Factors influencing visual outcome in anisometropic amblyopes

Abstract

Aim: To identify which factors influence the final visual acuity in children with anisometropic amblyopia. Methods: A retrospective analysis of 112 children with anisometropic amblyopia, identified from examining all case notes of children who had failed preschool or school screening. Results: The age at presentation had no effect on the final visual outcome (p=0.804). Both the degree of refractive error and the degree of anisometropia at presentation correlated with final visual acuity (p<0.001 and p=0.001). Those with strabismus had a poorer final outcome. Conclusions: The age at presentation of a child with anisometropic amblyopia appears to have no significant effect on the final visual acuity. The amount of refractive error and degree of anisometropia at presentation do correlate strongly with final visual acuity. This would suggest, firstly, that children with poorer visual acuity at presentation and higher degrees of anisometropia should be treated more aggressively and that, secondly, children with anisometropic amblyopia should be treated regardless of age.

Factors Influencing the Success of Treatment in Anisometropic Amblyopia

“…Our data demonstrated that age had no significant impact on the success of treatment. fluence of smaller refractive errors on treatment success, while Hussein et al, demonstrated no effect of the amount of difference in refraction between both eyes on treatment success [8,14,15]. Our data differs from several other studies with regards to the effect of compliance and presenting visual acuity on treatment success.…”

“…Hussein et al, demonstrated an increased risk of treatment failure if treatment was started after the age of 6 years old [8]. However, Cobb et al, and Chen et al, found no correlation between age and treatment success [13,14]. Our data demonstrated that age had no significant impact on the success of treatment.…”

A comparison of pre-school versus school-age orthoptic screening programmes in the North-East of England

“…There are published studies that report the effectiveness of treatment is no different if commenced any time between 3 and 7 years of age [7][8][9] and that deferring treatment until the age of 5 years does not appear to limit potential for improvement. 10 There are also suggestions in the literature that the window for treating amblyopia may be wider than current practice would suggest; 11,12 some even suggest a response to treatment at up to 17 years of age, though recognise compliance may become more difficult with increasing age.…”

Anisometropic amblyopia: factors influencing the success or failure of its treatment

“…17,[36][37][38] Most literature suggests that anisometropia leads to amblyopia, 16,30,32,[37][38][39] but some provide evidence that amblyopia may be the primary cause. 36 Either way, the onset of anisometropia and the onset of amblyopia are likely to occur at different ages.…”

“…The majority agree that a minimum interocular difference of 1 dioptre (D) is required to define anisometropia, [1][2][3][4][5][6][7][8][9][10][11] but the definition varies between 0.5D [12][13][14] and 2D. 15,16 The overall prevalence of anisometropia ranges from less than 1% to 1.6%. 11,17 It is a significant problem if left untreated as it can be associated with amblyopia in the more ametropic eye.…”