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Turkish Journal of Ophthalmology Feb 2018To evaluate the risk factors for strabismus in patients with anisometropia by comparing degree of anisometropia, depth of amblyopia, and binocular visual function in...
OBJECTIVES
To evaluate the risk factors for strabismus in patients with anisometropia by comparing degree of anisometropia, depth of amblyopia, and binocular visual function in anisometropic patients with and without strabismus.
MATERIALS AND METHODS
Sixty-five anisometropic patients older than 5 years with amblyopia in one eye who were followed in the Ankara University Faculty of Medicine, Department of Ophthalmology, Pediatric Ophthalmology and Strabismus Unit between May 2009 and April 2010 were included in this study. There were 27 cases of strabismus. The depth of amblyopia, degree of anisometropia, and binocular visual function were assessed in anisometropic cases with and without strabismus.
RESULTS
The 65 patients with anisometropia were divided into two groups: 27 patients with strabismus (group 1) and 38 patients without (group 2). Depth of amblyopia was greater in patients with strabismus compared to those without (p=0.006). In patients with strabismus, there was no correlation between angle of deviation and depth of amblyopia (p=0.453). In anisometropic amblyopia patients without strabismus, there was a positive correlation between depth of anisometropia and depth of amblyopia (p=0.35, Pearson's correlation coefficient=0.343). Comparison in terms of anisometropia showed that patients with strabismus had significantly larger spherical difference between the two eyes than in patients without strabismus (p=0.000, Mann-Whitney U test). There was no significant difference in terms of cylindrical values (p=0.146, Mann-Whitney U test). There was no statistically significant difference in the presence of fusion between anisometropic patients with and without strabismus.
CONCLUSION
The risk of developing strabismus increased as degree of anisometropia increased in anisometropic cases. In addition, depth of amblyopia was greater in anisometropic patients with strabismus.
PubMed: 29576894
DOI: 10.4274/tjo.44342 -
Middle East African Journal of... 2015Strabismus in myopes can be related to anisometropia, accommodation/convergence effects, and/or muscle path deviations. This review article highlights management... (Review)
Review
Strabismus in myopes can be related to anisometropia, accommodation/convergence effects, and/or muscle path deviations. This review article highlights management considerations in myopic patients.
Topics: Accommodation, Ocular; Anisometropia; Convergence, Ocular; Humans; Myopia; Ocular Motility Disorders; Strabismus
PubMed: 26180467
DOI: 10.4103/0974-9233.159728 -
Scientific Reports Oct 2016This systematic review and meta-analysis is to evaluate the risk of development of concomitant strabismus due to refractive errors. Eligible studies published from 1946... (Meta-Analysis)
Meta-Analysis Review
This systematic review and meta-analysis is to evaluate the risk of development of concomitant strabismus due to refractive errors. Eligible studies published from 1946 to April 1, 2016 were identified from MEDLINE and EMBASE that evaluated any kinds of refractive errors (myopia, hyperopia, astigmatism and anisometropia) as an independent factor for concomitant exotropia and concomitant esotropia. Totally 5065 published records were retrieved for screening, 157 of them eligible for detailed evaluation. Finally 7 population-based studies involving 23,541 study subjects met our criteria for meta-analysis. The combined OR showed that myopia was a risk factor for exotropia (OR: 5.23, P = 0.0001). We found hyperopia had a dose-related effect for esotropia (OR for a spherical equivalent [SE] of 2-3 diopters [D]: 10.16, P = 0.01; OR for an SE of 3-4D: 17.83, P < 0.0001; OR for an SE of 4-5D: 41.01, P < 0.0001; OR for an SE of ≥5D: 162.68, P < 0.0001). Sensitivity analysis indicated our results were robust. Results of this study confirmed myopia as a risk for concomitant exotropia and identified a dose-related effect for hyperopia as a risk of concomitant esotropia.
Topics: Anisometropia; Astigmatism; Child; Cross-Sectional Studies; Esotropia; Exotropia; Female; Humans; Hyperopia; Male; Myopia; Odds Ratio; Refractive Errors; Risk Factors; Strabismus
PubMed: 27731389
DOI: 10.1038/srep35177 -
BMJ Open Ophthalmology 2022Myopia is a global healthcare concern and effective analyses of dioptric power are important in evaluating potential treatments involving surgery, orthokeratology, drugs... (Review)
Review
Myopia is a global healthcare concern and effective analyses of dioptric power are important in evaluating potential treatments involving surgery, orthokeratology, drugs such as low-dose (0.05%) atropine and gene therapy. This paper considers issues of concern when analysing refractive state such as data normality, transformations, outliers and anisometropia. A brief review of methods for analysing and representing dioptric power is included but the emphasis is on the optimal approach to understanding refractive state (and its variation) in addressing pertinent clinical and research questions. Although there have been significant improvements in the analysis of refractive state, areas for critical consideration remain and the use of power matrices as opposed to power vectors is one such area. Another is effective identification of outliers in refractive data. The type of multivariate distribution present with samples of dioptric power is often not considered. Similarly, transformations of samples (of dioptric power) towards normality and the effects of such transformations are not thoroughly explored. These areas (outliers, normality and transformations) need further investigation for greater efficacy and proper inferences regarding refractive error. Although power vectors are better known, power matrices are accentuated herein due to potential advantages for statistical analyses of dioptric power such as greater simplicity, completeness, and improved facility for quantitative and graphical representation of refractive state.
Topics: Anisometropia; Humans; Myopia; Prescriptions; Refraction, Ocular; Refractive Errors
PubMed: 35452207
DOI: 10.1136/bmjophth-2021-000929 -
Clinical Ophthalmology (Auckland, N.Z.) 2019To compare the treatment efficacy of optical correction and occlusion therapy and/or penalization for different anisometropic refractive errors (hyperopic, myopic, and...
PURPOSE
To compare the treatment efficacy of optical correction and occlusion therapy and/or penalization for different anisometropic refractive errors (hyperopic, myopic, and mixed).
METHODS
Medical records of 51 patients with anisometropic amblyopia managed by both optical correction and occlusion therapy and/or penalization were evaluated retrospectively. Patients were categorized into hyperopic, myopic or mixed anisometropia groups. Cycloplegic refraction, spherical anisometropia, baseline visual acuity, baseline interocular difference, final visual acuity and final interocular difference were analyzed to assess association between type of anisometropia with both resolution of anisometropic amblyopia and the time required to achieve it.
RESULTS
Baseline visual acuity of the amblyopic was 0.94±0.47 in the hyperopic group; 1.12±0.56, in the myopic group; and 1.08 ±0.39 in the mixed group. Final visual acuity in the amblyopic eye was 0.34±0.30 in the hyperopic group, 0.78±0.59 in the myopic group, and 0.78±0.56 in the mixed group. The difference in final visual acuity in the amblyopic eye between the groups was significant (P=0.014). The amblyopia was improved in 50% of patients in the hyperopic group, 23.8% in the myopic group, and 14.3% in the mixed group (P=0.081). The type of anisometropia was significantly associated with the improvement of visual acuity in the amblyopic eyes (P=0.044). The mean time for amblyopia improvement was 16.50±10.52 months in the hyperopic groups, 15.60±12.44 months in the myopic group, and 21.00±21.21 months in the mixed group (P=0.947).
CONCLUSION
Lower amounts of hyperopic anisometropia are as amblyogenic as higher amounts of myopic or mixed anisometropia. Mean improvement in visual acuity of an amblyopic eye with both optical correction, occlusion therapy and/or penalization is higher in patients with hyperopic anisometropia in comparison with myopic or mixed anisometropia. No significant difference was found in the time required to achieve improvement between the study groups.
PubMed: 31824133
DOI: 10.2147/OPTH.S224463 -
Oman Journal of Ophthalmology 2022The aim of this study is to determine the outcome of accommodative esotropia (ET) and influencing factors in young Omani children.
AIM
The aim of this study is to determine the outcome of accommodative esotropia (ET) and influencing factors in young Omani children.
SUBJECTS AND METHODS
In this retrospective cohort, children diagnosed with accommodative ET who had followed up in a tertiary hospital from 2006 to 2011 were identified. Parameters studied included cycloplegic refraction and its change with time, ocular alignment, binocularity, visual acuity (VA), amblyopia, and requirement for surgery.
RESULTS
A total of 51 patients were identified. Twenty-four patients were diagnosed with fully accommodative ET (FAET) and 27 with partially accommodative ET (PAET). The mean (± standard deviation [SD]) age of onset and reporting were 2.6 (±1.58) and 3.2 (±1.84) years in the two groups, respectively. The mean (SD) cycloplegic refraction at presentation was 4.50 (±1.66) in the FAET group and 3.65 (±1.67) in the PAET group. Anisometropia was present in 28% of patients. The mean follow-up period was 4.9 years. The following were detected in the final visit. A reduction in amblyopia from 43% to 6% of patients, binocularity in 75% of patients, and a mean increase of 0.64 (±1.3) D in cycloplegic refraction from the first visit ( = 0.005). The mean angle of deviation at near and distance was 29.86 (±15.21) and 17.80 (±10.14) prism diopters, respectively, in FAET patients and 30.15 (±14.83) and 29.53 (±15.53), respectively, in PAET patients. Thirty-seven percent of the PAET patients underwent surgery within 5 years from diagnosis. All participants in this cohort continued to wear glasses in the last follow-up visit.
CONCLUSION
Most children with refractive accommodative ET have an excellent outcome in terms of VA and binocular vision. The PAET group was characterized by delayed reporting, the presence of anisometropia, and lower hypermetropia. Further study is required to determine the possibility of weaning glasses in FAET patients.
PubMed: 36760956
DOI: 10.4103/ojo.ojo_80_22 -
Journal of Vision 2016We measured saccadic latencies in a large sample (total n = 459) of individuals with amblyopia or risk factors for amblyopia, e.g., strabismus or anisometropia, and...
We measured saccadic latencies in a large sample (total n = 459) of individuals with amblyopia or risk factors for amblyopia, e.g., strabismus or anisometropia, and normal control subjects. We presented an easily visible target randomly to the left or right, 3.5° from fixation. The interocular difference in saccadic latency is highly correlated with the interocular difference in LogMAR (Snellen) acuity-as the acuity difference increases, so does the latency difference. Strabismic and strabismic-anisometropic amblyopes have, on average, a larger difference between their eyes in LogMAR acuity than anisometropic amblyopes and thus their interocular latency difference is, on average, significantly larger than anisometropic amblyopes. Despite its relation to LogMAR acuity, the longer latency in strabismic amblyopes cannot be attributed either to poor resolution or to reduced contrast sensitivity, because their interocular differences in grating acuity and in contrast sensitivity are roughly the same as for anisometropic amblyopes. The correlation between LogMAR acuity and saccadic latency arises because of the confluence of two separable effects in the strabismic amblyopic eye-poor letter recognition impairs LogMAR acuity while an intrinsic sluggishness delays reaction time. We speculate that the frequent microsaccades and the accompanying attentional shifts, made while strabismic amblyopes struggle to maintain fixation with their amblyopic eyes, result in all types of reactions being irreducibly delayed.
Topics: Adolescent; Adult; Amblyopia; Anisometropia; Child; Contrast Sensitivity; Female; Humans; Male; Reaction Time; Saccades; Strabismus; Visual Acuity; Young Adult
PubMed: 26943348
DOI: 10.1167/16.5.3 -
Eye (London, England) Feb 2016The purpose of this study was to determine the predictors of stereoacuity outcome in visually mature subjects with exotropia following surgical correction. Visually... (Review)
Review
The purpose of this study was to determine the predictors of stereoacuity outcome in visually mature subjects with exotropia following surgical correction. Visually mature subjects who were surgically aligned and had been tested for stereoacuity in the postoperative period were studied retrospectively. Subjects were grouped with respect to their responses to Titmus or TNO stereotests. Characteristics such as amblyopia, anisometropia, and characteristics of the exodeviation such as time of onset, duration, intermittency, presence of an A or V pattern, distance-near disparity, coexisting vertical deviation, and inferior oblique overaction, were compared between the groups. One hundred and four visually mature subjects with exotropia met the inclusion criteria. Stereoacuity was achieved in 77% of the study group and only 9% of these could achieve fine stereoacuity. Negative stereoacuity was more frequently associated with larger deviation angles, higher anisometropia, inferior oblique overaction, pattern strabismus, coexisting vertical strabismus, and distance-near disparity, but not at a statistically significant level. The optimal cutoff for strabismus duration was 20 years for a positive stereoacuity outcome. Any-level visual acuity difference was found to decrease the chance for positive stereoacuity significantly. The odds ratios for the stereoacuity positivity were 4.05 for strabismus duration <20 years, 7.9 for strabismus onset >1 year of age, 3.79 for weaker eye visual acuity >20/25 and 9.85 for intermittency of strabismus. Intermittence of exotropia was the strongest predictor for positive stereoacuity. Exotropia onset after 1 year of age, absence of any-level visual acuity difference, and strabismus duration <20 years were the other predictors with decreasing power.
Topics: Adolescent; Adult; Aged; Amblyopia; Animals; Anisometropia; Case-Control Studies; Child; Cross-Sectional Studies; Depth Perception; Exotropia; Female; Humans; Male; Middle Aged; Oculomotor Muscles; Ophthalmologic Surgical Procedures; Retrospective Studies; Vision, Binocular; Visual Acuity
PubMed: 26584792
DOI: 10.1038/eye.2015.241 -
Journal of Pediatric Neurosciences Sep 2022Patients presenting with craniofacial conditions present a unique challenge from an ophthalmological view point. There are no set guidelines as to their management or... (Review)
Review
Patients presenting with craniofacial conditions present a unique challenge from an ophthalmological view point. There are no set guidelines as to their management or their long-term monitoring and follow-up. Largely, this should be the remit of a dedicated craniofacial team. Here we present pertinent ophthalmological pathology occurring in combination with craniosynostosis alongside the protocol employed in Birmingham Children's Hospital for the management of these patients.
PubMed: 36388012
DOI: 10.4103/jpn.JPN_45_22 -
Scientific Reports Mar 2023This retrospective study evaluated long-term visual outcomes in children with regressed retinopathy of prematurity (ROP) and correlations between visual acuity (VA) and...
This retrospective study evaluated long-term visual outcomes in children with regressed retinopathy of prematurity (ROP) and correlations between visual acuity (VA) and clinical variables, including fundus findings. We reviewed the medical records of 57 consecutive patients diagnosed with ROP. We analyzed the correlations between best-corrected VA and anatomical fundus findings, such as macular dragging and retinal vascular tortuosity, after ROP regression. The correlations between VA and clinical variables such as gestational age (GA), birth weight (BW), and refractive errors (hyperopia and myopia in spherical equivalent [SE], astigmatism, and anisometropia) were also evaluated. Of 110 eyes, 33.6% had macular dragging; the presence of macular dragging and poor VA were significantly correlated (p = 0.002). Patients with larger macula-to-disc distance/disc diameter ratios had significantly poorer VA (p = 0.036). However, no significant correlation was observed between the VA and vascular tortuosity. Patients with smaller GA and BW had poorer visual outcomes (both, p = 0.007). The larger SE in absolute values, myopia, astigmatism, and anisometropia were significantly associated with poorer visual outcomes as well (all, p < 0.001). In children with regressed ROP, macular dragging, small GA and BW, large SE in absolute values, myopia, astigmatism, and anisometropia may be predictors of poor visual outcomes at early ages.
Topics: Humans; Infant, Newborn; Anisometropia; Astigmatism; Birth Weight; Gestational Age; Infant, Premature; Myopia; Retinopathy of Prematurity; Retrospective Studies
PubMed: 36906702
DOI: 10.1038/s41598-023-31234-2