-
JAMA Jan 2021
Topics: Amblyopia; Child; Humans; Infant; Strabismus; Vision Screening
PubMed: 33496776
DOI: 10.1001/jama.2020.5741 -
Annual Review of Vision Science Sep 2022Occlusion therapy has a long history as the gold standard treatment for amblyopia. Over the past two decades, large multicenter randomized controlled trials and... (Review)
Review
Occlusion therapy has a long history as the gold standard treatment for amblyopia. Over the past two decades, large multicenter randomized controlled trials and objective dose-monitoring studies have characterized the effects of refractive correction, patching, and atropine penalization, providing insights into the impact of factors such as age and treatment dose. More recent approaches, whose development has been accelerated by advances in technology, are designed to provide different stimulation to the amblyopic eye and the fellow eye. This review explores a variety of such dichoptic approaches, categorized according to whether they primarily feature requisite use of the amblyopic eye in the face of fellow-eye masking, integration of visual information from both eyes, or reduction of stimulus salience in the fellow eye. It is still unclear whether dichoptic treatments are superior to traditional, low-cost treatment methods or whether their therapeutic mechanisms are fundamentally different from those of established treatments.
Topics: Amblyopia; Atropine; Eye; Humans; Multicenter Studies as Topic; Vision, Binocular; Visual Acuity
PubMed: 35378045
DOI: 10.1146/annurev-vision-100720-022550 -
JPMA. the Journal of the Pakistan... Mar 2023The narrative review was planned to investigate the efficiency of binocular treatment for amblyopic children, and to compare it with the standard methods. Literature... (Review)
Review
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. Binocular treatment for amblyopic children was found to be an effective and fast process for the recovery of visual functions, especially in the critical time of visual development.
Topics: Animals; Amblyopia; Vision, Binocular; Visual Acuity; Databases, Factual
PubMed: 36932768
DOI: 10.47391/JPMA.6216 -
Medicine Oct 2023Adolescent scoliosis is one of the most common surgical disorders of the pediatric spine. With timely detection and early treatment, most scoliotic children can avoid... (Review)
Review
Adolescent scoliosis is one of the most common surgical disorders of the pediatric spine. With timely detection and early treatment, most scoliotic children can avoid major and expensive surgery. Vision problems are also frequently found at an early age and can take a toll on individuals quality of life. However, scoliosis, a severe health hazard to adolescents, is often accompanied by vision problems clinically, including myopia, astigmatism, strabismus, amblyopia, horizontal paralysis, and blindness. And people with genetic defects have a higher probability of suffering both spinal problems and vision problems than those with nongenetic defects. However, many individuals viewed scoliosis and vision problems as 2 irrelevant diseases. This review searched PubMed, China National Knowledge Infrastructure, and Web of Science for studies on adolescent, scoliosis, eye diseases, myopia, strabismus, spinal disorders, and vision problems for almost 3 decades, and thus confirmed the potential relationship between adolescent scoliosis and vision problems.
Topics: Adolescent; Humans; Child; Scoliosis; Quality of Life; Amblyopia; Strabismus; Myopia
PubMed: 37861544
DOI: 10.1097/MD.0000000000035178 -
Journal of Binocular Vision and Ocular... 2019Anisometropic amblyopia is unilateral by definition and current treatment recommendations reflect that characteristic. However, recent research suggests a binocular... (Review)
Review
Anisometropic amblyopia is unilateral by definition and current treatment recommendations reflect that characteristic. However, recent research suggests a binocular component that deserves consideration. The aim of this review is to consider the levels of anisometropia deemed amblyogenic, and the cortical changes that occur in the presence of anisometropic amblyopia. Particular attention is given to cortical changes that impact the binocularity of these individuals. Knowledge of binocular deficits in anisometropic amblyopia has implications for current, accepted treatment regimens which are monocular in nature. Therefore, the integrity of binocular function in anisometropic amblyopia and its impact on the visual outcome will be evaluated. Given the rise in binocular treatments under clinical trial for amblyopia, this review also aims to evaluate the evidence of potentially enhanced benefits to anisometropic amblyopes from proposed new binocular therapies.
Topics: Amblyopia; Contrast Sensitivity; Humans; Vision, Binocular; Visual Acuity; Visual Cortex
PubMed: 31486743
DOI: 10.1080/2576117X.2019.1656034 -
Graefe's Archive For Clinical and... Mar 2020To identify whether there are functional abnormalities in the retina of amblyopic eyes using multifocal electroretinography (mfERG).
PURPOSE
To identify whether there are functional abnormalities in the retina of amblyopic eyes using multifocal electroretinography (mfERG).
METHODS
This is a prospective study of patients ≥ 7 years of age identified with unilateral amblyopia (strabismic or anisometropic). Multifocal ERG and flash ERG were performed to compare parameters between the amblyopic and non-amblyopic fellow eyes. A complete analysis of the five ring averages was done including the central ring.
RESULTS
Thirty-eight patients were included: mean age was 14.3 ± 7.3 years; 18 patients were strabismic and 20 were anisometropic. Amblyopic eye responses across the rings in multifocal ERG were diminished compared with fellow non-amblyopic eyes with significant differences detected in the central rings (p = 0.001). On the other hand, flash ERG did not show any consistently significant differences. When divided by severity, amplitudes of central rings were significantly lower in severely amblyopic eyes compared with non-amblyopic eyes (p = 0.001), while in mild amblyopia, no significant differences were observed. No significant difference was observed between anisometropic and strabismic amblyopic eyes.
CONCLUSIONS
Using multifocal ERG, significantly decreased amplitudes were observed in amblyopic eyes compared with normal fellow eyes in the central ring. This correlated with the severity of amblyopia. No difference was observed when comparing the two groups of amblyopia (strabismic and anisometropic). Those findings may help clarify the pathophysiology of amblyopia better and open the door for new objective ways to monitor the response to amblyopia treatment but this needs to be further studied.
Topics: Adolescent; Amblyopia; Child; Electroretinography; Evoked Potentials, Visual; Female; Humans; Male; Nerve Fibers; Prospective Studies; Retina; Tomography, Optical Coherence; Visual Acuity; Visual Fields
PubMed: 31900648
DOI: 10.1007/s00417-019-04558-x -
Journal of AAPOS : the Official... Feb 2023To determine whether deficits in manual dexterity in children with amblyopia improve after binocular amblyopia treatment and whether improvements are related to age at...
PURPOSE
To determine whether deficits in manual dexterity in children with amblyopia improve after binocular amblyopia treatment and whether improvements are related to age at treatment, baseline sensory status, or amount of improvement in sensory status with treatment.
METHODS
Manual dexterity (Movement Assessment Battery for Children-2), visual acuity, fusion, suppression, and stereoacuity were measured at baseline and after 4-8 weeks of binocular amblyopia in 134 children with amblyopia, including 75 children in the "younger group" (aged 3 to <7 years) and 59 in the "older group" (aged 7-10 years), and in 40 age-similar control children.
RESULTS
Baseline manual dexterity standard scores of amblyopic children were significantly below those of controls in both the younger (8.81 ± 0.33 vs 11.80 ± 0.60 [P < 0.0001]) and older groups (7.19 ± 0.34 vs 9.75 ± 0.57 [P = 0.00013]). After 4-8 weeks of binocular amblyopia treatment, the younger group standard score improved to 9.85 ± 0.35 and the older group improved to 8.08 ± 0.39, but both groups remained significantly lower than controls (P = 0.03 and P = 0.01, resp.). Improvement in manual dexterity standard score was not associated with any baseline factors but was weakly correlated with the amount of visual acuity improvement (r = 0.26; 95% CI, 0.09-0.41) CONCLUSIONS: Manual dexterity impairments are common among children with amblyopia. In our study cohort, binocular amblyopia treatment improved visual acuity and manual dexterity.
Topics: Child; Humans; Amblyopia; Vision, Binocular; Video Games; Computers, Handheld; Visual Acuity
PubMed: 36567045
DOI: 10.1016/j.jaapos.2022.10.006 -
Scientific Reports Jun 2023An elevated threshold for neuroplasticity limits visual gains with treatment of residual amblyopia in older children and adults. Acetylcholinesterase inhibitors (AChEI)... (Clinical Trial)
Clinical Trial
An elevated threshold for neuroplasticity limits visual gains with treatment of residual amblyopia in older children and adults. Acetylcholinesterase inhibitors (AChEI) can enable visual neuroplasticity and promote recovery from amblyopia in adult mice. Motivated by these promising findings, we sought to determine whether donepezil, a commercially available AChEI, can enable recovery in older children and adults with residual amblyopia. In this open-label pilot efficacy study, 16 participants (mean age 16 years; range 9-37 years) with residual anisometropic and/or strabismic amblyopia were treated with daily oral donepezil for 12 weeks. Donepezil dosage was started at 2.5 or 5.0 mg based on age and increased by 2.5 mg if the amblyopic eye visual acuity did not improve by 1 line from the visit 4 weeks prior for a maximum dosage of 7.5 or 10 mg. Participants < 18 years of age further patched the dominant eye. The primary outcome was visual acuity in the amblyopic eye at 22 weeks, 10 weeks after treatment was discontinued. Mean amblyopic eye visual acuity improved 1.2 lines (range 0.0-3.0), and 4/16 (25%) improved by ≥ 2 lines after 12 weeks of treatment. Gains were maintained 10 weeks after cessation of donepezil and were similar for children and adults. Adverse events were mild and self-limited. Residual amblyopia improves in older children and adults treated with donepezil, supporting the concept that the critical window of visual cortical plasticity can be pharmacologically manipulated to treat amblyopia. Placebo-controlled studies are needed.
Topics: Animals; Mice; Acetylcholinesterase; Amblyopia; Donepezil; Visual Acuity
PubMed: 37349338
DOI: 10.1038/s41598-023-34891-5 -
Eye (London, England) Jan 2022Amblyopia is a cause of significant ocular morbidity in pediatric population and may lead to visual impairment in future life. It is caused due to formed visual... (Review)
Review
Amblyopia is a cause of significant ocular morbidity in pediatric population and may lead to visual impairment in future life. It is caused due to formed visual deprivation or abnormal binocular interactions. Several risk factors in pediatric age group may lead to this disease. Author groups have tried managing different types of amblyopia, like anisometropic amblyopia, strabismic amblyopia and combined mechanism amblyopia, with optical correction, occlusion therapy, penalization, binocular therapy and surgery. We review historical and current management strategies of different types of amblyopia affecting children and outcomes in terms of visual acuity, binocularity and ocular deviation, highlighting evidence from recent studies. Literature searches were performed through Pubmed. Risk factors for amblyopia need to be identified in pediatric population as early in life as possible and managed accordingly, as visual outcomes in amblyopia are best if treated at the earliest. Although, monocular therapies like occlusion or penalization have been shown to be quite beneficial over the years, newer concepts related to binocular vision therapy are still evolving.
Topics: Amblyopia; Child; Humans; Sensory Deprivation; Strabismus; Vision, Binocular; Vision, Low; Visual Acuity
PubMed: 34234293
DOI: 10.1038/s41433-021-01669-w -
Der Ophthalmologe : Zeitschrift Der... Jul 2021The successful outcome of treatment for infant and childhood cataract depends on many factors. It is crucial that the treatment falls into a phase in which neither the... (Review)
Review
The successful outcome of treatment for infant and childhood cataract depends on many factors. It is crucial that the treatment falls into a phase in which neither the eye nor the visual pathway and visual cortex are fully developed. This review summarizes the current state of knowledge and provides an overview of the epidemiology, causes and clinical forms, early detection and, above all, treatment options. Special attention is paid to time-critical stages of development, according to which the therapeutic concepts are based. Complications, such as amblyopia and glaucoma are discussed in detail. In addition to surgical aspects, much emphasis is placed on orthoptic-refractive aftercare, the quality and execution of which is the essential predictor of a good functional outcome.
Topics: Amblyopia; Cataract; Cataract Extraction; Child, Preschool; Glaucoma; Humans; Infant; Lens Implantation, Intraocular
PubMed: 33783620
DOI: 10.1007/s00347-021-01370-z