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Journal of Ophthalmology 2019The aim of the study was to determine the threshold values of myopic anisometropia that lead to the loss of stereoacuity in most of patients.
PURPOSE
The aim of the study was to determine the threshold values of myopic anisometropia that lead to the loss of stereoacuity in most of patients.
MATERIALS AND METHODS
Forty healthy subjects were included in the study. The inclusion criteria were as follows: lack of any functional or morphological ophthalmological disorders, or detectable damage to the visual system, anisometropia equal or less than 0.25 D in a spherical equivalent, and full stereoscopic vision for near and for distance. Myopic anisometropia was evoked by placing different focusing lenses in front of the right eye of the subject in the trial frame. Stereoscopic vision was assessed with the use of the Titmus test (dots) (Stereo Fly Test Stereo Optical Co. Inc.) for near and the Randot test for distance (Distance Randot Stereotest Stereo Optical Co. Inc.).
RESULTS
The threshold values for different types of myopic anisometropia for the loss of stereopsis in more than 50% of patients were determined. For near, this value was 3 D for sphere and "against the rule astigmatism" and 4 D for "with the rule astigmatism". For distance, the values were 2 D for sphere and "against the rule astigmatism" and 3 D for "with the rule astigmatism." . Myopic anisometropia of more than 2 D can cause a significant impairment of binocular vision. Stereoacuity at distance is more sensitive to myopic anisometropia than stereoacuity at near. Myopic anisometropia involving "against the rule" astigmatism potentially affects binocularity more than anisometropia with regular astigmatism. A prompt correction of anisometropia of more than 2 D is needed in children to prevent the development of amblyopia.
PubMed: 31198605
DOI: 10.1155/2019/2654170 -
Optometry and Vision Science : Official... Apr 2014To investigate the association of hyperopia greater than +3.25 diopters (D) with amblyopia, strabismus, anisometropia, astigmatism, and reduced stereoacuity in...
PURPOSE
To investigate the association of hyperopia greater than +3.25 diopters (D) with amblyopia, strabismus, anisometropia, astigmatism, and reduced stereoacuity in preschoolers.
METHODS
Three- to five-year-old Head Start preschoolers (N = 4040) underwent vision examination including monocular visual acuity (VA), cover testing, and cycloplegic refraction during the Vision in Preschoolers Study. Visual acuity was tested with habitual correction and was retested with full cycloplegic correction when VA was reduced below age norms in the presence of significant refractive error. Stereoacuity testing (Stereo Smile II) was performed on 2898 children during study years 2 and 3. Hyperopia was classified into three levels of severity (based on the most positive meridian on cycloplegic refraction): group 1: greater than or equal to +5.00 D, group 2: greater than +3.25 D to less than +5.00 D with interocular difference in spherical equivalent greater than or equal to 0.50 D, and group 3: greater than +3.25 D to less than +5.00 D with interocular difference in spherical equivalent less than 0.50 D. "Without" hyperopia was defined as refractive error of +3.25 D or less in the most positive meridian in both eyes. Standard definitions were applied for amblyopia, strabismus, anisometropia, and astigmatism.
RESULTS
Relative to children without hyperopia, children with hyperopia greater than +3.25 D (n = 472, groups 1, 2, and 3) had a higher proportion of amblyopia (34.5 vs. 2.8%, p < 0.0001) and strabismus (17.0 vs. 2.2%, p < 0.0001). More severe levels of hyperopia were associated with higher proportions of amblyopia (51.5% in group 1 vs. 13.2% in group 3) and strabismus (32.9% in group 1 vs. 8.4% in group 3; trend p < 0.0001 for both). The presence of hyperopia greater than +3.25 D was also associated with a higher proportion of anisometropia (26.9 vs. 5.1%, p < 0.0001) and astigmatism (29.4 vs. 10.3%, p < 0.0001). Median stereoacuity of nonstrabismic, nonamblyopic children with hyperopia (n = 206) (120 arcsec) was worse than that of children without hyperopia (60 arcsec) (p < 0.0001), and more severe levels of hyperopia were associated with worse stereoacuity (480 arcsec for group 1 and 120 arcsec for groups 2 and 3, p < 0.0001).
CONCLUSIONS
The presence and magnitude of hyperopia among preschoolers were associated with higher proportions of amblyopia, strabismus, anisometropia, and astigmatism and with worse stereoacuity even among nonstrabismic, nonamblyopic children.
Topics: Amblyopia; Anisometropia; Astigmatism; Child, Preschool; Female; Humans; Hyperopia; Male; Strabismus; Vision Tests; Visual Acuity
PubMed: 24637486
DOI: 10.1097/OPX.0000000000000223 -
The British Journal of Ophthalmology May 2006To study the distribution of anisometropia and aniso-astigmatism in young Australian children, together with clinical and ocular biometry relations.
AIM
To study the distribution of anisometropia and aniso-astigmatism in young Australian children, together with clinical and ocular biometry relations.
METHOD
The Sydney Myopia Study examined 1765 predominantly 6 year old children from 34 randomly selected Sydney schools during 2003-4. Keratometry, cycloplegic autorefraction, and questionnaire data were collected.
RESULTS
Spherical equivalent (SE) anisometropia (> or =1 dioptre) prevalence was 1.6% (95% confidence interval (CI) 1.1% to 2.4%). Aniso-astigmatism (>or =1D) prevalence was 1.0% (CI: 0.6% to 1.6%). Both conditions were significantly more prevalent among moderately hyperopic (SE > or =2.0D) than mildly hyperopic (SE 0.5-1.9D) children. Myopic children (SE < or =-0.5D) had higher anisometropia prevalence. Neither condition varied by age, sex, or ethnicity. In multivariate analyses, anisometropia was significantly associated with amblyopia, odds ratio (OR) 29, (CI: 8.7 to 99), exotropia (OR 7.7, CI: 1.2 to 50), and neonatal intensive care unit (NICU) admission (OR 3.6, CI: 1.1 to 12.6). Aniso-astigmatism was significantly associated with amblyopia (OR 8.2, CI: 1.4 to 47), maternal age >35 years (OR 4.0, CI: 1.3 to 11.9), and NICU admission (OR 4.6, CI: 1.2 to 17.2). Anisometropia resulted from relatively large interocular differences in axial length (p<0.0001) and anterior chamber depth (p = 0.0009). Aniso-astigmatism resulted from differences in corneal astigmatism (p<0.0001).
CONCLUSION
In this predominantly 6 year old population, anisometropia and aniso-astigmatism were uncommon, had important birth and biometry associations, and were strongly related to amblyopia and strabismus.
Topics: Amblyopia; Anisometropia; Astigmatism; Australia; Birth Weight; Child; Developmental Disabilities; Epidemiologic Methods; Ethnicity; Exotropia; Eye; Female; Humans; Hyperopia; Infant, Newborn; Infant, Premature; Male; Maternal Age; Multiple Birth Offspring
PubMed: 16622090
DOI: 10.1136/bjo.2005.083154 -
Frontiers in Integrative Neuroscience 2014Amblyopia is a cerebral visual impairment considered to derive from abnormal visual experience (e.g., strabismus, anisometropia). Amblyopia, first considered as a... (Review)
Review
Amblyopia is a cerebral visual impairment considered to derive from abnormal visual experience (e.g., strabismus, anisometropia). Amblyopia, first considered as a monocular disorder, is now often seen as a primarily binocular disorder resulting in more and more studies examining the binocular deficits in the patients. The neural mechanisms of amblyopia are not completely understood even though they have been investigated with electrophysiological recordings in animal models and more recently with neuroimaging techniques in humans. In this review, we summarize the current knowledge about the brain regions that underlie the visual deficits associated with amblyopia with a focus on binocular vision using functional magnetic resonance imaging. The first studies focused on abnormal responses in the primary and secondary visual areas whereas recent evidence shows that there are also deficits at higher levels of the visual pathways within the parieto-occipital and temporal cortices. These higher level areas are part of the cortical network involved in 3D vision from binocular cues. Therefore, reduced responses in these areas could be related to the impaired binocular vision in amblyopic patients. Promising new binocular treatments might at least partially correct the activation in these areas. Future neuroimaging experiments could help to characterize the brain response changes associated with these treatments and help devise them.
PubMed: 25147511
DOI: 10.3389/fnint.2014.00062 -
The British Journal of Ophthalmology Sep 2002Even in the absence of retinopathy of prematurity (ROP), premature birth signals increased risk for abnormal refractive development. The present study examined the...
BACKGROUND/AIMS
Even in the absence of retinopathy of prematurity (ROP), premature birth signals increased risk for abnormal refractive development. The present study examined the relation between clinical risk factors and refractive development among preterm infants without ROP.
METHODS
Cycloplegic refraction was measured at birth, term, 6, 12, and 48 months corrected age in a cohort of 59 preterm infants. Detailed perinatal history and cranial ultrasound data were collected. 40 full term (plus or minus 2 weeks) subjects were tested at birth, 6, and 12 months old.
RESULTS
Myopia and anisometropia were associated with prematurity (p<0.05). More variation in astigmatic axis was found among preterm infants (p<0.05) and a trend for more astigmatism (p<0.1). Emmetropisation occurred in the preterm infants so that at term age they did not differ from the fullterm group in astigmatism or anisometropia. However, preterm infants remained more myopic (less hyperopic) than the fullterm group at term (p<0.05) and those infants born <1500 g remained more anisometropic than their peers until 6 months (p<0.05). Infants with abnormal cranial ultrasound were at risk for higher hyperopia (p<0.05). Other clinical risk factors were not associated with differences in refractive development. At 4 years of age 19% of the preterm group had clinically significant refractive errors.
CONCLUSION
Preterm infants without ROP had high rates of refractive error. The early emmetropisation process differed from that of the fullterm group but neither clinical risk factors nor measures of early refractive error were predictive of refractive outcome at 4 years.
Topics: Anisometropia; Astigmatism; Birth Weight; Child, Preschool; Gestational Age; Humans; Infant; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Refraction, Ocular; Refractive Errors; Risk Factors; Skull; Ultrasonography
PubMed: 12185134
DOI: 10.1136/bjo.86.9.1035 -
Frontiers in Physiology 2022This study aimed to explore the macular structures and vascular characteristics of more myopic (MM) and contralateral eyes with highly myopic anisometropia....
This study aimed to explore the macular structures and vascular characteristics of more myopic (MM) and contralateral eyes with highly myopic anisometropia. Comprehensive ophthalmic examinations were performed for 33 patients with highly myopic anisometropia. Macular structures (total retinal layer [TRL], ganglion cell and inner plexiform layer [GCIPL], inner nuclear layer [INL], outer retinal layer [ORL], nerve fiber layer [NFL], choroidal layer [CHL]) and vascular characteristics (superficial vascular complex density [SVD], deep vascular complex density [DVD], choriocapillaris perfusion area [CCPA]) were assessed using swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCTA). Macular structures and vascular characteristics of each subregion were compared to those of the Early Treatment of Diabetic Retinopathy Study (ETDRS). With highly myopic anisometropia, the thicknesses of the TRL, GCIPL, INL, and ORL in MM eyes were smaller than those in contralateral eyes in at least one quadrant of the perifoveal and parafoveal circles (all < 0.05), with no changes in the foveal and temporal quadrants of perifoveal regions (all > 0.05). A thicker NFL ( = 0.018) was found in MM eyes than in contralateral eyes in the superior perifoveal quadrant. The CHL (all < 0.05) in MM eyes was thinner in all regions than in the contralateral eyes according to the ETDRS. There were no statistical differences in the SVD, DVD, and CCPA of MM and contralateral eyes (all > 0.05). All retinal layers, except the NFL, tended to be thinner in all subregions, except the temporal perifoveal and foveal quadrants in MM eyes, and choroidal thickness was thinned in all areas.
PubMed: 36045745
DOI: 10.3389/fphys.2022.918393 -
Indian Journal of Ophthalmology 2011There are few studies on pseudophakic monovision even though it is widely applied. We reviewed the published literature on pseudophakic monovision. Surgeons select... (Review)
Review
There are few studies on pseudophakic monovision even though it is widely applied. We reviewed the published literature on pseudophakic monovision. Surgeons select patients who not only have a strong desire to be free of glasses after surgery, but also fully understand monovision design and its drawbacks. However, other criteria adopted for pseudophakic monovision are very different. Both traditional monovision and cross monovision are used in pseudophakic monovision, and the target binocular anisometropia ranges from -1.0 D to -2.75 D. Postoperative results were acceptable in every study and most patients were satisfied, with vision being improved and presbyopia corrected. Complications were decreased stereopsis, contrast sensitivity, and visual fields, similar to other types of monovision. The term "pseudophakic monovision" should include more than just monocular intraocular lens implantation in two eyes, and further studies are required.
Topics: Cataract; Eyeglasses; Humans; Lens Implantation, Intraocular; Presbyopia; Pseudophakia; Vision, Monocular
PubMed: 22011494
DOI: 10.4103/0301-4738.86318 -
Frontiers in Public Health 2022The study aims to assess two refractive instrument-based methods of vision screening (SureSight and PlusoptiX) to detect refractive amblyopia risk factors (ARFs) and...
OBJECTIVE
The study aims to assess two refractive instrument-based methods of vision screening (SureSight and PlusoptiX) to detect refractive amblyopia risk factors (ARFs) and significant refractive errors in Chinese preschool children and to develop referral criteria according to the 2021 AAPOS guidelines.
METHODS
Eye examinations were conducted in children aged 61 to 72 months ( = 1,173) using a PlusoptiX photoscreener, SureSight autorefractor, and cycloplegic retinoscopy (CR). The Vision Screening Committee of AAPOS's preschool vision screening guidelines from 2021 were adopted for comparison. Paired -test analysis and Bland-Altman plots were used to assess the differences and agreement between the PlusoptiX photoscreener, SureSight autorefractor, and CR. In addition, the validity of the cut-off values of the several ARFs measured with the SureSight and PlusoptiX was estimated using receiver operating characteristic (ROC) curves and compared to the age-based 2021 AAPOS examination failure levels.
RESULTS
A total of 1,173 children were tested with comprehensive eye examinations. When the referral numbers based on the 2013 (43/3.67%) and 2021 (42/3.58%) AAPOS guidelines were compared, significant differences between the values of astigmatism (72.09 vs. 52.38%) and anisometropia (11.63 vs. 38.10%) were found. The 95% limits of agreement (LOA) of the spherical value and the cylindrical value between PlusoptiX and CR were 95.08 and 96.29%. It was 93.87 and 98.10% between SureSight and CR. Considering refractive failure levels, the ROC curves obtained the optimal cut-off points. However, the PlusoptiX and the SureSight showed lower efficiency in hyperopia (Youden index, 0.60 vs. 0.83) and myopia (Youden index, 078 vs. 0.93), respectively. After adjusting the above cut-off points, the optimized NES (Nanjing Eye Study) referral criteria for myopia, hyperopia, astigmatism, and anisometropia were -0.75, 1.25, -1.0, and 0.5 with PlusoptiX and -1.25, 2.75, -1.5, and 0.75 with SureSight.
CONCLUSIONS
SureSight and PlusoptiX showed a good correlation with CR and could effectively detect refractive ARFs and visually significant refractive errors. There were obvious advantages in detecting hyperopia using SureSight and myopia using PlusoptiX. We proposed instrumental referral criteria for age-based preschool children based on AAPOS 2021 guidelines.
Topics: Amblyopia; Anisometropia; Astigmatism; Child, Preschool; Humans; Hyperopia; Mydriatics; Myopia; Referral and Consultation; Refractive Errors; Reproducibility of Results; Sensitivity and Specificity
PubMed: 36225773
DOI: 10.3389/fpubh.2022.959757 -
Taiwan Journal of Ophthalmology 2018The objective of the study was to evaluate the refractive status and thereby assess anisometropia in children with unilateral congenital nasolacrimal duct obstruction...
OBJECTIVE
The objective of the study was to evaluate the refractive status and thereby assess anisometropia in children with unilateral congenital nasolacrimal duct obstruction (CNLDO).
STUDY DESIGN
This study design was a descriptive cross-sectional study.
PLACE AND DURATION
this study was conducted at the Department of Pediatric Ophthalmology and Strabismology, Al-Shifa Trust Eye Hospital, Rawalpindi; from August 2013 to July 2014.
METHODOLOGY
This study assessed consecutive children with unilateral CNLDO. Cycloplegic refraction on all children with CNLDO was performed followed by appropriate intervention. Refractive errors of the affected and normal eyes were compared.
RESULTS
One hundred and twenty-four children with a mean age of 29.69 ± 21.12 months (range, 2 months to 8 years) were studied. Based on spherical equivalent (SE), hypermetropia was more common in the affected eyes ( < 0.001). Anisometropia of >1.5 diopters (D) was present in = 17 (13.7%). Interocular difference was significant for spherical error and SE ( < 0.001) but not cylindrical errors.
CONCLUSION
Unilateral CNLDO is associated with statistically significant anisometropia, especially anisohypermetropia which has amblyogenic potential. It is vital to perform cycloplegic refraction routinely and counsel parents regarding prognosis and regular follow-ups.
PubMed: 29675347
DOI: 10.4103/tjo.tjo_77_17 -
BMC Ophthalmology Oct 2021To investigate the clinical characteristics of children with congenital ptosis, with particular attention given to the incidence of anisometropia, and the difference in...
BACKGROUND
To investigate the clinical characteristics of children with congenital ptosis, with particular attention given to the incidence of anisometropia, and the difference in axial length (AL) between the right and left eyes.
METHODS
The medical charts of 55 patients with congenital ptosis at Niigata University Medical and Dental Hospital were retrospectively analyzed. Clinical characteristics, including age, cycloplegic refraction, AL, and the presence of amblyopia and its causes were analyzed.
RESULTS
Age at the initial visit was 16 ± 20 (mean ± standard deviation, the same applies below) months. Of the 49 patients whose cycloplegic refraction was measured, hyperopic anisometropia, defined as ≥ one-diopter difference in spherical equivalent (SE), was observed in 1/11, 9/27 and 5/11 patients with bilateral, right, and left ptosis, respectively. Among 14/38 patients with hyperopic anisometropia involving unilateral ptosis, 13 demonstrated a larger SE in the ptotic eye than in the non-ptotic eye. The inter-eye difference in AL (AL of the ptotic eye minus that of the non-ptotic eye) in six patients with unilateral ptosis and hyperopic anisometropia ipsilateral to the ptotic eye (-0.29 ± 0.40 mm) was significantly smaller than that in three patients with unilateral ptosis and no hyperopic anisometropia (0.38 ± 0.29 mm).
CONCLUSIONS
At our institute, children with congenital ptosis had a high incidence of hyperopic anisometropia ipsilateral to the ptotic eye. Furthermore, this condition was associated with a shorter axial length. These results indicate that refractive correction for hyperopic anisometropia is important for proper visual development in children with congenital ptosis.
Topics: Amblyopia; Anisometropia; Blepharoptosis; Child; Humans; Hyperopia; Retrospective Studies
PubMed: 34625050
DOI: 10.1186/s12886-021-02126-8