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Journal of Ophthalmology 2015The aim of the present systematic review was to examine the benefits and harms associated with immediate sequential bilateral cataract surgery (ISBCS) with specific... (Review)
Review
The aim of the present systematic review was to examine the benefits and harms associated with immediate sequential bilateral cataract surgery (ISBCS) with specific emphasis on the rate of complications, postoperative anisometropia, and subjective visual function in order to formulate evidence-based national Danish guidelines for cataract surgery. A systematic literature review in PubMed, Embase, and Cochrane central databases identified three randomized controlled trials that compared outcome in patients randomized to ISBCS or bilateral cataract surgery on two different dates. Meta-analyses were performed using the Cochrane Review Manager software. The quality of the evidence was assessed using the GRADE method (Grading of Recommendation, Assessment, Development, and Evaluation). We did not find any difference in the risk of complications or visual outcome in patients randomized to ISBCS or surgery on two different dates. The quality of evidence was rated as low to very low. None of the studies reported the prevalence of postoperative anisometropia. In conclusion, we cannot provide evidence-based recommendations on the use of ISBCS due to the lack of high quality evidence. Therefore, the decision to perform ISBCS should be taken after careful discussion between the surgeon and the patient.
PubMed: 26351576
DOI: 10.1155/2015/912481 -
Translational Vision Science &... Apr 2023This study aimed to examine the differences of retinal oxygen saturation between the paired eyes in anisometropia and to further explore the relation between retinal... (Observational Study)
Observational Study
PURPOSE
This study aimed to examine the differences of retinal oxygen saturation between the paired eyes in anisometropia and to further explore the relation between retinal oxygenation and myopia.
METHODS
This was an observational cross-sectional study, with 124 adults with anisometropia included. According to the interocular differences in spherical equivalent (SE), individuals with a difference ≥3.0 D belonged to the ΔSE ≥ 3.0 D group, and those with a difference ≥1.5 D and <3.0 D belonged to the ΔSE <3.0 D group. The ΔSE ≥ 3.0 D group contained 61, and the ΔSE < 3.0 D group contained 64. All were performed examinations of retinal oximetry, SE, axial length (AL), intraocular pressure, central corneal thickness and average keratometry.
RESULTS
The median SE and AL were -5.06 (-7.22 ∼ -3.41) D and 25.54 (24.73 ∼ 26.62) mm in the "ΔSE < 3 D" group and -4.25 (-6.88 ∼ -2.09) D and 25.52 (24.49 ∼ 26.45) mm in the other group. The retinal arterial oxygen saturation (SaO2) was 93.97% ± 1.26% in the less myopic eyes and 93.18% ± 1.53% (P < 0.001) in the more myopic eyes. In multivariate analyses, SE and AL were both significantly associated with the SaO2.
CONCLUSIONS
The SaO2 between anisometropic myopic eyes was different, and it was associated with SE and AL.
TRANSLATIONAL RELEVANCE
This study demonstrates a relationship between myopia and retinal vascular oxygenation through a novel retinal oximeter.
Topics: Humans; Adult; Anisometropia; Cross-Sectional Studies; Oxygen Saturation; Axial Length, Eye; Myopia
PubMed: 37052910
DOI: 10.1167/tvst.12.4.14 -
Indian Journal of Ophthalmology Jun 2022To investigate the choroidal vascularity index (CVI) and morphological features of the choroid in anisometropic amblyopia.
PURPOSE
To investigate the choroidal vascularity index (CVI) and morphological features of the choroid in anisometropic amblyopia.
METHODS
In this prospective cross-sectional study, 39 patients with unilateral anisometropic amblyopic patients and 33 eyes of 33 healthy control participants were involved. These participants were examined in terms of axial length (AL), spherical equivalent (SE), central macular thickness (CMT), choroidal thickness (CT), total choroidal area (TCA), luminal area (LA), stromal area (SA), LA/SA ratio, and CVI. All parameters were compared between amblyopic eyes, healthy fellow eyes, and healthy control eyes. The Shapiro-Wilk tests, Chi-square test, the paired t-test, Wilcoxon signed-rank test, Mann-Whitney U test, Kruskal-Wallis test, and Pearson/Spearman correlation tests were used.
RESULTS
In the hyperopic patients; SE, subfoveal CT, nasal CT, temporal CT, TCA, LA, SA, and CMT were greater in amblyopic eyes than in healthy fellow eyes and control eyes (P < 0.001, P < 0.001, P < 0.001, P < 0.001, P < 0.001, P < 0.001, and P < 0.001, respectively), and CVI, LA/SA ratio, and AL were smaller in amblyopic eyes than in healthy fellow eyes and control eyes ([P < 0.001, P = 0.006], P < 0.001, and P < 0.001, respectively). In the myopic patients, subfoveal CT, nasal CT, temporal CT, TCA, LA, SA values were statistically smaller in amblyopic eyes than in healthy eyes and control eyes ([P < 0.001, P = 0.002), [P = 0.004, P = 0.012], [P = 0.012, P = 0.032], [P < 0.001, P = 0.013], [P < 0.001, P = 0.024], and [P < 0.001, P = 0.047], respectively). The differences in the AL and choroidal parameters were due to myopia and hyperopia.
CONCLUSION
The choroidal structural parameters of the amblyopic eyes were different from that of the healthy eyes.
Topics: Amblyopia; Anisometropia; Choroid; Cross-Sectional Studies; Humans; Hyperopia; Prospective Studies; Tomography, Optical Coherence; Visual Acuity
PubMed: 35647979
DOI: 10.4103/ijo.IJO_3092_21 -
Clinical Ophthalmology (Auckland, N.Z.) 2022The American Association for Pediatric Ophthalmology and Strabismus (AAPOS) issued a 2021 update of Uniform Validation Guidelines for instrument-based pediatric vision...
BACKGROUND
The American Association for Pediatric Ophthalmology and Strabismus (AAPOS) issued a 2021 update of Uniform Validation Guidelines for instrument-based pediatric vision screeners. With each update it is important for each manufacturer to update the Instrument Referral Criteria (IRC) programed into their devices in order to optimize sensitivity and specificity to detect AAPOS criteria.
METHODS
De-identified data comparing photoscreening with simultaneous confirmatory examinations constituted separate cohorts for the development of IRC via receiver operating characteristic (ROC) curves. The refractions of the devices were also compared.
RESULTS
This study defines three sets of refractive IRC (Sensitive, Medium, and Specific) for three leading infrared photoscreening devices, PlusoptiX A12, Welch-Allyn SPOT, and Adaptica 2WIN for children < 4 and ≥ 4 years in order to better target the 2021 AAPOS guidelines. The cohorts were similar but the SPOT group (n=755, mean age 9) was older with more astigmatism and the 2WIN (n=1362, mean age 7) was younger with more hyperopia and anisometropia compared to the cohort for PlusoptiX A12 (n=616, mean age 8). The age-based, medium magnitude IRC for anisometropia, hyperopia, astigmatism and myopia for SPOT were: <4y: 1.5, 1.75, 3.25, 3.5 and ≥4y: 1.5, 1.75, 2.25, 2.0; for PlusoptiX: <4y: 1.75, 3.0, 3.5, 3.5 and ≥4y: 1.75, 3.0, 2.5, 2.5; and for 2WIN: <4y: 1.75, 2.5, 3.5, 3.5 and ≥4y: 1.5, 2.0, 2.5, 2.0. The mean ABCD ellipsoid spectacle matches differed; SPOT: 1.8±1.3 (better) versus PlusoptiX: 1.9±1.6 and 2WIN: 2.2±1.4 (p<0.001).
CONCLUSION
The 2021 AAPOS exam guidelines foster early specificity before age 4 and sensitivity after age 4. These evidence-based IRC for current SPOT, PlusoptiX, and 2WIN photoscreeners should allow device manufacturers the data necessary to adjust their device IRC to maximize specificity, sensitivity or a medium between the two. This paper provides practical suggestions for better validation. Improved early screening combined with thorough treatment should reduce life-long vision impairment due to amblyopia.
PubMed: 35250260
DOI: 10.2147/OPTH.S342666 -
Ophthalmology Jan 2010To determine anisometropia prevalence and associated risk factors in Hispanic and African American preschoolers.
PURPOSE
To determine anisometropia prevalence and associated risk factors in Hispanic and African American preschoolers.
DESIGN
Population-based, cross-sectional study.
PARTICIPANTS
We included 3030 Hispanic and 2994 African American children aged 6 to 72 months from Inglewood, California.
METHODS
Retinomax autorefraction was performed on all participants after cycloplegia. Anisometropia was defined by difference in spherical equivalent (SE), by difference in plus cylinder in any axis (cylindrical), and by difference in cylinder axis vectors (vertical Jackson cross cylinder vector [J0] and oblique Jackson cross cylinder vector [J45] between the eyes. Strabismus was determined by prism-cover testing. A parental questionnaire explored potential risk factors including developmental delay, prematurity, prenatal exposure, and family history.
MAIN OUTCOME MEASURES
Anisometropia prevalence stratified by age, gender, and ethnicity. The association of anisometropia with strabismus and other biological risk factors was assessed.
RESULTS
The prevalence of SE anisometropia > or =1.0 diopter (D) was 4.3% for Hispanics and 4.2% for African Americans. Prevalence of cylindrical anisometropia > or =1.0 D was 5.6% and 4.5%, respectively. Prevalence of cylindrical or SE anisometropia > or =3.0 D was < or =0.4% for both ethnic groups. Cylinder vector anisometropia > or =0.5 was twice as common as cylindrical anisometropia > or =1.0 D. The SE anisometropia decreased at age 1 year in Hispanics (P = 0.0016) but not African Americans. Cylindrical anisometropia decreased in the first year of life in both ethnic groups (P < or = 0.001). There was no trend in SE or cylindrical anisometropia beyond 1 year of age, but cylinder vector anisometropia steadily decreased beyond 1 year of age in both ethnic groups. Cylinder vector anisometropia was more prevalent among African Americans, but there was no difference in other measurements of anisometropia between ethnic groups. Anisometropia did not vary by gender. Strabismus was associated with all types of anisometropia. No association of anisometropia with gestational age, birth weight, cerebral palsy, family history, or prenatal exposure could be identified.
CONCLUSIONS
Spherical and cylindrical anisometropia (> or =1.0 D) each affect 4% to 6% of Hispanic and African American preschoolers. Anisometropia > or =3.0 D is rare. Except for cylinder axis vector, the prevalence of anisometropia does not diminish beyond 1 year of age. Strabismus is associated with all forms of anisometropia.
FINANCIAL DISCLOSURE(S)
The authors have no proprietary or commercial interest in any of the materials discussed in this article.
Topics: Black or African American; Age Distribution; Anisometropia; Child; Child, Preschool; Cross-Sectional Studies; Female; Hispanic or Latino; Humans; Infant; Los Angeles; Male; Prevalence; Refraction, Ocular; Retinoscopy; Risk Factors; Sex Distribution
PubMed: 19818509
DOI: 10.1016/j.ophtha.2009.06.008 -
Acta Ophthalmologica Aug 2017To study anisometropia of spherical equivalent and astigmatism from the onset of myopia at school age to adulthood. (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
To study anisometropia of spherical equivalent and astigmatism from the onset of myopia at school age to adulthood.
METHODS
A total of 240 myopic schoolchildren (mean age 10.9 years), with no previous spectacles, were recruited during 1983-1984 to a randomized 3-year clinical trial of bifocal treatment of myopia. Examinations with subjective cyclopedic refraction were repeated 3 years later (follow-up 1) for 238 subjects and thereafter at the mean ages of 23.2 (follow-up 2) and 33.9 years (follow-up 3) for 178 and 134 subjects. After exclusions, the 102 subjects who attended all three follow-ups were included in the analyses. Corneal refractive power and astigmatism and anterior chamber depth was measured with Pentacam topography and axial length with IOL master at study end. Prevalence and changes in anisometropia of spherical equivalent (AnisoSE) and astigmatism (AnisoAST) and their relationships with refractive and axial measures were studied.
RESULTS
Mean (±SD) of spherical equivalent (SE), AnisoSE and AnisoAST increased from baseline to follow-up end from -1.44 ± 0.57 D to -5.11 ± 2.23 D, from 0.28 ± 0.30 D to 0.68 ± 0.69 D and from 0.14 ± 0.18 D to 0.37 ± 0.36 D, respectively. Prevalence of AnioSE, ≥1 D, increased from 5% to 22.6% throughout follow-up. Higher AnisoSE was associated with SE in the less myopic eye at baseline and at follow-up 1, and with SE in the more myopic eye in follow-ups 2 and 3 in adulthood. At study end, AnisoSE was associated with the interocular difference in axial length (AL) (r = 0.612, p < 0.001) but not with the interocular difference in corneal refraction (CR) (r = -0.122, p = 0.266). In cases of low AnisoSE(≤1.00 D), the negative correlation between the real interocular differences (value of right eye minus value of left eye) in CR and AL (r = -0.427, p < 0.001) decreased the influence of the interocular difference in AL on AnisoSE, causing emmetropization in AnisoSE. The interocular difference in corneal astigmatism was the main factor associated with AnisoAST (r = 0.231, p = 0.020). No significant relationship was found between AnisoAST and level of SE.
CONCLUSION
Anisometropia of the spherical equivalent (AnisoSE) increased along with the myopic progression and at study end was mainly associated with the interocular difference in AL. AnisoAST was mainly explained by the interocular difference in corneal astigmatism. In cases with low AnisoSE (≤1.0 D), the interrelationship between CR and AL decreased AnisoSE causing emmetropization in AnisoSE.
Topics: Adolescent; Adult; Anisometropia; Astigmatism; Axial Length, Eye; Child; Cornea; Corneal Topography; Disease Progression; Eyeglasses; Female; Finland; Follow-Up Studies; Forecasting; Humans; Male; Myopia; Prevalence; Refraction, Ocular; Young Adult
PubMed: 28481050
DOI: 10.1111/aos.13405 -
Clinical Ophthalmology (Auckland, N.Z.) 2022To provide the clinical characteristics of amblyopia in children under 17 years of age in Qassim Region, Saudi Arabia.
PURPOSE
To provide the clinical characteristics of amblyopia in children under 17 years of age in Qassim Region, Saudi Arabia.
PATIENTS AND METHODS
The study was a cross-sectional hospital-based, included 121 children with amblyopia aged between 3 and 17 years, referred from 6 hospitals in Qassim region to the paediatric optometry clinic at Qassim University medical city. Demographics and comprehensive ocular examination including visual acuity (VA), assessment of anterior and posterior segment, cycloplegic refraction (RE), angle of deviation, and cause of amblyopia were collected.
RESULTS
The mean age at diagnosis of amblyopia was 8.93 ± 3.67 years. The leading cause of amblyopia was strabismus and anisometropia shared the same percentage at 29.75%, and the combined-mechanism at 18.18%. Amblyopia was more common in males 57.85%, particularly strabismic amblyopia in 66.67% and anisometropic amblyopia in 61.11%, = 0.408. Amblyopia was more predominant in the age group 6- to 9-year-old, particularly, strabismic amblyopia 44.44%, and amblyopia due to a combined mechanism of 36.36%, = 0.066. The degree of hyperopia was not varied by the cause of amblyopia ( = 0.401), with slightly high hyperopia found in ametropic and strabismic amblyopia. Conversely, hyperopic astigmatism was significantly associated with amblyopia = 0.020, with a high degree of hyperopic astigmatism found in meridional amblyopia and ametropic amblyopia.
CONCLUSION
The commonest types of amblyopia in children were attributed to strabismus and anisometropia. Causes of amblyopia differed by age group with strabismus, anisometropia, and combined mechanism accounting for most children aged 6- to 9-years and strabismus for children aged less than 6 years. Hyperopic and myopic astigmatism were significantly associated with anisometropia and meridional amblyopia. Therefore, efforts should be made for early diagnosis and management of childhood amblyopia and uncorrected refractive errors to avoid their impact on quality of life.
PubMed: 36003073
DOI: 10.2147/OPTH.S379550 -
International Journal of Ophthalmology 2023To evaluate the safety, effectiveness, and predictability of small incision lenticule extraction (SMILE) for the treatment of anisometropia, and to explore the...
AIM
To evaluate the safety, effectiveness, and predictability of small incision lenticule extraction (SMILE) for the treatment of anisometropia, and to explore the personalized design scheme of SMILE in correcting adult myopia anisometropia based on the nomogram.
METHODS
It's a prospective cohort study. Patients with anisometropic myopia of refractive difference ≥ 2.0 diopters (D) who underwent SMILE between September 2020 and March 2021 were enrolled. Clinical features and visual function were assessed preoperatively and at 1wk, 1, 3, and 6mo after the operation. The examination included tests for uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive errors, effectiveness index (preoperative CDVA/postoperative UDVA), safety index (postoperative CDVA/preoperative CDVA), nomogram and stereoscopic function. Paired -test, Wilcoxon signed-rank test and repeated-measures analyses of variance were used for continuous variables, and Pearson Chi-squared test was used for categorical variables.
RESULTS
The study involved 45 consecutive patients (average age: 25.0±6.9y; 82 out of 90 eyes underwent SMILE, while 8 eyes were not operated). The average preoperative spherical equivalent (SE) was -4.74±0.22 D. Six months after surgery, the effectiveness index was 1.05±0.12, and the safety index was 1.09±0.11. Seventy eyes (85.4%) exhibited SE correction error within ±0.5 D. The percentage of eyes with Titmus stereoscopic function equal to or less than 200″ significantly increased from 55.6% preoperatively to 88.9% postoperatively (<0.05). There was statistically significant difference between higher myopia eyes and contralateral eyes in average nomogram value/spherical refraction ratio.
CONCLUSION
SMILE is safe, effective and predictable in correcting myopic anisometropia, and it improves stereoscopic visual function of anisometropia patients. The precise and individualized design of the nomogram is a vital element to ensure the balance of both eyes after SMILE.
PubMed: 38028522
DOI: 10.18240/ijo.2023.11.16 -
Beyoglu Eye Journal 2022The objectives of the study were to investigate the inter and intraocular differences in posterior pole asymmetry analysis (PPAA) with optical coherence tomography (OCT)...
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.
PubMed: 35692278
DOI: 10.14744/bej.2022.48344 -
Transactions of the American... 1999First, to determine if thresholds exist for the development of amblyopia and subnormal binocularity with various types of anisometropia and to confirm or refute existing... (Comparative Study)
Comparative Study
PURPOSE
First, to determine if thresholds exist for the development of amblyopia and subnormal binocularity with various types of anisometropia and to confirm or refute existing guidelines for its treatment or observation. Second, to delineate any association between the degree or type of anisometropia and the depth of amblyopia and severity of binocular sensory abnormalities.
METHODS
Four hundred eleven (411) patients with various levels of anisometropia, no previous therapy, and no other ocular pathology were evaluated. The effect of anisometropia (both corrected and uncorrected) on monocular acuity and binocular function was examined.
RESULTS
Spherical myopic anisometropia (SMA) of > 2 diopters (D) or spherical hypermetropic anisometropia (SHA) of > 1 D results in a statistically significant increase in the incidence of amblyopia and decrease in binocular function when compared to non anisometropic patients. Increasing levels of SMA and SHA beyond these thresholds were also associated with increasing depth (and in the case of SHA, incidence as well) of amblyopia. Cylindrical myopic anisometropia (CMA) or cylindrical hyperopic anisometropia (CHA) of > 1.5 D results in a statistically significant increase in amblyopia and decrease in binocular function. A clinically significant increase in amblyopia occurs with > 1 D of CMA or CHA. Increasing levels of CMA and CHA beyond > 1 D were also associated with an increased incidence (and in the case of SMA, depth as well) of amblyopia.
CONCLUSIONS
This study provides guidelines for the treatment or observation of anisometropia and confirms and characterizes the association between the type and degree of anisometropia and the incidence and severity of amblyopia and subnormal binocularity.
Topics: Amblyopia; Anisometropia; Child; Eyeglasses; Humans; Incidence; Practice Guidelines as Topic; Refraction, Ocular; Retrospective Studies; Strabismus; Treatment Outcome; Vision, Binocular; Visual Acuity
PubMed: 10703148
DOI: No ID Found