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Indian Journal of Ophthalmology Aug 2022To report retinal nerve fiber layer thickness (RNFLT) in eyes with amblyopia compared with contralateral healthy eyes.
PURPOSE
To report retinal nerve fiber layer thickness (RNFLT) in eyes with amblyopia compared with contralateral healthy eyes.
METHODS
In this cross-sectional study, we included patients with anisometropic amblyopia, strabismic amblyopia, and mixed amblyopia. All subjects underwent complete ophthalmic examination, including RNFLT measurement with time-domain OCT (Stratus OCT) and scanning laser polarimeter (GDX VCC). A paired "t" test was used to compare average and quadrant-wise RNFL thickness between the amblyopic and contralateral normal eyes. In addition, an analysis of variance test was used to compare various RNFL thickness parameters between the three groups.
RESULTS
A total of 33 eyes of 33 subjects with anisometropic amblyopia, 20 eyes of 20 subjects with strabismic amblyopia, and 38 eyes of 38 subjects with mixed amblyopia were included. In the anisometropic amblyopia group, the average RNFLT in the amblyopic eye was 98.2 μm and 99.8 μm in the fellow normal eye (P = 0.5), the total foveal thickness was 152.82 μm (26.78) in the anisometropic eye and 150.42 μm (23.84) in the fellow eye (P = 0.38). The difference between amblyopic and contralateral normal eye for RNFL and macular parameters was statistically insignificant in all three groups. The RNFL thickness in four quadrants was similar in the amblyopic and non-amblyopic eye between all three groups and statistically non-significant.
CONCLUSION
Our study showed that RNFL thickness was similar in amblyopic and non-amblyopic eyes between all three amblyopia groups.
Topics: Amblyopia; Cross-Sectional Studies; Humans; Nerve Fibers; Retinal Ganglion Cells; Tomography, Optical Coherence; Visual Acuity
PubMed: 35918974
DOI: 10.4103/ijo.IJO_2875_21 -
Klinische Monatsblatter Fur... Oct 2020The digital media becomes more and more common in our everyday lives. So it is not surprising that technical progress is also leaving its mark on amblyopia therapy. New... (Review)
Review
The digital media becomes more and more common in our everyday lives. So it is not surprising that technical progress is also leaving its mark on amblyopia therapy. New media and technologies can be used both in the actual amblyopia therapy or therapy monitoring. In particular in this review shutter glasses, therapy monitoring and analysis using microsensors and newer video programs for amblyopia therapy are presented and critically discussed. Currently, these cannot yet replace classic amblyopia therapy. They represent interesting options that will occupy us even more in the future.
Topics: Amblyopia; Eyeglasses; Humans; Internet; Rotation; Sensory Deprivation
PubMed: 33059376
DOI: 10.1055/a-1264-8048 -
Current Opinion in Ophthalmology Nov 2022We examine the development of amblyopia and the effectiveness of conventional and emerging therapies through the lens of the Bienenstock, Cooper, and Munro (BCM) theory... (Review)
Review
PURPOSE OF REVIEW
We examine the development of amblyopia and the effectiveness of conventional and emerging therapies through the lens of the Bienenstock, Cooper, and Munro (BCM) theory of synaptic modification.
RECENT FINDINGS
The BCM theory posits metaplastic adjustment in the threshold for synaptic potentiation, governed by prior neuronal activity. Viewing established clinical principles of amblyopia treatment from the perspective of the BCM theory, occlusion, blur, or release of interocular suppression reduce visual cortical activity in the amblyopic state to lower the modification threshold and enable amblyopic eye strengthening. Although efficacy of these treatment approaches declines with age, significant loss of vision in the fellow eye by damage or disease can trigger visual acuity improvements in the amblyopic eye of adults. Likewise, reversible retinal inactivation stimulates recovery of amblyopic eye visual function in adult mice and cats.
SUMMARY
Conventional and emerging amblyopia treatment responses abide by the framework of BCM theory. Preclinical studies support that the dramatic reduction in cortical activity accompanying temporary retinal silencing can promote recovery from amblyopia even in adulthood, highlighting a promising therapeutic avenue.
Topics: Amblyopia; Animals; Humans; Mice; Neuronal Plasticity; Retina; Visual Acuity
PubMed: 36094025
DOI: 10.1097/ICU.0000000000000901 -
Journal of Pediatric Ophthalmology and... Nov 2020To assess the prevalence of amblyopia in a population of adolescents screened for amblyogenic risk factors at preschool age.
PURPOSE
To assess the prevalence of amblyopia in a population of adolescents screened for amblyogenic risk factors at preschool age.
METHODS
Data were retrospectively collected from the preschool screening for amblyogenic risk factors routinely performed in the authors' hospital. A stratified random sampling was used. A school from the region was randomly selected and then two grades were randomly selected. All classes from these grades were evaluated and only children who were previously screened for amblyogenic risk factors were included. Ophthalmological examination included best visual acuity (distance and near, Early Treatment of Diabetic Retinopathy Study scale and Jaeger eye chart) and stereopsis (Randot Stereo Test; Stereo Optical Company, Inc). Sample size was estimated as more than 283 participants. Pertinent data were extracted for analysis.
RESULTS
A total of 520 children were recruited, and 299 met the inclusion criteria. Fifteen percent of children (n = 46) had results at the screening that prompted a further ophthalmological evaluation and 9% of children (n = 26) had meaningful refractive errors or strabismus. Overall amblyopia prevalence was 1.00%. One of the 3 children who developed amblyopia had microstrabismus, and the remaining 2 children had a previous positive screening result but missed the follow-up evaluations. At the follow-up evaluation, 79.3% (n = 237) of children were not wearing glasses.
CONCLUSIONS
A structured screening may allow the early detection of amblyogenic factors and prevent further vision deterioration in children, thus improving their long-term quality of life. The prevalence of amblyopia in this study was lower than that recently stated for Europe. [J Pediatr Ophthalmol Strabismus. 2020;57(6):372-377.].
Topics: Amblyopia; Child; Cross-Sectional Studies; Female; Humans; Male; Portugal; Prevalence; Quality of Life; Retrospective Studies; Risk Factors; Vision Screening; Visual Acuity
PubMed: 33211894
DOI: 10.3928/01913913-20200824-01 -
Journal Francais D'ophtalmologie Jan 2022To investigate the differences between the amblyopic eye and the fellow eye in adults with anisometropic amblyopia.
OBJECTIVE
To investigate the differences between the amblyopic eye and the fellow eye in adults with anisometropic amblyopia.
MATERIALS AND METHODS
Measurements of the central macular thickness [CMT], subfoveal choroidal thickness [SFCT], and retinal nerve fiber layer [RNFL] in patients with anisometropic amblyopia were obtained using optical coherence tomography [OCT]. Axial length [AL], anterior chamber depth [ACD], and central corneal thickness [CCT] were measured with optical biometry. All 12 parameters were compared between the amblyopic eye [Group 1] and the fellow eye [Group 2].
RESULTS
A total of 110 eyes of 55 patients [9 myopic, 46 hypermetropic] were analyzed retrospectively. The ages of the patients ranged from 17 to 55 years, with a mean of 30.8±10.7 years. 56.4% [n=31] of the patients were female, and 43.6% [n=24] were male. The mean spherical equivalent [SE] was 1.96±3.79 in Group 1 and 1.28±2.45 in Group 2. SFCT was 312.00±53.03 in Group 1 and 283.47±51.91 in Group 2. AL was 22.53±1.40 in Group 1 and 22.79±1.18 in Group 2. SE, SFCT, and AL were statistically significantly different between the two groups. There was no difference between the two groups in terms of CMT, RNFL, ACD and CCT values.
CONCLUSION
In adults with anisometric amblyopia, the SFCT of the amblyopic eye is greater than that of the fellow eye. The choroid plays an important role in the nutrition of the retinal layers, the development of ocular function and refractive error, and its development may be affected by the refractive error. Since the majority of our patients were hyperopic, the AL was found to be shorter in the amblyopic eye. CMT, RNFL, ACD and CCT values were the similar in both groups. There was no clinically significant relationship between biometric parameters and OCT parameters.
Topics: Adolescent; Adult; Amblyopia; Choroid; Female; Humans; Male; Middle Aged; Retrospective Studies; Tomography, Optical Coherence; Visual Acuity; Young Adult
PubMed: 34801272
DOI: 10.1016/j.jfo.2021.06.010 -
Scientific Reports Jul 2020Amblyopia is a neurodevelopmental disorder of the visual cortex arising from abnormal visual experience early in life which is a major cause of impaired vision in...
Amblyopia is a neurodevelopmental disorder of the visual cortex arising from abnormal visual experience early in life which is a major cause of impaired vision in infants and young children (prevalence around 3.5%). Current treatments such as eye patching are ineffective in a large number of patients, especially when applied after the juvenile critical period. Physical exercise has been recently shown to enhance adult visual cortical plasticity and to promote visual acuity recovery. With the aim to understand the potentialities for translational applications, we investigated the effects of voluntary physical activity on recovery of depth perception in adult amblyopic rats with unrestricted binocular vision; visual acuity recovery was also assessed. We report that three weeks of voluntary physical activity (free running) induced a marked and long-lasting recovery of both depth perception and visual acuity. In the primary visual cortex, ocular dominance recovered both for excitatory and inhibitory cells and was linked to activation of a specific intracortical GABAergic circuit.
Topics: Amblyopia; Animals; Depth Perception; Disease Models, Animal; Exercise Therapy; GABAergic Neurons; Humans; Rats; Running; Treatment Outcome; Visual Acuity; Visual Cortex
PubMed: 32728106
DOI: 10.1038/s41598-020-69630-7 -
American Journal of Ophthalmology Oct 2022Standard-of-care assessment for children with amblyopia includes measuring amblyopic eye best-corrected visual acuity (AE BCVA) with the fellow eye occluded. By...
PURPOSE
Standard-of-care assessment for children with amblyopia includes measuring amblyopic eye best-corrected visual acuity (AE BCVA) with the fellow eye occluded. By definition, this abolishes the interocular suppression fundamental to amblyopia. Thus, measured AE BCVA may not accurately represent that eye's contribution to natural binocular viewing. We compared dichoptic and monocular AE BCVA and examined whether any differences were associated with eye-hand coordination or reading speed.
DESIGN
Cross-sectional study.
METHODS
Dichoptic and monocular AE BCVA of children aged 6-12 years (42 with amblyopia, 24 with recovered normal AE BCVA, 30 control) were measured. Stereoacuity, suppression, eye-hand coordination, and reading speed were also assessed.
RESULTS
Overall, 81% of amblyopic children had worse dichoptic than monocular AE BCVA (mean difference=0.15±0.11 logMAR; P < .0001), and 71% of children with recovered normal AE BCVA had worse dichoptic than monocular AE BCVA (mean difference = 0.20±0.17 logMAR, P < .0001). Controls had no significant difference. The difference between dichoptic and monocular AE BCVA was correlated with performance in standardized aiming/catching (r = -0.48, 95% CI -0.72, -0.14) and manual dexterity tasks (r = -0.37, 95% CI -0.62, -0.06), and with reading speed (r = -0.38, 95% CI -0.65, -0.03).
CONCLUSIONS
Dichoptic AE BCVA deficits were worse than monocular AE BCVA deficits and were associated with reduced stereoacuity and suppression, consistent with the hypothesis that binocular dysfunction plays a role. Further, impaired eye-hand coordination and slow reading were associated with dichoptic, but not monocular, AE BCVA. Some children with amblyopia may benefit from extra time for school tasks requiring eye-hand coordination or reading.
Topics: Amblyopia; Child; Cross-Sectional Studies; Humans; Vision, Binocular; Visual Acuity
PubMed: 35738394
DOI: 10.1016/j.ajo.2022.06.002 -
Journal of Neuro-ophthalmology : the... Mar 2022Acquired sixth nerve (CN6) palsies in children may be benign or associated with an underlying neurologic condition. In children who presented with isolated (no...
BACKGROUND
Acquired sixth nerve (CN6) palsies in children may be benign or associated with an underlying neurologic condition. In children who presented with isolated (no associated neurologic or ophthalmic symptoms or signs) CN6 palsies, the rate of newly diagnosed neurologic disorders (such as tumors) is unclear. Moreover, the factors associated with spontaneous resolution and amblyopia in children with acquired CN6 palsies are unknown.
METHODS
We retrospectively reviewed the charts of all children younger than 18 years diagnosed with CN6 palsy at our institution from 2010 to 2020. We recorded ophthalmologic and neurologic history and examination findings, neuroimaging results, etiology of CN6 palsy, and outcomes including spontaneous resolution and amblyopia. We assessed etiologies of isolated and nonisolated CN6 palsies as well as frequency and factors associated with spontaneous resolution and amblyopia (in children ≤7 years).
RESULTS
One hundred seventy-two children met inclusion criteria. Twenty CN6 palsies (12%) were isolated at presentation. Most isolated cases were presumed postviral or postvaccination (50%) or idiopathic (30%), but 2 cases (10%) were associated with newly diagnosed tumors. Spontaneous resolution occurred in 59% of CN6 palsies at a median of 12.3 weeks and was associated with older age (P = 0.03) and nontumor etiology (P = 0.006). Amblyopia developed in 18% of children at risk, exclusively in those with anisometropia, pre-existing strabismus, or younger than 12 months.
CONCLUSIONS
Our findings and chart reviews suggest that approximately 10% of isolated acquired pediatric CN6 palsies are associated with a newly diagnosed brain tumor. This risk must be discussed with parents when considering immediate vs delayed neuroimaging. In addition, infants and children ≤7 years with secondary amblyogenic risk factors (anisometropia or pre-existing strabismus) require close follow-up to monitor and treat amblyopia.
Topics: Abducens Nerve Diseases; Amblyopia; Anisometropia; Brain Neoplasms; Child; Humans; Infant; Paralysis; Retrospective Studies; Strabismus
PubMed: 34417775
DOI: 10.1097/WNO.0000000000001390 -
Seminars in Ophthalmology May 2021Traditional therapies to treat amblyopia, such as optical correction or occlusion/penalization of the non-amblyopic eye, are efficacious but are not without limitations...
Traditional therapies to treat amblyopia, such as optical correction or occlusion/penalization of the non-amblyopic eye, are efficacious but are not without limitations such as poor adherence and decreased success with increasing age. Recently, there has been an interest in new amblyopia therapies, some using binocular techniques, through a variety of platforms including video games, movies, and virtual reality. Overall, available efficacy results for these treatments are highly variable.
Topics: Amblyopia; Humans; Video Games; Vision, Binocular; Visual Acuity
PubMed: 33656963
DOI: 10.1080/08820538.2021.1893765 -
Journal of Binocular Vision and Ocular... Oct 2023Childhood cataract is a complex condition requiring longitudinal care, including early diagnosis, timely referral to a specialist, early surgical intervention, and... (Review)
Review
Childhood cataract is a complex condition requiring longitudinal care, including early diagnosis, timely referral to a specialist, early surgical intervention, and dedicated postoperative care. Adherence to refractive correction and amblyopia therapy are critical for visual rehabilitation, even months to years after the cataract is removed. We review the impact of the social determinants of health on each step in the visual rehabilitation pathway for children with congenital and infantile cataracts. Children from socioeconomically marginalized backgrounds are more likely to experience delays in access to care and utilization of surgical services. They are also less likely to adhere to amblyopia therapy, with corresponding decrements in visual outcomes. Additional sociocultural factors, including parental stress, self-efficacy, and health literacy, pose barriers for these children. Standardizing clinical roles, improving health communication, managing parental stress, and implementing systemic policy changes may alleviate socioeconomic disparities in outcomes for children with cataracts.
Topics: Child; Humans; United States; Cataract Extraction; Amblyopia; Lens Implantation, Intraocular; Cataract; Visual Acuity
PubMed: 37931121
DOI: No ID Found