopic eyes after successful treatment. Younger age and lower SCP macular density are predictive of a greater therapeutic effect of occlusion therapy.
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Halička, Juraj, Erik Sahatqija, Michal Krasňanský, Karolína Kapitánová, Monika Fedorová, and Peter Žiak. "Visual Training in Virtual Reality in Adult Patients With Anisometric Amblyopia." Czech and Slovak Ophthalmology 76, no. 1 (December 5, 2019): 24–28. http://dx.doi.org/10.31348/2020/3.
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Purpose: Amblyopia is one of the most common childhood disease. The average prevalence of amblyopia in children is estimated at 2-5 %. It arises during the child development until the age of six, if not treated then, it persist throught adulthood. The aim of our work is to retrospectively analyze the results of treatment of anisometropic amblyopia using dichoptical training in virtual reality in adult amblyopic patients. Materials and Methods: Our group consisted of 84 amblyopic patients with anisometropic amblyopia with an average age of 33.8 ± 9.4 years. Patients played a video game twice a week in the Oculus Rift 3D virtual reality. Together they completed 8 visual trainings, with one training lasting 60 minutes. Before and after the training we evaluated the best corrected visual acuity (BCVA). Discussion: Throughout the group, we observed an improvement of 0.1 BCVA from 0.48 to 0.58 Sloan table (p <0.05). 17% of patients before training and 31% after visual training reached BCVA better or equal to 0.9. The overall response rate was 56% in adult patients (n = 47). Conclusion: Our results suggest that a certain degree of residual neuro-plasticity in the visual cortex can be revealed in the adult brain, thereby improve visual acuity in adult amblyopic patients.
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Subedi, Santosh, Jyoti Baba Shrestha, Anand Kumar Sharma, and Jyoti Sapkota. "Evaluation of Retinal Nerve Fibre Layer and Macular Thickness in Amblyopia." Nepal Medical Journal 5, no. 1 (September 3, 2022): 45–49. http://dx.doi.org/10.37080/nmj.128.
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Introduction: Amblyopia is reduced visual acuity in one or both eyes due to abnormal visual development in early part of life. Purpose of this study was to evaluate and compare the retinal nerve fibre layer (RNFL) and central macular thickness (CMT) between amblyopic and fellow (normal) eyes using spectral-domain optical coherence tomography (SD-OCT).
Methods: This was a hospital based, cross-sectional comparative study conducted in the department of Ophthalmology, B.P. Koirala Lions Centre for Ophthalmic Studies (BPKLCOS), Institute of Medicine (IOM), Tribhuvan University Teaching Hospital (TUTH). All consecutive cases of age ≥5 years and ≤15 years diagnosed with unilateral amblyopia from January 2013 to June 2014 were included in this study. RNFL and macular thicknesses were measured using SD-OCT and compared between fellow eyes.
Results: A total of 32 cases with unilateral amblyopia, 19 with hypermetropic anisometropic, 4 with myopic anisometropic and 9 with strabismic amblyopia were enrolled in the study. The mean age of presentation was 9.75±2.77 years. The mean CMT in amblyopic eyes (241±45.27 μm) was significantly greater than the normal fellow eyes (233.22±44.24 μm), p= 0.042. The difference remained significant in hypermetropic anisometropic group but not in myopic anisometropic and strabismic group. The mean RNFL thickness was similar in amblyopic (104.16±13.64 μm) and fellow eyes (104.03±13.06 μm).
Conclusions: The CMT was significantly greater in the amblyopic eyes than the normal fellow eyes. There was no significant difference in the RNFL thickness between the amblyopic and normal eyes.
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Aljohani, Saeed, and Rakan Al-Mutairi. "Evaluating the Psychological Impacts of Patching Treatment on Parents in Qassim Region, Saudi Arabia." Open Access Macedonian Journal of Medical Sciences 11, B (February 13, 2023): 340–45. http://dx.doi.org/10.3889/oamjms.2023.11418.
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BACKGROUND: The previous studies showed that patching treatment for amblyopia in children may have adverse psychological effects on children and families. AIM: The aim of the study was to investigate the reliability and validity of an Arabic version of the Amblyopia Treatment Index questionnaire and to evaluate the psychosocial impacts of patching treatment on parents of amblyopic children. METHODS: This was a cross-sectional study of 239 parents or guardians of amblyopic children who had at least five weeks of patching treatment experience in the past 6 months before enrolment. Eligible parent was either enrolled in the study from Qassim University Medical City eye clinics or referred by optometrists and ophthalmologists from 6 hospitals in Qassim province. Twenty parents were asked to repeat the same questionnaire after 14 days ± 2 days for test-retest reliability. RESULTS: The findings showed good internal validity and reliability for the Arabic version of the Amblyopia Treatment Index questionnaire among Saudi amblyopic patients. The factor analysis revealed that 16 of 21 items were strongly correlated through the questionnaire’s internal consistency ≥0.5 under three factors. Seven items were strongly correlated with the factor of adverse effects of amblyopia treatment. Similarly, seven items were strongly correlated with the lack of amblyopia treatment adherence, and only two were strongly correlated with the factor of social stigma. Reliability tested by Cronbach’s α coefficient showed good internal reliability and consistency (0.774). Cronbach’s α coefficient for the three factors was 0.734 for adverse effect, 0.644 for lack of treatment adherence, and 0.723 for social stigma. There is no significant association between parents’ education level and the final questionnaire score. CONCLUSION: The Arabic version of the amblyopia treatment index questionnaire showed high validity and reliability for factors related to patching therapy and was useful for Saudi children. Treatment of amblyopia in the Saudi community is strongly affected by adverse effects, adherence, and social stigma of adhesive patching.
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Terada, Noriko, Manabu Miyata, Yuki Muraoka, Masayuki Hata, Masahiro Fujimoto, Satoshi Yokota, Hideo Nakanishi, et al. "Abnormal Outer Choroidal Vasculature in Amblyopia." Journal of Ophthalmology 2019 (January 10, 2019): 1–7. http://dx.doi.org/10.1155/2019/2097087.
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Purpose. Several studies have indicated morphological changes in the choroid in amblyopia cases. This study investigates whether choroidal vasculature was different among amblyopic and fellow eyes in unilateral amblyopia patients and healthy eyes, using en face images acquired via swept-source optical coherence tomography (SS-OCT). Design. Prospective, observational case-control study. Methods. This study included 14 consecutive patients with unilateral amblyopia and 22 age- and axial length-matched healthy eyes. Using SS-OCT, we obtained en face images of choroidal vasculature midway through the subfoveal inner and total choroid, corresponding to the vasculature of the choriocapillaris and Sattler’s layer (inner choroid) and Haller’s layer (outer choroid), respectively. We analyzed the en face images of the inner and outer choroidal vascular areas in 3 × 3 mm squares adjusted from 6 × 6 mm squares, using Littmann’s magnification correction, after binarization of the images as a portion of the whole area. Results. The outer choroidal vascular areas were larger in both amblyopic and fellow eyes than in healthy eyes (both P<0.001), although there were no significant differences in inner (56.35 ± 2.46% and 56.27 ± 3.75%, respectively) or outer (61.49 ± 4.95% and 61.48 ± 3.73%, respectively) choroidal vascular area between amblyopic and fellow eyes (P=0.98 and 0.91, respectively). An outer choroidal vascular area of 59% was set as an appropriate cutoff value for distinguishing patients from controls. Conclusions. The outer choroidal vascular area was larger in both amblyopic eyes and fellow eyes compared to healthy eyes. Our findings may help clarify the etiology of amblyopia.
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Canadanovic, Vladimir, Dragana Bjelica, Sinisa Babovic, Tatjana Bedov, Nikola Babic, and Desanka Grkovic. "Detection and treatment of amblyopia in children." Medical review 64, no. 1-2 (2011): 73–76. http://dx.doi.org/10.2298/mpns1102073c.
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Refractive errors are a common cause of decreased visual acuity. They can be found in 2-4% of preschool children. If not discovered on time and not properly treated, they can lead to amblyopia and strabismus. The active participation of parents and paediatricians is of great importance in timely discovering and treatment of amblyopia. The most common causes of amblyopia are strabismus (50.1%) and refractive error (44.7%). The best treatment results are achieved in amblyopic children with strabismus. The cooperation of physicians of all specialties, above all paediatricians and ophthalmologists, as well as a good collaboration of parents based on their being well-informed, must exist in the process of timely diagnosing and treating of amblyopia.
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Zha, Yi, Jinfei Zhuang, Wangqiang Feng, Haihua Zheng, and Jianqiu Cai. "Evaluation of choroidal thickness in amblyopia using optical coherence tomography." European Journal of Ophthalmology 30, no. 4 (February 26, 2019): 629–34. http://dx.doi.org/10.1177/1120672119834179.
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Objective: To investigate the choroidal thickness in children with amblyopia through spectral-domain optical coherence tomography. Methods: A total of 31 children with unilateral amblyopia and 31 right eyes of controls with normal vision were enrolled in the study. The choroidal thickness was measured directly below the fovea and at 12 other locations: 1, 2 and 3 mm superior, temporal, inferior, and nasal to the fovea. All the parameters were compared between amblyopic eyes, fellow eyes, and control eyes. Results: The mean subfoveal choroidal thickness was 398.03 ± 74.60, 354.13 ± 81.78, and 328.12 ± 65.93 μm in amblyopic eyes, fellow eyes, and control eyes, respectively. Significant difference was found in choroidal thickness among three groups at subfoveal choroidal thickness, N1, and S1 using multivariate analysis of covariance after adjusting for axial length. Significant negative correlation was found only between subfoveal choroidal thickness and axial length in amblyopic eyes (r = –0.463, p = 0.01). Conclusion: The subfoveal choroid is significantly thicker in amblyopic eyes than control eyes only at subfoveal choroidal thickness, N1, and S1. The choroidal thickness was thickest in the subfoveal region and thinnest in the nasal region. There are other changes in choroidal structure associated with amblyopia.
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Shrestha, Chunu, Reeta Rajbhandari, and Manish Poudel. "Macular and Peripapillary Retinal Nerve Fiber Thickness in Unilateral Amblyopic Eye." Nepal Medical College Journal 23, no. 2 (July 29, 2021): 132–38. http://dx.doi.org/10.3126/nmcj.v23i2.38522.
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Amblyopia is the most common cause of monocular visual impairment in both children, and young to middle-aged adults, affecting 2%–5% of the general population. The objective of this study was to compare the peripapillary nerve fiber thickness and macular thickness in amblyopic eyes, fellow eyes and normal control eyes using spectral domain optical coherence tomography. This was a cross-sectional observational study conducted at R M Kedia Eye Hospital, Birgunj, Nepal from February 2020 to July 2020. Pediatric patients with unilateral amblyopia (anisometropic amblyopia, strabismic amblyopia or both) among the age group of 6-18 years attending pediatric department of RM Kedia Eye Hospital were enrolled for the study. All patients underwent a full ophthalmological assessment, including visual-acuity testing, anterior segment evaluation with Topcon slit lamp and fundus examination with Volk +90D lenses. All statistical analysis was done in SPSS V. 20. The average peripapillary retinal nerve fiber layer thickness was 120.6 μm (SD=14.6 μm) in the amblyopic eye, 118.1 μm (SD=15.6 μm) in the fellow eye and 113.2 μm (SD=9.4 μm) in the normal eye (p=0.104) respectively. The average macular thickness was 298.6 μm (SD=19.1 μm) in the amblyopic eye, 296.9 μm (SD=11.2 μm) in the fellow eye and 303 μm (SD=12.4 μm) in the normal eye (p=0.260) respectively. In conclusion, our study did not find any significant difference in the peripapillary retinal nerve fiber thickness or macular thickness when compared between amblyopic eyes, fellow eyes, gender and age matched normal eyes.
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Adhikari, Sikshya, Rinkal Suwal, Basanta Singh, Rashmi Shrestha, Sudip Karki, and Bijay Khatri. "Amblyopia among Patients Attending the Outpatient Department of Ophthalmology of a Tertiary Care Centre: A Descriptive Cross-sectional Study." Journal of Nepal Medical Association 60, no. 254 (October 1, 2022): 844–47. http://dx.doi.org/10.31729/jnma.7868.
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Introduction: Amblyopia is defined as a reduction in visual acuity unilaterally or bilaterally without any detectable cause. It is a major public health issue in developing and underdeveloped countries. Its prevalence is usually underestimated because of proper study and lack of awareness. The aim of the study was to find out the prevalence of amblyopia among patients attending the Outpatient Department of Ophthalmology of a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among outpatients visiting a tertiary care centre in the Outpatient Department of Ophthalmology between 1 January 2017 to 31 December 2019. Ethical approval was obtained from the Institutional Review Board (Registration number: 407/2020 P). All patients had gone through a comprehensive eye examination. Convenience sampling was used. Point estimate and 99% Confidence Interval were calculated. Results: Among 82972 patients, prevalence of amblyopia was 344 (0.41%) (0.37-0.46, 99% Confidence Interval). Amblyopia was more common in anisometropia 263 (63.50%). A total of 117 (34%) patients had no history of eye examination and were newly diagnosed with amblyopia. Astigmatism was the most common type of refractive error among 224 (56.70%) amblyopic patients. Conclusions: The prevalence of amblyopia was found to be lower than in previous studies conducted in similar settings. Early detection and diagnosis of amblyopia can help to design more effective plans and treatments to reduce amblyopia through optical correction and amblyopia therapy.
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Shrestha, Sabina, Dikchhya Sharma, Aparajita Manoranjan, Subee Joshi, and Yuliya Shrestha. "Visual Functions among amplyopic patients." Nepal Medical College Journal 25, no. 3 (October 3, 2023): 191–95. http://dx.doi.org/10.3126/nmcj.v25i3.58710.
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Apart from decreased visual acuity, amblyopia may be associated with alteration in color vision, contrast sensitivity and stereopsis. The study was conducted to assess visual functions among amblyopic patients. Cross sectional observational study was done with appropriate examination. Best corrected visual acuity, color vision, contrast sensitivity and stereopsis were done among 31 amblyopic patients of age 5-18 years, visiting Department of Ophthalmology in Kathmandu Medical College from October 2021 to March 2022. Among thirty-one patients, male is to female ratio was 1.81:1. Mean age of participants was 9.45±3.49 years. Among patients with stimulus deprivation amblyopia, visual acuity was <6/60, color vision and contrast sensitivity were decreased in 100% and moderate stereopsis (80-200 seconds of arc) was present. Among patients with strabismic amblyopia, visual acuity was decreased (6/12-6/18), color vision and contrast sensitivity were normal in 100% and good stereopsis (<60 seconds of arc) was seen. Among those with refractive amblyopia, visual acuity was 6/6-6/9 in 34.5%, 6/12-6/18 in 44.8% and 6/24-6/60 in 20.7%. Color vision was decreased in 27.3% in ametropic, 9.1% in meridional and normal in anisometropic type. Contrast sensitivity was decreased in 27.3% each in ametropic and anisometropic, and in 63.6% in meridional amblyopia. Good and poor (>200 seconds of arc) stereopsis was found in 24.1% each and moderate in 51.7% of refractive amblyopia. Contrast sensitivity was seen to be decreased with decrease in vision (40.0%, 42.8%, 50.0% and 100.0% in visual acuity 6/6-6/9, 6/12-6/18, 6/24-6/60 and<6/60 respectively). To conclude, visual functions are affected in different types of amblyopia.
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Yekta, Abbasali, Hassan Hashemi, Reza Norouzirad, Hadi Ostadimoghaddam, Payam Nabovati, Nooshin Dadbin, Fereidon Nirouzad, Ehsan Shir-Alivand, and Mehdi Khabazkhoob. "The Prevalence of Amblyopia, Strabismus, and Ptosis in Schoolchildren of Dezful." European Journal of Ophthalmology 27, no. 1 (May 23, 2016): 109–12. http://dx.doi.org/10.5301/ejo.5000795.
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Purpose To determine the prevalence of amblyopia, strabismus, and ptosis among schoolchildren in Dezful in the west of Iran. Methods In this cross-sectional study, 1,375 schoolchildren of Dezful were selected through multistage cluster sampling. After obtaining written consents, participants had uncorrected and corrected visual acuity tests, cycloplegic refraction, and the cover test, and were examined for ptosis at the school site. Results Of the 1,151 study participants (83.7%), examinations were completed for 1,130 schoolchildren. Prevalence rates of amblyopia, strabismus, and ptosis were 2.7% (95% confidence interval [CI] 0.8-4.7), 1.9% (95% CI: 0.2-3.8), and 0.8%, respectively. Anisometropia was the most common cause of amblyopia; 45.2% of cases had anisometropic amblyopia. Among cases with strabismus, 63.6% were exotropic and 36.4% were esotropic. Conclusion The present study indicated that the prevalence of amblyopia and strabismus in Dezful schoolchildren falls in the average range. Since the Amblyopia Screening Program has been running for years, we expected lower rates compared to previous years, but this was not observed. Correcting refractive errors can significantly reduce amblyopic cases.
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Guimaraes, Sandra, Andreia Soares, Cristina Freitas, Pedro Barros, Ricardo Dourado Leite, Patrício Soares Costa, and Eduardo D. Silva. "Amblyopia screening effectiveness at 3–4 years old: a cohort study." BMJ Open Ophthalmology 6, no. 1 (January 2021): e000599. http://dx.doi.org/10.1136/bmjophth-2020-000599.
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ObjectiveTo study the effectiveness of amblyopia screening at ages 3–4.Methods and AnalysisFrom a population with no previous screening, a cohort of 2300 children with 3–4 years old attending school (91% of children this age attend school in Portugal), were submitted to a complete ophthalmological evaluation. Amblyopia was diagnosed, treated and followed. Amblyopia prevalence, treatment effectiveness, absolute risk reduction (ARR), number needed to screen (NNS) and relative risk reduction (RRR) were estimated.ResultsPast/present history of amblyopia was higher than 3.1%–4.2%, depending on amblyopia definition normatives. Screening at age 3–4, had estimated ARR=2.09% (95% CI 1.50% to 2.68%) with a reduced risk of amblyopia in adulthood of 87% (RRR). NNS was 47.8 (95% CI 37.3 to 66.7). Treatment effectiveness of new diagnosis was 88% (83% if we include children already followed). 91% of new amblyopia diagnoses were refractive (of which 100% surpassed amblyopia Multi-Ethnic Pediatric Eye Disease Study criteria after treatment), while most strabismic amblyopias were already treated or undertreatment. Only 30% of children with refractive amblyopia risk factors that were not followed by an ophthalmologist, ended up having amblyopia at age 3–4. Eye patch was needed equally in new-diagnosis versus treated-earlier refractive amblyopia.ConclusionsScreening amblyopia in a whole-population setting at age 3–4 is highly effective. For each 48 children screened at age 3–4, one amblyopia is estimated to be prevented in the future (NNS). Screening earlier may lead to overdiagnosis and overtreatments: Treating all new diagnosis before age 3–4 would have a maximal difference in ARR of 0.3%, with the possible burden of as much as 70% children being unnecessary treated before age 3–4.Involving primary care, with policies for timely referral of suspicious/high-risk preverbal children, plus whole screening at age 3–4 seems a rational/effective way of controlling amblyopia.
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Boiko, E. V., A. I. Shilov, K. K. Shefer, and I. V. Khizhnyak. "Refractive lens replacement for refractive amblyopia: «treatment» or diagnostics?" Fyodorov journal of ophthalmic surgery, no. 4 (December 28, 2023): 45–53. http://dx.doi.org/10.25276/0235-4160-2023-4-45-53.
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Relevance. Refractive amblyopia is one of conditions that reduce best corrected visual acuity (BCVA) in patients. With the advent of new methods of refractive surgery, we note new features of the course of refractive amblyopia in adult patients after refractive surgery. Purpose. Determination of changes in uncorrected visual acuity and BCVA as well as changes in the degree of amblyopia in patients with high-grade refractive errors after implantation of toricIOLs during refractive lens replacement (RLL). Materials and methods. Retrospective evaluation of functional outcomes in 20 patients over 18 years (28 eyes) who received surgical treatment in the form of refractive lens replacement for myopic and hypermetropic astigmatism in the presence of high-grade ametropia with amblyopia. Results. In 35.3% of patients with myopic refraction, the diagnosis of amblyopia was removed. In 41.2%, we saw reducing the degree of amblyopia, 23.5% added 1 line of BCVA without changing the degree of amblyopia. When comparing the BCVA of patients with myopic refraction before and after surgical treatment, significant differences were obtained. In all eyes with hypermetropic refraction, there was no change in the degree of amblyopia after surgery, 22% of operated ones received an increase in BCVA by 1 line. There were no significant differences of BCVA a week after surgery in patients with hyperopic refraction. Conclusion. The revealed change in the degree of amblyopia in patients in early stages after RLL makes us clarify diagnosis and doubt sufficiency of standard methods for diagnosing amblyopia and determining its degree. In amblyopic patients with high myopia, in comparison with patients with hyperopia, refractive replacement of the transparent lens in most cases leads to an increase in BCVA in a short time after. Refractive lensectomy, is a amblyopia treatment, and is an important tool to exclude the diagnosis of amblyopia or reduce its degree. Key words: amblyopia, lens, refractive surgery, myopia, hypermetropia
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Thakur, Ajit, Nabin Raj Joshi, and Anita Gupta. "Visual Functional Limitation in Amblyopia: A Review." ECS Transactions 107, no. 1 (April 24, 2022): 6945–54. http://dx.doi.org/10.1149/10701.6945ecst.
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Amblyopia is a unilateral or bilateral reduction in visual acuity in absence of any pathological causes. It results in limitations of various visual functions including visual acuity that are essential for performing daily living activities. In this study, we conducted a comprehensive review of affected visual functions in amblyopia through a Pubmed search with an extensive search strategy. Seventeen research articles were selected out of 420 possible research articles and included in the study. Besides visual acuity, other visual functions such as contrast sensitivity, fixation stability, accommodative functions, visuomotor behavior, binocularity, stereopsis, and visual attention were found to be significantly affected in amblyopia. Interestingly, the visual functions corresponding to the "normal eye" of the amblyopic patients were also found to be significantly affected in all forms of amblyopia.
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Toor, Sonia, Anna M. Horwood, and Patricia Riddell. "Asymmetrical accommodation in hyperopic anisometropic amblyopia." British Journal of Ophthalmology 102, no. 6 (October 19, 2017): 772–78. http://dx.doi.org/10.1136/bjophthalmol-2017-310282.
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Background/aimsTo investigate the presence of asymmetrical accommodation in hyperopic anisometropic amblyopia.MethodsAccommodation in each eye and binocular vergence were measured simultaneously using a PlusoptiX SO4 photorefractor in 26 children aged 4–8 years with hyperopic anisometropic amblyopia and 13 controls (group age-matched) while they viewed a detailed target moving in depth.ResultsWithout spectacles, only 5 (19%) anisometropes demonstrated symmetrical accommodation (within the 95% CI of the mean gain of the sound eye of the anisometropic group), whereas 21 (81%) demonstrated asymmetrical accommodation. Of those, 15 (58%) showed aniso-accommodation and 6 (23%) demonstrated ‘anti-accommodation’ (greater accommodation for distance than for near). In those with anti-accommodation, the response gain in the sound eye was (0.93±0.20) while that of the amblyopic eye showed a negative accommodation gain of (−0.44±0.23). Anti-accommodation resolved with spectacles. Vergence gains were typical in those with symmetrical and asymmetrical accommodation.ConclusionThe majority of hyperopic anisometropic amblyopes demonstrated non-consensual asymmetrical accommodation. Approximately one in four demonstrated anti-accommodation.