Does Amblyopia Protect against Age-Related Maculopathy?

Abstract

Ten patients are presented with clinically relevant age-related maculopathy (AMD) in one eye. Five of them had severe amblyopia with eccentric fixation in the non-affected eye. The remaining five had equal visual acuity in the two eyes before the onset of AMD. All patients have been followed over a six year period, in order to detect the time-course of involvement of the second eye. Visual acuity measurements and fluorescein angiography were repeated annually. AMD in the affected eye evolved towards a cicatricial neovascular pattern. Initial fluoroangiographic lesions developed after the first year of observation in the non-amblyopic patients., These alterations evolved gradually and affected more or less severely visual function over the six year period. In comparison, no significant lesions developed in the second eye of patients with amblyopia.To our knowledge, this is the first report of a “protective” effect for AMD of severe amblyopia. It can be speculated that the non-use of the central retina delays the evolution of AMD. The same amount of light enters both eyes: light cannot be therefore considered as a causative or favoring element. Presumably, the inner retinal metabolism involved in image formation, has a contributing effect in establishing initial AMD lesions.