Anisometropic Amblyopia Research Articles

Saccadic as Well as Manual Reaction Times to Targets Given to the Amblyopic Eye are Faster than Those of the Opposite Eye or Normal Eyes

Aim: Amblyopia is caused by a combination of neural and visual impairments caused by abnormal early visual growth. One of the many drawbacks of amblyopia is that the amblyopic eye's saccadic and physical reaction times to targets presented to it are much slower than the other eye or normal eyes.
 Methodology: Assumed that amblyopic eye's recognized impairments in contrast sensitivity, the question immediately arises if the longer reaction times are merely a result of the stimuli's diminished visibility. Our current research was conducted at People Medical College Hospital Nawabshah from May 2019 to April 2020.
 Results: RTs to perifoveal stimuli are measured in study 1 as a function of efficient stimulus contrast, i.e., contrasting as measured by the amblyopic eye's comparison threshold. In our anisometropic amblyopes, researchers find that the asymptotic RTs including both eyes are the same when the sensory differences among eyes are minimized or eliminated. Several cross-eyed amblyopes, though, might have had an insurmountable delayed at asymptote. However, after accounting for stimulus sensory changes, these individuals' saccadic response times exhibited considerable interocular discrepancies. According to our results, eliminating the fixation image does slow down the amblyopic eye's reaction time, and that the gap impact is the same in both eyes. Therefore, the amblyopic eye's intrinsic delayed is not eliminated by the gap impact.
 Conclusion: Last but not least in Experiment 3, we looked at the interocular variations in saccadic and manual reaction times for the same participants. As a result, we were able to determine the relationship between latencies in the two modes.

Modern Methods for the Diagnosis of Morphological and Functional Features of the Retina in Dysbinocular and Anisometropic Amblyopia

Child health is a global health priority. Anomalies of refraction, complicated by amblyopia and squint, occupy one of the leading places in the pathology of the visual system of children. According to data obtained from 26 regions of Russia, the leading place in the ocular morbidity of children and adolescents is occupied by ametropia and strabismus with amblyopia. They account for up to 90 % of all cases of visual impairment in childhood. The term amblyopia is understood to mean a decrease in the maximum corrected visual acuity that occurred at an early age, which is caused by disorders of the functions of the visual analyzer, without changes in the fundus and organic lesions of the visual pathways and centers. Despite the outstanding achievements of 21st century medicine, today the questions of the pathophysiological essence of this condition remain open, which is the subject of discussions among pediatric ophthalmologists around the world. In this regard, the literature review presents the results of domestic and foreign authors who studied the morphological (optical coherence tomography) and functional (electroretinography, microperimetry) features of the retina in dysbinocular and anisometropic amblyopia. Some authors have demonstrated the presence of differences in the thickness of the central region and the layer of nerve fibers in patients with amblyopia compared with paired and healthy eyes, their correlation with functional parameters, as well as changes in the thickness of the choroid and microvasculature of the retina. Recently, there have been works devoted to the study of the photosensitivity of the retina in patients with amblyopia and visual rehabilitation using this equipment. A number of authors have shown that with amblyopia, the retinal photosensitivity parameters in the central region are reduced, and there is a correlation between these changes and morphological changes in the posterior pole. The microperimeter also makes it possible to carry out visual rehabilitation, in particular in pediatric patients, and isolated results have been published on the use of this method in patients with amblyopia. The literature data are quite contradictory, and more research remains to be done to determine whether these changes in the retina are primary in relation to this disease, or whether they can be the result of retrograde changes that are obscured by defocusing of visual images from birth.

Clinical Management of Monofixation Syndrome due to Microtropia

BACKGROUND: Monofixation syndrome is a binocular vision disorder characterized by peripheral fusion with a central suppression of one eye due to smallangle strabismus (microtropia) or anisometropic amblyopia. Reduced stereopsis and acuity are noted in the non-fixating eye. Although often left untreated due to good cosmetic appearance, central suppression and reduced stereopsis can affect visual performance, comfort, and depth perception. CASE REPORT: EJ, a 17-year-old Caucasian female was previously treated for amblyopia of the left eye (OS) with glasses and patching since age 8 with no improvement to vision. EJ experienced the following symptoms: blurred vision at near when reading, blurred vision at far distances, eye pain and fatigue, difficulty copying from the board, difficulty seeing at night while driving, and poor depth perception. Entering uncorrected visual acuity was 20/20-2 OD and 20/50-2 OS with Snellen Letter Chart. Near uncorrected acuity was 20/20 OD and 20/200 OS with a reduced Snellen chart at 40 cm. Microtropia of 2 to 12 prism diopters of esotropia, eccentric fixation on visuoscopy, and central suppression on various tests were measured. EJ was diagnosed with monofixation syndrome, monocular esotropia of the left eye, strabismic amblyopia of the left eye, suppression of binocular vision (OS), and fusion with defective stereopsis. The patient completed 19 sessions of in-office vision therapy with the practice of home reinforcement activities between therapy sessions. Visual performance was reassessed after 10 and 19 sessions of vision training with improvements noted in acuity, accommodation, oculomotor accuracy and speed, eye alignment, fusional vergence skills, and stereopsis. CONCLUSION: Optometric vision therapy can decrease suppression, improve central fusional ability, visual acuity, accommodative accuracy, and stereopsis in a patient with monofixation syndrome.

Efficacy of supplemental Occlu-pad therapy with partial occlusion in children with refractive anisometropic amblyopia.

Purpose:To study the efficacy of supplemental occlu-pad therapy with partial occlusion in children with refractive anisometropic amblyopia.Methods:Thirty-one children who did not improve after partial occlusion of 6 h for 6 months were supplemented with the use of occlu-pad for 1 h per day and three such sessions in a week.Results:The mean age was 6.8+/-1.4 years (range 5–9 years). A significant improvement of 3.2+/-1.3 lines in visual acuity was noticed at the end of 3 months of starting this supplemental therapy in children. Out of 31 children, 26 children improved at least 2 lines or more at the end of 3 months. All children (n = 9) having anisohyperopic amblyopia improved at the end of 3 monthsConclusion:Occlu-pad is useful in supplementing occlusion therapy in cases of refractive amblyopia and is more effective in anisohyperopic amblyopia.

A prospective study of amblyopia and its risk factors in selected school going children of Bhopal region

In vision 2020, amblyopia is a major preventable and treatable cause of low vision in paediatric age group. If not treated at appropriate time, paediatric amblyopia can result into monocular and binocular low vision with associated deterioration in Quality of Life indices in adulthood. This should be the hallmark of the blindness control programme in India. So this study was carried out to assess the magnitude of amblyopia and its associated risk factors in school going children and to correct the amblyopia by whatever treatment modality possible depending upon the type of amblyopia and to follow up the patient for any improvement in it. This was a prospective, observational study on 1200 school going children between 5-16 years of age. All the children were subjected to visual acuity examination. Those children with refractive error were further screened at Hospital. : Out of 1200 cases, 30 cases had amblyopia. Prevalence of amblyopia was 2.5%. Anisometropia was the most predominant risk factor associated with amblyopia (53.33%). Anisometropic amblyopia (53.33%) was most common. Amblyopia was more common in children with lower socio-economic background (40%). Maximum patients had unilateral (80%) and moderate amblyopia (46.7%). Association between duration of occlusion therapy and visual improvement in children with amblyopia was statistically insignificant (p=0.19). Amblyopia is one of the major hidden visual problem in the society which can be prevented by early identification and proper management in appropriate time. Early diagnosis and treatment can prevent and minimize risk of permanent deficit of vision in amblyopia if detected earlier especially before 10 years of age. Screening programs in school going children can detect amblyogenic factors earlier to prevent major permanent deficit in vision by amblyopia so screening of children should be done through school surveys, awareness should be spread through various campaigns among the teachers and parents of the children about amblyopia and its adverse consequences not only on visual impairment part but also functional, psychological, social, economic impact.

Anisometropic Amblyopia: Analysis of treatment results with patching of dominant eye and refraction with active visual therapy (AVT) in school age children.

Objectives: To analyse the results of Active Visual Therapy with patching and refraction in anisometropic amblyopia in school age children from age 7-15 years. Study Design: Analytical study. Setting: Department of Ophthalmology, DHQ KDA Teaching Hospital Kohat. Period: January 2016 to December 2018. Material & Methods: The school age children suffering from anisometropic amblyopia with age range from 7-15 years. Proper documentation proforma was designed for record and follow up of patients. Informed consents were taken from parents of patients and they were specially trained for compliance. Total 41 patients were included comprising 28(68.29%) male and 13(31.70%) female with age range of 7-15 years. Anterior and posterior segments were properly examined. Best corrected visual therapy was recorded. Difference of two or more lines on snellen chart between the two eyes was considered to be anisometropic amblyopia. Before treatment 14(34.14%) patients had BCVA of 6/24, 8(19.51%) patients had 6/36, 10(24.39%) patients had 6/60 and 9(21.95%) patients had CF. Out of 41 patients 29(70.73%) patients were hypermetropic while 12(29.26%) were myopic. The refractive error of amblyopic eyes in spherical equivalent was from + 7 to – 5 diopters. Proper refractive correction was done. Patching of the normal eye was advised for three hours per day at the dose of one week per year of age. The amblyopic eye was exposed to active visual therapy with video games with computer and smart phones. The patients were examined after each three months and improvement in visual acuity and change in refraction was addressed. Results were analysed on the basis of pretreatment and post treatment visual acuity. Finally T-test for regression and co-relation was applied on the post treatment status of visual acuity of 6/24, 6/36, 6/60 and Counting finger with pretreatment status of visual acuity of 6/24, 6/36, 6/60 and Counting finger showing P = 0.005 which is less than 0.05 and is statistically significant. Results: Cumulatively after treatment out of 41 patients 10(24.39%) had best corrected visual acuity 6/6, 6(14.63%) had 6/9, 7(17.07%) had 6/12, 7(17.07%) had 6/18, 4(9.75%) had 6/24, 5(12.19%) had 6/60 and 2(4.87%) had best corrected visual acuity of CF. Conclusion: Patching of dominant eye and refraction with Active Visual Therapy of amblyopic eye is effective in treatment of anisometropic amblyopia.

Features of the Choroidal Structure in Children With Anisometropic Amblyopia.

To examine the choroidal structure in children with anisometropic amblyopia using the binarization method. Thirty children with unilateral anisometropic amblyopia and 30 healthy age- and sex-matched controls were included in the study. Choroidal thickness was measured with optical coherence tomography. The choroidal layer was examined with the binarization method using ImageJ software (National Institutes of Health). The total choroidal area, stromal area, luminal area, luminal area to stromal area ratio, and choroidal vascular index were calculated. The values were compared by correlating the spherical equivalent (SE) (determined by an autorefractometer) with anterior chamber depth, axial length, central corneal thickness (measured by optical biometry), and choroidal thickness values. Mean SE values were 3.75 ± 2.16 diopters (D) in the amblyopic eyes, 2.39 ± 2.09 D in the fellow eyes, and -0.27 ± 0.53 D in the control eyes. Best corrected visual acuity (BCVA) was 0.29 ± 0.11 logarithm of the minimum angle of resolution (logMAR) in the amblyopic eyes, 0.02 ± 0.04 logMAR in the fellow eyes, and 0 ± 0 logMAR in the control eyes. Choroidal thickness values were 351 ± 47 µm in the amblyopic eyes, 333 ± 55 µm in the fellow eyes, and 324 ± 51 µm in the control eyes. Luminal area to stromal area ratio values were 1.73 ± 0.13 in the amblyopic eyes, 1.76 ± 0.15 in the fellow eyes, and 2.02 ± 0.25 in the control eyes. Choroidal vascular index values were 63% ± 0.02 in the amblyopic eyes, 64% ± 0.02 in the fellow eyes, and 66% ± 0.03 in the control eyes. BCVA, SE, choroidal thickness, luminal area to stromal area ratio, and choroidal vascular index were significantly different in each group. The total choroidal area, luminal area, and stromal area were similar in all eyes. No correlation was found between choroidal vascular index and choroidal thickness, anterior chamber depth, axial length, and central corneal thickness. In children with anisometropic amblyopia, the total choroidal area was relatively larger in both the amblyopic and the fellow eyes compared to the control eyes. Due to the higher stromal area and lower luminal area, both the amblyopic and the fellow eyes also had lower choroidal vascular index values than control eyes. [J Pediatr Ophthalmol Strabismus. 2022;59(5):320-325.].

Visual outcomes of photorefractive keratectomy in non-children with anisometropic amblyopia: One-year Follow-up Outcomes.

To evaluate the safety, efficiency, short term stability, and sensory results of photorefractive keratectomy (PRK) in anisometropic in non-compliant children with correction. Twelve eyes of 12 children with an age range: 6-17 years and anisometropic amblyopia who underwent PRK under general anesthesia to correct the dioptric difference between the eyes were included in this study. A complete ophthalmic assessment including refractive status, uncorrected and corrected distance visual acuity (UDVA & CDVA), and binocular vision status using the Worth 4-dot test and stereopsis were performed before and 1, 3, 6, and 12 months after PRK. The mean preoperative CDVA was 0.34 ± 0.24 LogMAR which showed a statistically significant improvement at 12 months (0.20 ± 0.19, p = 0.024) after surgery compared to the preoperative assessment. (p = 0.003) The mean preoperative UDVA was 0.63 ± 0.24 LogMAR that increased to 0.44 ± 0.24, 0.32 ± 0.16, 0.25 ± 0.19, and 0.25 ± 0.19 LogMAR at 1, 3, 6, and 12 months after PRK, respectively. One to three lines improvement in UDVA and CDVA was seen in 10 (83.4%) and 8 eyes (66.7%); while one line UDVA and CDVA loss was seen in one (8.3%) and one (8.3%) eye and unchanged UDVA and CDVA was seen in 1 (8.3%) and 3 eyes (25%), respectively. The mean preoperative stereoacuity was 341.9 ± 245.7 s of arc, which significantly improved to 166.6 ± 87.5 s of arc 12 months after PRK. (p = 0.012). PRK was an effective surgical alternative to improve visual acuity and stereopsis in anisometropic children who did not cooperate with conventional methods of amblyopia therapy.

Comparison of clinical efficacy effect between anisometropia amblyopia and strabismus amblyopia

Comparison of clinical efficacy effect between anisometropia amblyopia and strabismus amblyopia

A Randomized Trial of Binocular Dig Rush Game Treatment for Amblyopia in Children Aged 4 to 6 Years.

Binocular treatment for unilateral amblyopia is an emerging treatment that requires evaluation through a randomized clinical trial. This study aimed to compare change in amblyopic-eye visual acuity (VA) in children aged 4 to 6 years treated with the dichoptic binocular iPad (Apple, Cupertino, CA) game, Dig Rush (not yet commercially available; Ubisoft, Montreal, Canada), plus continued spectacle correction versus continued spectacle correction alone. Children (mean age, 5.7 years) were randomly assigned to home treatment for 8 weeks with the iPad game (prescribed 1 h/d, 5 d/wk [n = 92], or continued spectacle correction alone [n = 90]) in a multicenter randomized clinical trial. Before enrollment, children wearing spectacles were required to have at least 16 weeks of wear or no improvement in amblyopic-eye VA (<0.1 logMAR) for at least 8 weeks. Outcome was change in amblyopic-eye VA from baseline to 4 weeks (primary) and 8 weeks (secondary) assessed by masked examiner. A total of 182 children with anisometropic (63%), strabismic (16%; <5∆ near, simultaneous prism and cover test), or combined-mechanism (20%) amblyopia (20/40 to 20/200; mean, 20/63) were enrolled. After 4 weeks, mean amblyopic VA improved by 1.1 logMAR lines with binocular treatment and 0.6 logMAR lines with spectacles alone (adjusted difference, 0.5 lines; 95.1% confidence interval [CI], 0.1 to 0.9). After 8 weeks, results (binocular treatment: mean amblyopic-eye VA improvement, 1.3 vs. 1.0 logMAR lines with spectacles alone; adjusted difference, 0.3 lines; 98.4% CI, -0.2 to 0.8 lines) were inconclusive because the CI included both zero and the pre-defined difference in mean VA change of 0.75 logMAR lines. In 4- to 6-year-old children with amblyopia, binocular Dig Rush treatment resulted in greater improvement in amblyopic-eye VA for 4 weeks but not 8 weeks. Future work is required to determine if modifications to the contrast increment algorithm or other aspects of the game or its implementation could enhance the treatment effect.

Analysis of Macular Retinal Thickness and Microvascular System Changes in Children with Monocular Hyperopic Anisometropia and Severe Amblyopia.

Objective To study the changes of macular retinal thickness and microvascular system in children with monocular hyperopic anisometropia and severe amblyopia using optical coherence tomography angiography (OCTA) and to explore the value of OCTA in the diagnosis and treatment of amblyopia. Methods Thirty-two children with monocular hyperopic anisometropia and severe amblyopia who were treated in the Department of Ophthalmology of the First Affiliated Hospital of Gannan Medical College from January 2020 to December 2020 were included in the study. Eyes with amblyopia (n = 32) served as the experimental group, and the contralateral healthy eyes (n = 32 eyes) served as the control group. All children underwent comprehensive ophthalmological examination including slit lamp, eye position, visual acuity, optometry, eye movement, intraocular pressure, ocular axis, and fundus examination to rule out organic lesions. Macular 6 mm × 6 mm scans were performed on both eyes of all subjects by the same experienced clinician using an OCTA instrument. After ImageJ processing, the vessel density, inner layer, and full-layer retinal thickness (RT) of superficial retinal capillary plexus (SCP) were obtained. All data were analyzed by SPSS21.0 software, and a paired t-test was used for comparison between groups. P < 0.05 was considered to indicate statistical significance. Results The vessel densities of macular SCP in the amblyopia and control groups were 47.66 ± 2.36% and 50.37 ± 2.24% in the outer superior, 49.19 ± 2.64% and 51.44 ± 2.44% in the inner inferior, 49.63 ± 2.51% and 51.41 ± 3.03% in the outer inferior, and 45.56 ± 3.44% and 50.44 ± 3.52% in the outer temporal regions, respectively. The vessel density of macular SCP in the amblyopia group was significantly lower than that in contralateral healthy eyes in the outer superior, inner inferior, outer inferior, outer temporal, and central regions. There was no significant difference between the two groups in the inner superior, inner nasal, outer nasal, and inner temporal regions. The macular RT in the amblyopia group and the control group is 90.38 ± 6.09 μm and 87.56 ± 5.55 μm in the outer temporal, respectively. The RT in the macular inner layer in the outer temporal region of the amblyopia group was thicker than that of the control group (P < 0.05). There was no significant difference in the other eight regions between the two groups. The whole macular RT in the amblyopia group was thicker than that in the control group in nine regions, and the central area of macular RT in the amblyopia and control groups was 229.06 ± 6.70 μm and 214.50 ± 10.36 μm, respectively. Conclusion The OCTA results showed the overall RT of macula in 9 areas in the amblyopia group was thicker than that in the control group, which could show that the macular retinal thickness can be a potential way to distinguish the children with monocular hyperopic anisometropia and severe amblyopia.

New treatment for amblyopia based on rules of synaptic plasticity: a randomized clinical trial.

Amblyopia resulting from early deprivation of vision or defocus in one eye reflects an imbalance of input from the eyes to the visual cortex. We tested the hypothesis that asynchronous stimulation of the two eyes might induce synaptic plasticity and rebalance input. Experiments on normal adults showed that repetitive brief exposure of grating stimuli, with the onset of each stimulus delayed by 8.3 ms in one eye, results in a shift in perceptual eye dominance. Clinical studies (Clinical trial registration number: ChiCTR2100049130), using popular 3D movies with similar asynchrony between the two eyes (amblyopic eye stimulated first) to treat anisometropic amblyopia, established that just 10.5 h of conditioning over <3 weeks produced improvement that met criteria for successful treatment. The benefits of asynchronous conditioning accumulate over 20-30 45 min sessions, and are maintained for at least 2 years. Finally, we demonstrate that asynchronous binocular treatment alone is more effective than patching only. This novel treatment is popular with children and is some 50 times more efficient than patching alone.

Correlation of chorioretinal parameters with anatomical, optical and functional indicators of eyes with amblyopia of various origins

The study included 50 patients aged 5 to 16 years (mean age 10.04±3.01 years). All patients were divided into 6 groups: 1 - relative amblyopia with congenital myopia (23 eyes); 2 - dysbinocular amblyopia (14 eyes); 3 - refractive amblyopia (16 eyes); 4 - anisometropic amblyopia (7 eyes); 5 - paired eyes of patients with amblyopia (20 eyes); 6 - control group (20 eyes). Chorioretinal parameters were determined using the RS-3000 Advance 2 spectral optical coherence tomography system («Nidek», Japan). Correlation analysis was performed using the Pearson's linear correlation coefficient (r). The level of significance of the differences was determined by the standard Student's t-test. Morphological changes in the sensory and choroid membranes of the eye were revealed in groups with amblyopia of various origins compared to the control group, as well as in the fellow eyes. Intergroup comparison showed the presence of more significant disorders in refractive and relative amblyopia due to congenital myopia. Correlation analysis showed that structural changes in the posterior pole are more related to the anatomical and optical parameters of the eyes. Optical coherence tomography allows detection of microscopic structural anomalies in the posterior pole of the eye in amblyopia of various origins, assists in differential diagnosis of this condition with organic pathology, and - most importantly - helps peer deeper into the pathogenesis of this disease.

The effect of wavelength-controlling lenses on contrast sensitivity in patients with anisometropic amblyopia

The effect of wavelength-controlling lenses on contrast sensitivity in patients with anisometropic amblyopia

Laser keratomileusis in treatment of anisometropic amblyopia in adults.

To compare and evaluate improvement in corrected distant visual acuity (CDVA) between myopia and hyperopia after laser in situ keratomileusis (LASIK) in adult patients with anisometropic amblyopia. This prospective clinical study included 103 amblyopic eyes (103 patients), which underwent LASIK correction of refractive error from January 2013 to January 2018. Uncorrected distance visual acuity (UDVA), CDVA, spherical equivalent (SE), postoperative astigmatism, and intraocular pressure were evaluated at time points of 1, 6, and 12 months. Patients were divided into two groups according to refractive error. Group 1: Forty-six patients with myopia and Group 2: Fifty-seven patients with hyperopia. Mean CDVA (logarithm of the minimum angle of resolution [logMAR]) preoperatively was 0.23 ± 0.16 in Group 1 and 0.40 ± 0.19 in Group 2. Postoperative CDVA (logMAR) was 0.17 ± 0.13 in Group 1 and 0.32 ± 0.17 in Group 2. There was statistically significant increase in UDVA (P < 0.0001) postoperatively and no change during the follow-up period of 12 months in both groups. Group 1 showed more expectable results, 95% of variability SE achieved was dependent on SE intended (R2 = 0.95), while in Group 2, the percentage was slightly lower of expected 87% (R2 = 0.87). There was statistical significance in respect of CDVA change postoperatively and preoperatively in both groups. Correlation factors are low, in Group 1 r = -0.53 and in Group 2 r = -0.39. LASIK can improve CDVA in a considerable portion of amblyopic eyes, both myopic and hyperopic. Eyes with better initial CDVA and those with myopia were associated with greater improvement in postoperative CDVA.

Descemet’s membrane rupture due to forceps injury: macroscopic aspect by anterior segment optical coherence tomography

AbstractPurposeTo describe corneal changes after birth trauma from forceps delivery, using anterior segment optical coherence tomography (AS‐OCT), in order to reduce the risk of potential anisometropic amblyopia.MethodsA 73‐year‐old female patient came to the ocular surface section consulting for dry eye disease symptoms. At the slit lamp examination, a vertical endothelial stria was observed in the right eye. After an exhaustive anamnesis, the patient referred having a traumatic birth in which forceps had been used.ResultsAn AS‐OCT was performed, showing a vertical rupture in the Descemet membrane secondary to traumatic birth with forceps.ConclusionsDescemet’s membrane rupture can cause corneal oedema which usually clears over time, but those ruptures often persist. The residual corneal changes can result in anisometropia and the main cause of vision loss after such injury is anisometropic amblyopia. The AS‐OCT is a useful diagnostic tool to detect these alterations at early stages.BibliographySarma P, Borgohain M, Tayab S, Sangma CA. Descemet's membrane rupture secondary to forceps‐induced birth injury. Indian J Ophthalmol. 2020;68(10):2253. https://doi.org/10.4103/ijo.IJO_149_20Alobaidy R, Srinivasan S. Forceps‐induced birth injury to the cornea. BMJ Case Rep. 2014;2014:bcr2013201786. Published 2014 Apr 9. https://doi.org/10.1136/bcr‐2013‐201786

Evaluation of stereoacuity and binocular functions in patients with anisometropic amblyopia via Titmus, TNO and synoptophore

Evaluation of stereoacuity and binocular functions in patients with anisometropic amblyopia via Titmus, TNO and synoptophore

Comparison of sweep visual evoked potential of visual acuity and Snellen visual acuity in healthy and amblyopic children.

To evaluate the visual acuity of healthy and amblyopic children using sweep visual evoked potential and compare the results with those of Snellen visual acuity testing. A total of 160 children aged 6-17 years were included in the study. Of these, 104 (65%) were aged 7-17 years old, able to verbally communicate, and did not have any systemic or ocular pathology (Group 1). Group 2 included 56 (35%) children aged 6-17 years, able to verbally communicate, and had strabismus or anisometropic amblyopia whose best corrected visual acuity was between 0.1 and 0.8. All subjects underwent a detailed ophthalmological examination and sweep visual evoked potential measurement. Demographic characteristics, ocular findings, best corrected visual acuity, and sweep visual evoked potential results were recorded. In Group 1, the mean and maximum visual acuity values for sweep visual evoked potential were lower than the Snellen best corrected visual acuity (p<0.001, for both, respectively). Bland-Altman analysis revealed that in Group 1, the distribution of the differences between the Snellen best corrected visual acuity and mean sweep visual evoked potential visual acuity was ±0.11 logMAR, and the distribution of the differences between the Snellen best corrected visual acuity and maximum sweep visual evoked potential visual acuity was ±0.023 logMAR. In Group 2, the mean and maximum sweep visual evoked potential visual acuity were lower than the Snellen best corrected visual acuity (p<0.001 and p=0.009, respectively). Bland-Altman analysis revealed that the distribution of the differences between the Snellen best corrected visual acuity and mean sweep visual evoked potential visual acuity was ±0.16 logMAR, and the distribution of the differences between the Snellen best corrected visual acuity and maximum sweep visual evoked potential visual acuity was ±0.19 logMAR. Sweep visual evoked potential visual acuity measurements have comparable results with Snellen visual acuity measurements. This technique is an objective and reliable method for evaluating visual acuity in children.

Anaglyphic Three-Dimensional Movie: A Simple Binocular Method to Treat Anisometropic or Strabismic Amblyopia in Adults.

Purpose:To evaluate the efficacy of anaglyphic three-dimensional movies to treat adults with anisometropic or strabismic amblyopia.Methods:This is an interventional case series. The seven cases were put on a trial frame containing subjective refraction, fogging plus lenses for the dominant eye, correcting prism, and anaglyphic red-cyan plastic spectacles. Patients participated in 20 sessions of 1.5 h of anaglyphic three-dimensional animated movie watching in the office. Significant visual acuity (VA) improvement was defined as improvement ≥0.2 in logMAR values. Change in octaves of stereopsis was defined as halving the arcsec or 0.3 change in log arcsec.Results:The average age was 26.9 ± 10.0 (16–42) years. The mean VA in amblyopic eye improved significantly from 0.42 ± 0.19 (0.15–0.7) logMAR to 0.25 ± 0.15 (0.1–0.5) logMAR after completion of sessions (P = 0.02), and four cases showed significant VA improvement. The mean stereoacuity improved significantly from 2.6 ± 0.3 (2.1–2.9) log arcsec to 2.1 ± 0.5 (1.7–2.9) log arcsec (P = 0.04). Four cases showed ≥2 octaves improvements in stereopsis.Conclusion:A simple and readily available method of amblyopia treatment can be effective in some adult cases.

Posterior Pole Asymmetry Analysis in the Children with Anisometropia.

Objectives:The objectives of the study were to investigate the inter and intraocular differences in posterior pole asymmetry analysis (PPAA) with optical coherence tomography (OCT) in anisometropia, to examine the relationship between the presence of anisometropia and amblyopia and retinal thickness.Methods:Patients between ages of 5 and 16 years with anisometropia who applied to our clinic were included in the study. Macular retinal thickness measurements were evaluated by PPAA using the posterior pole algorithm of the spectral domain-OCT device. Asymmetry was analyzed both as the difference between the right and left eyes and the difference between the superior, inferior, and mean retinal thicknesses of 64 separate quadrants in the same eye. Hemispheric and right-left eye asymmetry differences analyses were performed.Results:118 patients were included in the study(65 females and 53 males). Group 1 consisted of anisometropic patients (n=46), Group 2 consisted of anisometropic amblyopia patients (n=40), and Group 3 consisted of control group (n=32). The mean age of the patients was 9.72±5.6 years. The mean spherical equivalent difference between the two eyes of the patients was 1.7±0.6 D. When anisometropic eyes were compared with normal eyes, there was no significant difference between mean superior, inferior and total retinal thickness, and right-left eye asymmetry values (for all, p>0.05). In the asymmetry evaluation performed by counting the black boxes in the PPAA, a significant difference was found in the right-left asymmetry evaluation in anisometropic amblyopic eyes, in some quadrants and in the right-left asymmetry analysis (p<0.05).Conclusion:While no difference was found between anisometropic and normal eyes in the PPAA, there was differences in some quadrants in the anisometropic amblyopic group compared to the control group suggesting that there is an involvement in the peripheral quadrants of the macula, especially in treatment resistant amblyopic patients.