Hyperopic Anisometropic Amblyopia Research Articles

Thickened photoreceptor outer segment layer in children with hyperopic anisometropic amblyopia.

To quantitatively investigate the reflectivity and structure of the outer retinal layers in children with hyperopic anisometropic amblyopia by using swept-source optical coherence tomography (SS-OCT). Seventy-eight patients with amblyopia and 64 age-matched children with normal vision were included in this study. All participants underwent SS-OCT and detailed ophthalmic examinations. Longitudinal reflectance profile measurements were measured using Image J. The reflectivity of outer retinal layers was measured at the three selected positions: subfovea, 1 mm nasal to the fovea, and 1 mm temporal to the fovea. The reflectivity ratios were calculated by outer retinal layers divided by the nuclear layer (ONL) for normalization. Photoreceptor outer segment layer thickness was also measured. The results were compared between the amblyopia and normal controls. The possible effects of age, sex, and axial length on results were adjusted by generalized estimating equations. Photoreceptor outer segment layer thickness was significantly greater in amblyopic eyes than in normal control eyes at all three regions (18.41 ± 1.83 vs. 16.84 ± 1.39, P < 0.001 at the fovea; 14.78 ± 1.34 vs. 14.19 ± 1.40, P = 0.030 at 1 mm nasal to the foveal; 14.92 ± 1.48 vs. 14.41 ± 1.32, P = 0.049 at 1 mm temporal to the fovea). The reflectivity ratio of outer segment/ONL was higher only at 1 mm nasal to the fovea (2.94 ± 0.61 vs. 2.70 ± 0.42, P = 0.02). Subfoveal OS thickness was positively correlated with choroidal thickness (r = 0.248, P = 0.018) but was not correlated with spherical equivalent, age, axial length, or logMAR visual acuity. Quantitative measurement of SS-OCT images revealed greater photoreceptor outer segments in both eyes of children with amblyopia than in normal control eyes. A thicker OS thickness is somehow related to amblyopia, and this may be a new useful diagnostic parameter for amblyopia.

Quantitative comparison of binocular suppression of patients with anisometropic amblyopia and ametropic amblyopia

Objective: To explore the differences in clinical characteristics and interocular interactions between patients with anisometropic amblyopia and ametropic amblyopia. Methods: Cross-sectional study. The newly diagnosed anisometropic (the binocular difference in spherical equivalent≥1.00 D) amblyopia patients and ametropic amblyopia patients (aged 4 to 6 years) in Beijing Tongren Hospital from January 2020 to December 2022 were involved. Patients were further categorized by the refractive status after cycloplegia, including hyperopia, myopia, astigmatism, hyperopia with astigmatism, myopia with astigmatism, mild anisometropia and severe anisometropia. Quantitative measurements of best-corrected visual acuity (logMAR), stereoacuity (transformed to log units), perceptual eye position and interocular suppression were performed, and the differences between groups were analyzed. The rank sum test was used for statistical evaluation. Results: The average age of 45 ametropic amblyopia patients (21 males and 24 females) and 84 anisometropic amblyopia patients (48 males and 36 females) was 5.0 (4.0, 5.0) years and 5.0 (4.0, 6.0) years, respectively. The interocular differences in spherical equivalent [2.56 (1.50, 4.19) D vs. 0.25 (0.13, 0.56) D] and best-corrected visual acuity [0.40 (0.18, 0.70) logMAR vs. 0.07 (0.00, 0.12) logMAR] were larger in patients with anisometropic amblyopia than those with ametropic amblyopia. The anisometropic amblyopia patients had worse stereoacuity [2.60 (2.00, 2.90) log arcsec vs. 2.00 (2.00, 2.30) log arcsec] and deeper suppression [20.0% (13.3%, 40.0%) vs. 10.0% (0, 23.3%)], compared with the ametropic amblyopia patients. The differences were all statistically significant (P<0.05). The suppression and stereoacuity between patients with hyperopic anisometropic amblyopia [suppression, 30.0% (17.5%, 50.0%); stereoacuity, 2.90 (2.30, 2.90) log arcsec] and astigmatic anisometropic amblyopia [suppression, 10.0% (0, 20.0%); stereoacuity, 2.00 (2.00, 2.30) log arcsec] were significantly different (P<0.05). The differences of suppression and stereoacuity between patients with severe (binocular difference in spherical equivalent>2.50 D) [suppression, 30.0% (20.0%, 53.3%); stereoacuity, 2.90 (2.57, 2.90) log arcsec] and mild anisometropia [suppression, 20.0% (0, 30.0%); stereoacuity, 2.00 (2.00, 2.90) log arcsec] were also statistically significant (P<0.05). Conclusions: Patients with anisometropic amblyopia have deeper binocular suppression, worse stereoacuity and more severe binocular interaction abnormality than those with ametropic amblyopia. The severity of anisometropia affects the degree of the interaction abnormality.

Factors affecting the total occlusion time in eyes with hyperopic anisometropic amblyopia

BackgroundAmblyopia treatment by occluding the healthy eye is known to be effective during a sensitive critical period. This study aims to clarify the factors for the total occlusion time (TOT) required for the amblyopic eye to achieve a normal visual acuity (VA) level of 1.0 (0.0 logMAR equivalent). This could contribute to an efficient treatment plan for eyes with hyperopic anisometropic amblyopia.MethodsSubjects were 58 patients (26 boys and 32 girls; age range, 3.6-9.2, average, 5.8 ± 1.3 years) with hyperopic anisometropic amblyopia. All the subjects had initially visited and completed occlusion therapy with improved VA of 1.0 or better in the amblyopic eye at Kindai University Hospital between January 2007 and March 2017. Using the subjects’ medical records, we retrospectively investigated five factors for the TOT: the age at treatment, the initial VA of the amblyopic eye, refraction of the amblyopic eye, anisometropic disparity, and the presence of microstrabismus. Patient’s VA improvement at one month after treatment was also evaluated to confirm the effect of the occlusion therapy.ResultsThe initial VA of the amblyopic eye ranged from 0.1 to 0.9 (median, 0.4). The TOT ranged from 140 to 1795 (median, 598) hours with an average daily occlusion time of 7 hours. The initial VA of the amblyopic eye and presence of microstrabismus were the significant factors for the TOT (p < 0.01). To achieve VA of 1.0 or better, patients with an initial VA of ≤ 0.3 in the amblyopic eye required a longer TOT. Moreover, patients with concomitant microstrabismus required a 1.7-fold longer TOT compared to those without microstrabismus.ConclusionLonger daily occlusion hours and early start of the treatment will be necessary for patients with poor initial VA or microstrabismus to complete occlusion therapy within the sensitive critical period.

Choroid vascular changes in hyperopic anisometropia amblyopia using SS-OCTA

PurposeTo observe and understand the structural changes in choroidal vessels in eyes with hyperopic anisometropic amblyopia using swept-source optical coherence tomography angiography (SS-OCTA).MethodsA total of 44 patients were enrolled in this study: 22 children with hyperopic anisometropic amblyopia and 22 age-matched controls. SS-OCTA was used to scan the 6*6 mm macular area of their eyes. The average choroidal thickness (CT) and choroidal capillary flow area (CC) in a 3 mm diameter area centered on the macular area were obtained. The choroidal vascularity volume (CVV) was automatically extracted and 3D reconstructed by inbuild software, and the three-dimensional choroidal vascularity index (3D-CVI) was calculated. The effect of amblyopia on the choroidal vessel structure was assessed using generalized linear estimating equations (GEEs) corrected for axial length, sex, age, and best-corrected visual acuity.ResultsThe CC was greater in amblyopic eyes than in fellow eyes (P = 0.014) but was not significantly different from that in control eyes (P = 0.963). After correcting for sex, age, axial length, and visual acuity using GEEs, the mean CT in the amblyopic eyes was greater than that in the fellow eyes (P = 0.030) but was not significantly different from that in the control eyes (P = 0.160). The 3D-CVI in amblyopic eyes was higher than that in control eyes (P = 0.038) but was not significantly different from that in fellow eyes (P = 0.407). The three-dimensional choroidal vascularity volume (3D-CVV) was higher in amblyopic eyes than in fellow eyes (P = 0.046) and control eyes (P = 0.023).ConclusionsWe found that eyes with hyperopic anisometropic amblyopia demonstrated higher CT, CC and 3D-CVV values than the contralateral eyes after correction, while the 3D-CVI was unchanged. Compared with control eyes, amblyopic eyes had higher 3D-CVV and 3D-CVI values but similar CT and CC values. Amblyopic eyes may have different choroidal vascular structures from fellow and control eyes.

The Association Between Improvement of Stereoacuity and Suppression in the Treatment of Anisometropic Amblyopia.

To investigate the association between stereoacuity and suppression during occlusion therapy for patients with anisometropic amblyopia. Retrospective study. This study included 19 patients with hyperopic anisometropic amblyopia who underwent occlusion therapy. The mean age of the patients was 5.5 ± 1.4 years. The participants were evaluated for improvement in stereoacuity and suppression before beginning occlusion therapy, when the highest amblyopic visual acuity (VA) was achieved, during tapering, at the end of occlusion therapy, and at the final visit. Stereoacuity was evaluated using the TNO test or JACO stereo test. The presence of suppression was evaluated using circle No. 1 of the Stereo Fly Test or JACO results as the optotype. Of the 19 patients, 13 (68.4%) had suppression before occlusion, eight (42.1%) when the highest VA was achieved, five (26.3%) during tapering, and none at the final visit. Of the 13 patients with suppression before occlusion, 10 (76.9%) showed further improvement in stereoacuity when suppression disappeared, and nine had foveal stereopsis of 60 arcseconds. A significant association was confirmed between foveal stereopsis and suppression when the highest VA was achieved and during the tapering period (P<0.05, Fisher's exact test). Suppression was observed even when the VA in amblyopic eyes reached the highest score. By gradually decreasing the duration of occlusion, suppression was eliminated, leading to the acquisition of foveal stereopsis.

Evaluation of Macular Pigment Optical Density in Eyes with Hyperopic Anisometropic Amblyopia Using Fundus Reflectometry.

This study aimed to evaluate the macular pigment optical density (MPOD) scores in eyes with hyperopic anisometropic amblyopia and compare those with their fellow and control eyes using one-wavelength fundus reflectometry. This cross-sectional study enrolled 33 patients diagnosed with hyperopic anisometropic amblyopia aged 12-40 years. The control group consisted of 36 hyperopic and 42 emmetropic children, age-matched to the patients. Central macular thickness (CMT), MPOD, axial length (AL), best-corrected visual acuity, and refraction errors were measured between the study group and the control group. Eyes with the diagnosis of hyperopic anisometropic amblyopia had significantly higher mean and maximum (max) MPOD scores compared with their fellow eyes as well as hyperopic and emmetropic eyes (p<0.001 for all). The mean AL in eyes with hyperopic anisometropic amblyopia was statistically shorter than that in hyperopic and emmetropic controls (p=0.027, p<0.001, respectively). The mean CMT was found to be thicker in eyes with hyperopic anisometropic amblyopia when compared to their fellow eyes, as well as hyperopic and emmetropic controls, eventhough there was no significant difference was found among the four groups (p=0.052). The mean MPOD levels were significantly correlated with the difference in CMT (r=-0.21, p=0.032), and logMAR visual acuity scores (r=-0.44, p<0.001) in the hyperopic anisometropic amblyopia group. The present study indicates that the MPOD is reduced in eyes with hyperopic anisometropic amblyopia. This reduction may be due to less visual stimulus-induced deterioration of foveal development and microarchitecture in anisometropic amblyopic eyes.

Evaluation of Choroidal Vascular Structure in Hyperopic Anisometropic Amblyopia.

The aim of the study was to investigate the choroidal structure of patients with anisohypermetropic amblyopia compared to that of healthy eyes in controls of the same age. The study comprises three groups: One group was the amblyopic eyes of patients with anisometropic hypermetropia (AE group), another group was the fellow eyes of patients with anisometropic hypermetropia (FE group), and a final group of healthy controls. Both the choroidal thickness (CT) and choroidal vascularity index (CVI) values were obtained using the spectral-domain optical coherence tomography (OCT) method of improved depth imaging (EDI-OCT; Heidelberg Engineering GmbH, Spectralis, Germany, Heidelberg). This study included 28 anisometropic amblyopic patients (AE and FE groups) and 35 healthy controls. Regarding the distribution of ages and sexes (p=0.813 and p=0.745), the groups were the same. The mean best-corrected visual acuity in AE, FE, and the control group was 0.58±0.76, 0.008±1.30, and 0.004±1.20 logMAR units, respectively. There was a significant difference in terms of CVI, luminal area (LA), and all the CT values between groups. Post hoc univariate analyses indicated that CVI and LA were significantly higher in AE compared to FE and the control group (p<0.05, for each). The temporal, nasal, and subfoveal CT values were considerably higher in AE compared to FE and the control groups (p<0.05, for each). However, there was no difference between FE and the control group (p>0.05, for each). The AE group had larger LA, CVI, and CT values compared to the FE and control groups. These results show that choroidal changes in amblyopic eyes in children are permanent in adulthood if untreated and are involved in the pathogenesis of amblyopia.

Assessment of choroidal vascularity and choriocapillaris blood perfusion in Chinese preschool-age anisometropic hyperopic amblyopia children.

To determine the macular and peripapillary area choroid microstructure parameters of hyperopic anisometropic amblyopia eyes and compare to fellow and age-matched control eyes. To assess the correlation between the axial length (AL), choroidal thickness (CT) and choroid microstructure parameters. This cross-sectional comparative, non-interventional study involved 52 hyperopic anisometropic amblyopia children and 48 age-matched heathy controls. 52 eyes with hyperopic anisometropic amblyopia and 48 age-matched control eyes were studied. The peripapillary and subfoveal CT were determined. The total choroidal area (TCA), luminal area (LA), and stromal area (SA) of the subfoveal and peripapillary choroid were measured. In addition, the correlation between the AL, CT and choroid microstructure parameters were calculated. The peripapillary and subfoveal CT of the amblyopic eyes was significantly thicker than the fellow and control eyes (all P < 0.05). The subfoveal and peripapillary choroidal SA, LA and TCA of the amblyopic eyes were significantly increased than that of the fellow and control eyes (all P < 0.05). The choroidal vascularity index (CVI) values of the amblyopic eye were significantly different among the three groups (P < 0.05). There was a statistically significant negative correlation between AL and subfoveal CT (SFCT), LA and TCA levels (P < 0.001, P = 0.039, P = 0.027, respectively). Spherical equivalent (SE) was positive correlated with SFCT, LA and TCA levels (P = 0.456, 0.229 and 0.240, respectively; all P < 0.05). There was a statistically significant positive correlation between SFCT, SE, LA, SA, TCA and CVI levels (all P < 0.05). The subfoveal and peripapillary CT of amblyopic children abnormally increased and correlated with shorter AL and higher SE. The choroidal structure of the amblyopic eyes was different from the fellow and control eyes, the hyperopic anisometropic amblyopic eyes had significantly thicker sub-foveal choroid, higher LA, SA, and TCA. AL and CT affect choroidal structure and vascular density. Choroidal blood flow may be increased in amblyopic eyes. The larger LA, SA, TCA, and lower CVI were characteristic of the amblyopic eye.

Macular pigment optical density of hyperopic anisometropic amblyopic patients measured by fundus reflectometry.

PurposeHyperopic anisometropia is a major cause of amblyopia and may be associated with macular pigment optical density (MPOD) reduction. To explore whether the MPOD changes in hyperopic anisometropic amblyopia, we measured the MPOD using fundus reflectometry in eyes with hyperopic anisometropic amblyopia and normal vision.MethodsThis was a cross-sectional study conducted from January 2017 to June 2017. Forty subjects (25 males and 15 females) between the ages of 6 and 10 years were recruited. The subjects' eyes were divided into two groups: amblyopic eyes (best-corrected visual acuity (BCVA) not more than 20/25 or BCVA of two eyes differing by two or more lines) and fellow eyes. All enrolled subjects underwent a comprehensive ophthalmic examination, including extraocular motility assessment, cover-uncover testing, and refractive error (noncycloplegic), BCVA, axial length (AL), macular foveal thickness (MFT) and MPOD (Visucam® 200, Carl Zeiss Meditec AG, Germany).ResultsThe MPOD of amblyopic and fellow eyes was 0.12 ± 0.03 log units and 0.13 ± 0.04 log units, respectively, with a significant difference (P = 0.026). The MFT of amblyopic and fellow eyes was 241.28 ± 13.95 and 237.13 ± 16.02 μm, respectively, revealing that the MFT was significantly higher in amblyopic eyes than in fellow eyes (P = 0.028). Conversely, there was no correlation between the MPOD and MFT in the two groups.ConclusionsThis study is the first to report that the MPOD is decreased in hyperopic anisometropic amblyopia. In this study, no correlation between the MPOD and MFT was found. In the future, factors that induce a decrease in the MPOD in eyes with hyperopic anisometropic amblyopia should be explored in a large-sample study with follow-up observation.

Changes in Choroidal Thickness and Structure Induced by 1% Atropine Instillation in Children With Hyperopic Anisometropic Amblyopia.

To investigate the effects of 1% atropine eye drops on the choroidal thickness and structure of amblyopic and fellow eyes in children with hyperopic anisometropic amblyopia. This study included 16 children with hypermetropic anisometropic amblyopia. All patients received 1% atropine eye drops in both eyes twice a day for 7 days. In the subfoveal choroidal region, choroidal thickness, total choroidal area, luminal area, and stromal area were measured quantitatively using swept-source optical coherence tomography. The choroidal parameters of the amblyopic and fellow eyes were compared between the baseline and atropine conditions. There were no significant differences in all choroidal parameters of the amblyopic eye between baseline and atropine conditions. However, the subfoveal choroidal thickness in the fellow eye was significantly higher for the atropine condition than the baseline condition. This change was accompanied by a significant increase in both the luminal and stromal areas of the choroid. The median differences of subfoveal choroidal thickness between the conditions were larger for the fellow eye (6.46%) than the amblyopic eye (0.26%). The choroidal structural change induced by 1% atropine instillation was smaller for the amblyopic eye than the fellow eye in children with hyperopic anisometropic amblyopia. Mechanisms of choroidal thickness changes could be inhibited in amblyopic eyes. [J Pediatr Ophthalmol Strabismus. 2023;60(1):39-45.].

The iridocorneal angle and related anterior segment structures in pediatric anisohyperopic amblyopic eyes.

Objectives:We aimed at investigating the iridocorneal angle, anterior segment structural differences, and their relationship in pediatric anisohyperopic amblyopic eyes.Methods:This study was designed as an observational case-control study. We prospectively evaluated the pediatric patients who were newly diagnosed with hyperopic anisometropic amblyopia. Iridocorrneal angle in four sectors, axial length, and anterior segment structures were compared to emmetropic fellow and control eyes using Pentacam and IOLMaster 700 devices. The anisohyperopia and iridocorneal angle related factors were determined in hyperopic anisometropic amblyopic eyes.Results:Forty-three hyperopic anisometropic amblyopic eyes, 43 fellow eyes, and 44 control eyes were included. The mean axial length, anterior chamber volume, and anterior chamber depth were significantly reduced in the study eyes compared to the fellow (p < 0.001, p = 0.021, and p = 0.045, respectively) and control eyes (p < 0.001, p = 0.001, and p = 0.009, respectively). The average iridocorneal angle was significantly lower in the study eyes than in the fellow and control eyes (p < 0.001 and p = 0.018, respectively). The iridocorneal angle correlated with anterior chamber depth (r = 0.49, p = 0.013), anterior chamber volume (r = 0.42, p = 0.038), the anterior radius of curvature (r =−0.54, p = 0.005), the posterior radius of curvature (r =−0.58, p = 0.002), and lens thickness (Rho =−0.41, p = 0.033) in the study eyes. Anisohyperopia was related to the interocular difference in axial length (Rho = 0.53, p = 0.005), anterior chamber depth (Rho = 0.53, p = 0.005), and anterior chamber volume (Rho = 0.42, p = 0.031).Conclusion:Pentacam and IOLMaster 700 are suitable for non-contact imaging of iridocorneal angle and anterior segment structures in the pediatric age. These biometric differences and their relationship should be kept in mind whenever anterior or posterior segment surgery is planned for pediatric anisohyperopic amblyopic eyes.

Evaluation of Retinal Nerve Fiber Layer Thickness and Macular Thickness in Amblyopic Children

Objective: To compare central macular and retinal nerve fiber layer (RNFL) thickness using Spectral Domain Optical Coherence Tomography (SD-OCT) among patients with hyperopic anisometropic, strabismic and mixed amblyopia and healthy controls. Method: This prospective, cross-sectional study included 39 amblyopic children, their fellow eyes and 20 healthy individuals. Central macular and RNFL (superior, nasal, inferior and temporal quadrants and mean RNFL) thicknesses were measured with SD-OCT. Results: Difference was not statistically significant in the central macular thickness when the anisometropic, strabismic and mixed amblyopia groups were compared among themselves, fellow eyes and healthy control group. In the anisometropic amblyopic group, the inferior RNFL and nasal RNFL values were significantly thicker compared to the fellow eyes (p=0.009, p=0.028, respectively). Mean RNFL measurements were significantly thicker in anisometropic and mixed groups in the amblyopic eyes compared to the fellow eyes (p=0.009, p=0.031, respectively). In the temporal quadrant, the RNFL was found to be statistically significantly thinner in the anisometropic and mixed amblyopic groups compared to the fellow eyes (p=0.049, p=0.010, respectively). Conclusions: There was no considerably difference in the central macular thickness among the amblyopia groups, fellow eyes and healthy controls. However, significant changes were found in the mean RNFL and certain quadrants of the RNFL thicknesses in the anisometropic and mixed amblyopic groups.

EVALUATION OF PERIPAPILLARY RETINAL NERVE FIBRE LAYER AND CENTRAL MACULAR THICKNESS INADULTS WITH HYPEROPIC ANISOMETROPIC AMBLYOPIA

Objective: To study per-papillary retinal nerve fibre layer (pRNFL) and central macular thickness (CMT) changesin adults with hyperopic anisometropic amblyopia using optical coherence tomography.&#x0D; Study Design: Cross sectional study.&#x0D; Place and Duration of Study: Combined Military Hospital, Lahore, Pakistan, from Oct 2019 to Feb 2020.&#x0D; Methodology: In this study 30 adults, 18-40 years of age were included who presented in our clinic with monocular poor vision. They underwent detailed ophthalmic clinical examination: including corrected and uncorrected distance visual acuity, slit lamp bio-microscopy and fundus examination with 90 diopter lens. After fulfilling criteria of anisometropic amblyopia, central maular thickness (CMT) and per-papillary retinal nerve fibre layer (pRNFL) thickness was measured by using RS-3000 SLO, NIDEK Co, Japan spectral domain optical coherence tomography device and compared the central maular thickness (CMT) and per-papillary retinal nerve fibre layer (pRNFL) thickness in amblyopic and fellow eye of same individual.&#x0D; Results: The mean change in per-papillary retinal nerve fibre layer (pRNFL) thickness in amblyopic eyes, 121.48± 4.90 μm and non amblyopic eyes was 112.92 ± 4.72 μm with statistical significance (p&lt;0.001). The mean change in central macular thickness (CMT) in amblyopic eyes was 198.50 ± 5.30 μm and non amblyopic eyes was 206.80 ± 3.11 μm with statistical significance (p&lt;0.001). There was significant increase in per-papillary retinal nerve fibre layer (pRNFL) thickness and significant decrease in central macular thickness (CMT) on comparing the amblyopic and the fellow eyes of the same patients.&#x0D; Conclusion: Central macular thickness (CMT) decreased.........................

Ambliyopik ve Sağlam Gözlerde Makuler Ve Retinal Sinir Lifi Tabakası Kalınlığının Karşılaştırılması

Purpose: The purpose of this study is to investigate the relationship between macular and peripapillary retinal nerve fiber layer thickness and amblyopia. Methods: A total of 56 pediatric patients with hyperopic anisometropic amblyopia were evaluated in this study. As the control group, we used the patients’ fellow eyes. A comprehensive eye examination was performed, including best-corrected visual acuity with Snellen charts (converted to logMAR for analysis), slit-lamp examination, fundus examination, cover and, cover-uncover testing, and ocular motility testing. The macular thickness, retinal nerve fiber layer thickness, axial length and optic disc area of both eyes were measured. Results: The mean age was 7.25±1.89 years. For the amblyopic and fellow eyes, the mean best-corrected visual acuity was 0.33± 0.20 logMAR and 0.0± 0.0 logMAR, respectively. Macular center thicknesses were 225,55±18,86 µm and 215,7±12,96 µm in amblyopic and fellow eyes, respectively. Macular 6mm ring thicknesses were 281,32±33,51 µm and 256,07±28,91 µm in amblyopic and fellow eyes, respectively. RNFLT were 108,39±11,59 µm and 104,61±8,43 µm in amblyopic and fellow eyes, respectively There was a statistically significant difference in the macular center thickness, in macular 6-mm ring area thickness and in RNFLT (p&lt;0.05). There was a positive correlation between visual acuity of amblyopic eyes and macular thickness and RNFLT. Conclusions: This study explored objectively measured retinal changes in amblyopia and found a slightly thicker central macular region and 6-mm ring area thicknesses and RNFLT in amblyopic compared with normal eyes.

Macular Microvasculature Density Changes in Anisometropic Amblyopic Eyes after Successful Treatment

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 &lt; 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 &lt; 0.018 and P &lt; 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.

Hipermetropik Anizometropik Ambliyopide Retina Tabakalarının Optik Koherens Tomografi Segmentasyon Analizi ile Değerlendirilmesi

Amaç: Hipermetropik anizometropik ambliyopisi olan olgularda spektral domain optik koherens tomografi (OKT) kullanarak retina tabakalarını analiz etmek ve ambliyopik gözlerle normal gözleri kıyaslamak. Gereç ve Yöntemler: Detaylı oftalmolojik muayeneyi takiben hipermetropik anizometropik ambliyopisi olan olguların her iki gözü OKT ile değerlendirildi. Merkezi makula kalınlığı (MMK) analizi sonrasında, ganglion hücre tabakası, iç pleksiform tabaka, iç nükleer tabaka, dış pleksiform tabaka, dış nükleer tabaka ve retina pigment epiteli tabakasına ait ortalama kalınlıklar kaydedildi. Retinal katmanlar ayrıca iç ve dış retina katmanlar olmak üzere 2 katmana ayrılarak analiz edildi. Bulgular: Yirmi (%33,3)'si kadın, 40 (%66,7)'ı erkek hipermetropik anizometropik ambliyopiden oluşan olguların ortalama yaşı 17,3±9,0 olarak hesaplandı. Ortalama MMK ambliyopik gözlerde 27030±1815 µm, normal gözlerde ise 265,13±19,25 µm olarak hesaplandı. Ambliyopik gözlerde MMK'nin normal gözlere kıyasla istatistiksel olarak anlamlı düzeyde kalın olduğu saptandı (p0,05, her biri için). Sonuç: Hipermetropik anizometropik ambliyopisi olan olgularda ambliyopik gözlerde normal gözlere kıyasla merkezi makulanın anlamlı düzeyde daha kalın olduğu saptanırken, retina tabakaları kalınlıkları arasında istatistiksel olarak anlamlı bir fark bulunmamıştır.

Levodopa Plus Occlusion Therapy versus Occlusion Therapy Alone for Children with Anisometropic Amblyopia.

Purpose This study aimed to compare the effects of short-term administration of levodopa plus occlusion therapy versus occlusion therapy alone in preschool children with hyperopic anisometropic amblyopia.Methods This comparative interventional study included 40 eligible preschool children aged 6 to 7 years with hyperopic anisometropic amblyopia. The primary outcome measure was the logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity recorded at baseline, 3 weeks after the treatment initiation and 12 weeks after the treatment termination. The results were compared between the two groups.ResultsNo statistically significant intergroup difference was observed in baseline logMAR visual acuities (P = 0.92). The mean logMAR visual acuities of the amblyopic eyes were significantly better in both groups three weeks after the treatment initiation than the baseline (P 0.01 in both groups). At 12 weeks after treatment termination, the logMAR visual acuities of the amblyopic eyes were significantly better than the baseline values (P 0.001 in the placebo group and P = 0.09 in the levodopa group). Intergroup comparisons revealed no statistically significant difference in visual acuities 3 weeks after the treatment initiation (P = 0.11) and 12 weeks after the treatment termination (P=0.10). Twelve weeks after the treatment termination, visual acuities regressed 0.037 logMAR in the placebo group and 0.042 logMAR in the levodopa group. These regression rates were not significantly different (P = 0.89).ConclusionThe results of this study provide evidence that adding short-term administration of levodopa to occlusion therapy in hyperopic anisometropic amblyopia offers no additional benefit in visual outcomes and provides no advantage in terms of the regression rate.

Quantitative analysis of retinal microcirculation in children with hyperopic anisometropic amblyopia: an optical coherence tomography angiography study

To evaluate optical coherence tomographic angiography (OCTA) findings on retinal microcirculation in hyperopic anisometropic amblyopia compared with fellow eyes and nonamblyopic control eyes. A total of 40 pediatric patients with hyperopic anisometropic amblyopia and 57 control subjects were recruited, and 137 eyes (40 amblyopic, 40 fellow, and 57 control eyes) were evaluated. Data on best-corrected visual acuity (logMAR), axial length (mm), refractive error, and OCTA findings (foveal avascular zone parameters, macular vascular density in superficial and deep retinal capillary plexus, central macular thickness) were recorded in amblyopic, fellow, and control eyes. Compared with fellow and control eyes, amblyopic eyes were associated with significantly lower foveal vessel density values within 300μm around the foveal avascular zone (P<0.01) and lower vascular density in certain areas of superficial and deep retinal capillary plexus in axial length- and refraction-adjusted analysis (P<0.05 for all), along with significantly higher full thickness of the central macula (P=0.04). In amblyopic eyes, best-corrected visual acuity values were negatively correlated with foveal density (r=-0.57; P=0.02) and deep capillary retinal plexus vascular density in foveal (r=-0.51; P=0.03) parafovea temporal (r=-0.52; P=0.03), and parafovea superior (r=-0.51; P=0.04) areas. Our findings indicate a possible association between retinal microcirculation and amblyopia.

Interocular aberration profiles in different severities of hyperopic anisometropic amblyopia

Interocular aberration profiles in different severities of hyperopic anisometropic amblyopia

Analysis of Peripapillary Choroidal Thickness in Unilateral Amblyopia.

Purpose:To evaluate the peripapillary choroidal thickness (CT) in children with unilateral amblyopia using spectral-domain optical coherence tomography (SD-OCT).Methods:One hundred and six eyes of 53 children with unilateral amblyopia and 20 eyes of 20 children with normal vision were involved in this study. Of the 53 children with unilateral amblyopia, 29 (54.7%) had hyperopic anisometropic amblyopia and 24 (45.3%) had strabismic amblyopia. Peripapillary CT was measured from 6 mm length radial B-scans at the optic nerve head using the enhanced depth imaging program of an SD-OCT (Heidelberg Engineering, Germany). Age, sex, refractive error, and best-corrected visual acuity were also recorded.Results:The average peripapillary CT was greater in amblyopic eyes than in the fellow eyes of the children with amblyopia (P = 0.002), and control eyes (P < 0.001). There was no significant difference between the fellow eyes of children with amblyopia and the control eyes (P = 0.158). The average peripapillary CT was negatively correlated with axial length (AL) in amblyopic eyes (r = -0.381; P = 0.005) and fellow eyes (r = -0.392; P = 0.004) but not in control eyes (r = -0.232; P = 0.325). After adjustment for the possible effects of AL, the average peripapillary CT in amblyopic eyes was still greater than in fellow eyes (P = 0.014) and control eyes (P = 0.022).Conclusion:The peripapillary choroid of eyes with amblyopia was thicker than that of the fellow eyes and control eyes. No significant difference was observed between fellow eyes and control eyes.