Factors predicting recurrence in successfully treated cases of anisometropic amblyopia

Saxena, Rohit; Puranik, Shraddha; Singh, Digvijay; Menon, Vimla; Sharma, Pradeep; Phuljhele, Swati

doi:10.4103/0301-4738.123144

Cited by 16 publications

(20 citation statements)

References 12 publications

(29 reference statements)

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“…While research shows some improvement in stereoacuity in amblyopic children following monocular treatment (patching, atropine), these improvements occur following months of treatment and normal stereoacuity is rarely achieved. 2 , 3 , 7 , 15 – 18 …”

Section: Discussionmentioning

confidence: 99%

“… 1 – 6 Furthermore, 19%–50% of successfully treated children will experience a recurrence of amblyopia. 2 , 7 , 8 In addition to decreased visual acuity, amblyopia is accompanied by binocular dysfunction, including nil or impaired stereoacuity and interocular suppression. 9 – 14 Yet, rarely is normal binocularity restored following patching treatment, even when normal visual acuity is achieved.…”

mentioning

confidence: 99%

“… 9 – 14 Yet, rarely is normal binocularity restored following patching treatment, even when normal visual acuity is achieved. 2 , 3 , 7 , 15 – 18 Because amblyopia arises from binocular discordance when pediatric eye disorders such as strabismus and/or anisometropia are present, binocular treatments may yield better vision outcomes.…”

mentioning

confidence: 99%

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Improved Binocular Outcomes Following Binocular Treatment for Childhood Amblyopia

Kelly

Jost

Wang

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PurposeChildhood amblyopia can be treated with binocular games or movies that rebalance contrast between the eyes, which is thought to reduce depth of interocular suppression so the child can experience binocular vision. While visual acuity gains have been reported following binocular treatment, studies rarely report gains in binocular outcomes (i.e., stereoacuity, suppression) in amblyopic children. Here, we evaluated binocular outcomes in children who had received binocular treatment for childhood amblyopia.MethodsData for amblyopic children enrolled in two ongoing studies were pooled. The sample included 41 amblyopic children (6 strabismic, 21 anisometropic, 14 combined; age 4–10 years; ≤4 prism diopters [PD]) who received binocular treatment (20 game, 21 movies; prescribed 9–10 hours treatment). Amblyopic eye visual acuity and binocular outcomes (Randot Preschool Stereoacuity, extent of suppression, and depth of suppression) were assessed at baseline and at 2 weeks.ResultsMean amblyopic eye visual acuity (P < 0.001) and mean stereoacuity improved (P = 0.045), and mean extent (P = 0.005) and depth of suppression (P = 0.003) were reduced from baseline at the 2-week visit (87% game adherence, 100% movie adherence). Depth of suppression was reduced more in children aged <8 years than in those aged ≥8 years (P = 0.004). Worse baseline depth of suppression was correlated with a larger depth of suppression reduction at 2 weeks (P = 0.001).ConclusionsAfter 2 weeks, binocular treatment in amblyopic children improved visual acuity and binocular outcomes, reducing the extent and depth of suppression and improving stereoacuity. Binocular treatments that rebalance contrast to overcome suppression are a promising additional option for treating amblyopia.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Improved Binocular Outcomes Following Binocular Treatment for Childhood Amblyopia

Kelly

Jost

Wang

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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“…Previous studies have suggested that maximal visual acuity is reached by 15 weeks of treatment and visual regression can occur in up to 67% following cessation of treatment ( Gunton 2013 ), and usually within six months post-treatment ( Nilsson, Baumann and Sjöstrand 2007 ). The published risk factors include the presence of microtropia, age at start of treatment, abrupt cessation of treatment, the amount of improvement in visual acuity, age at termination of amblyopia treatment and the final visual acuity ( Tacagni et al 2007 ; Gunton 2013 ; Nilsson, Baumann and Sjöstrand 2007 ; Saxena et al 2013 ; Walsh et al 2009 ; Holmes et al 2007 ; Bhola et al 2006 ; Pediatric Eye Disease Investigator Group 2004 ).…”

Section: Introductionmentioning

confidence: 99%

The Need for a Unified Protocol for Termination of Amblyopia Treatment

Nassar

Mitchell

2018

British and Irish Orthoptic Journal

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Introduction Many authors have intensely investigated the management and outcomes of amblyopia treatment. Despite the fact that recurrence of amblyopia following cessation of treatment is expected there is no agreement on the exact incidence or the risk factors associated with visual regression (Tacagni et al. 2007; Gunton 2013; Nilsson, Baumann and Sjöstrand 2007). Current practice consists of an evidence-based approach to diagnose and treat amblyopia; however, the protocols for the cessation of treatment and duration of posttreatment follow-up remain arbitrary (Tacagni et al. 2007). Previous studies have suggested that maximal visual acuity is reached by 15 weeks of treatment and visual regression can occur in up to 67% following cessation of treatment (Gunton 2013), and usually within six months post-treatment (Nilsson, Baumann and Sjöstrand 2007). The published risk factors include the presence of microtropia, age at start of treatment, abrupt cessation of treatment, the amount of improvement in visual acuity, age at termination of amblyopia treatment and the final visual acuity (

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“…Therefore, developing decentralized pediatric and ophthalmic health care would go a long way in managing diseases such as amblyopia, which have a simple treatment process. ( 15 )…”

Section: Discussionmentioning

confidence: 99%

Burden of ocular motility disorders at a Tertiary Care Institution: A case to enhance secondary level eye care

Saxena¹,

Singh²,

Gantyala³

et al. 2016

Indian J Community Med

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Aim:To evaluate the profile of strabismus and amblyopia in patients presenting to a tertiary care institution in order to understand the disease burden.Materials and Methods:A retrospective, prospective hospital-based observational study was conducted at a tertiary level eye care hospital in India. All patients with strabismus or amblyopia who presented over a 1-year period were identified and referred to the squint clinic, where they were evaluated with a detailed clinical history and examination.Results:A total of 24475 patients were evaluated, of which 1950 had strabismus or amblyopia. The overall magnitude of amblyopia and strabismus was 2.0% [95% confidence interval (CI), 1.8-2.2)] and 6.9% (95% CI, 6.6-7.2), respectively. About 20% of those seeking an ophthalmic consultation were children and they constituted over half of the population referred to the squint clinic. Among younger children, the burden of amblyopia and strabismus was 84.4% and 26.6%, respectively. Among the referred patients, strabismus was noted in 84.6% (N = 1649), most of the cases of which was of the comitant subtype (78.1%, N = 1288) with an equal distribution of exotropia and esotropia. Paralytic [12.9% (N = 251)] and restrictive [4.7% (N = 85)] squint constituted the remaining burden of strabismus.Conclusion:Strabismus and amblyopia affect a sizeable proportion of patients presenting to a tertiary care ophthalmology setup. A significantly higher burden is present in the pediatric population. The majority of the cases of strabismus are of a comitant variety, which do not merit tertiary level eye care. There is a need to improve pediatric eye care at a secondary level to reduce the immense burden on tertiary referral centers.

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Factors predicting recurrence in successfully treated cases of anisometropic amblyopia

Cited by 16 publications

References 12 publications

Improved Binocular Outcomes Following Binocular Treatment for Childhood Amblyopia

Improved Binocular Outcomes Following Binocular Treatment for Childhood Amblyopia

The Need for a Unified Protocol for Termination of Amblyopia Treatment

Burden of ocular motility disorders at a Tertiary Care Institution: A case to enhance secondary level eye care

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