Amblyopia: neural basis and therapeutic approaches

Bretas, Caio César Peixoto; Soriano, Renato Nery

doi:10.5935/0004-2749.20160099

Cited by 14 publications

(12 citation statements)

References 59 publications

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“…Functional amblyopia is a visual developmental disorder consisting of reduced best-corrected visual acuity in one or rarely in both eyes without the presence of any ocular pathology [1]. Due to the abnormalities in visual processing occurring in amblyopia, there are also deficits in contrast sensitivity, accommodation, binocular vision, fixation, saccades, color, and form and motion perception, among others [2][3][4][5][6][7][8][9]. ere are four types of amblyopia depending on its etiology: anisometropic amblyopia, strabismic amblyopia, mixed amblyopia (if anisometropia and strabism coexist), and deprivation amblyopia (if there was pathology during visual development which struggled the eye stimulation) [7].…”

Section: Introductionmentioning

confidence: 99%

Active Vision Therapy for Anisometropic Amblyopia in Children: A Systematic Review

Hernández-Rodríguez

Piñero

2020

Journal of Ophthalmology

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Purpose. The aim of the study was evaluation of the scientific evidence about the efficacy of vision therapy in children and teenagers with anisometropic amblyopia by performing a systematic literature review. Methods. A search was performed using 3 searching strategies in 4 different databases (PubMed, Web of Science, Scopus, and PruQuest). The quality of the included articles was evaluated using two tools for the risk of bias assessment, ROBINS-I for nonrandomized studies of intervention (NRSI), and ROB 2.0 for randomized clinical trials. Results. The search showed 1274 references, but only 8 of them passed the inclusion criteria after the complete text review. The articles that were finally included comprised 2 randomized control trials and 6 nonrandomized studies of intervention. These articles provided evidence supporting the efficacy of vision therapy for the treatment of anisometropic amblyopia in children and teenagers. Assessment of the risk of bias showed an appropriate risk of bias for the randomized control trials, but a high risk of bias for nonrandomized studies of intervention (NRSI). A main source of risk of bias for NRSI was the domain related to the measurements of the outcomes, due to a lack of double-blind studies. Conclusion. Vision therapy is a promising option for the treatment of anisometropic amblyopia in children and teenagers. However, the level of scientific evidence provided by the studies revised is still limited, and further randomized clinical trials are necessary to confirm the results provided to date and to optimize the vision therapy techniques by knowing the specific neural mechanisms involved.

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Section: Introductionmentioning

confidence: 99%

Active Vision Therapy for Anisometropic Amblyopia in Children: A Systematic Review

Hernández-Rodríguez

Piñero

2020

Journal of Ophthalmology

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“…Most of the studies indicate the sensitive period for visual development as age 0–7 [19–21]. However, there is evidence that supports more effective treatment of amblyopia in younger children [22, 23].…”

Section: Discussionmentioning

confidence: 99%

Threshold Values of Myopic Anisometropia Causing Loss of Stereopsis

Gawęcki¹

2019

Journal of Ophthalmology

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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.” Conclusions. 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.

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“…Amblyopia (synonym: lazy eye) is a neurodevelopmental visual disorder which is caused by abnormal visual experience early in life (Ciuffreda et al, 1991;Levi, 2020) and results in the affected eye losing its ability to effectively drive vision. Consequently, the brain suppresses the visual information coming from the affected amblyopic eye (interocular suppression), which impairs the fusion of images needed for binocular vision (Bretas & Soriano, 2016). Losses in contrast sensitivity and visual acuity are a landmark of the amblyopic eye (Hess & Howell., 1977;Levi & Harwerth, 1977); however, amblyopic individuals show a range of sensory and oculomotor deficiencies, including higher level deficits (for recent reviews see Kiorpes & Daw, 2018, Levi, 2020Verghese et al, 2019).…”

Section: Introductionmentioning

confidence: 99%