Interventions for stimulus deprivation amblyopia

Abstract

Background Stimulus deprivation amblyopia (SDA) develops due to an obstruction to the passage of light, preventing clear formation of an image on the retina (e.g. cataract, ptosis). It is particularly severe and can be resistant to treatment, leading to poor visual prognosis. Precise estimates of SDA prevalence are difficult to come by but it probably constitutes less than 3% of all amblyopia cases. In developed countries, most patients present under the age of one; in less developed parts of the world, presentation is likely to be significantly later than this. The mainstay of treatment is occlusion of the better-seeing eye, but regimens vary, can be difficult to execute and are traditionally believed to lead to disappointing results. Objectives The objectives of this review were to evaluate the effectiveness of occlusion treatment for SDA, to establish the optimum treatment regimen, to determine the factors that may affect outcome, and to identify realistic treatment goals. Search methods We searched the Cochrane Central Register of Controlled Trials-CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register

Retinal and Optic Nerve Integrity Following Monocular Inactivation for the Treatment of Amblyopia

“…Conventional therapies for human amblyopia such as patching, atropine and Bangerter filter, have been employed for centuries to treat amblyopia (Hoyt, 2015) but are limited in their ability to produce recovery beyond about the age of 7 years, and are impeded by poor compliance that can be magnified by the requirement for long treatment duration (Stewart et al, 2003;Holmes et al, 2011;Holmes and Levi, 2018). Stimulus deprivation-induced amblyopia is a particularly severe form of the disorder and can be unresponsive to mainstay therapy ultimately resulting in poor visual outcomes even with adequate treatment conditions (Hatt et al, 2006). In its current form, occlusion therapy aims to maximize recovery of the amblyopic eye without adversely affecting the fellow eye, which serves to provide a good second eye in case the better-seeing eye is lost or damaged (Rahi et al, 2002;Hatt et al, 2006).…”

“…Stimulus deprivation-induced amblyopia is a particularly severe form of the disorder and can be unresponsive to mainstay therapy ultimately resulting in poor visual outcomes even with adequate treatment conditions (Hatt et al, 2006). In its current form, occlusion therapy aims to maximize recovery of the amblyopic eye without adversely affecting the fellow eye, which serves to provide a good second eye in case the better-seeing eye is lost or damaged (Rahi et al, 2002;Hatt et al, 2006). The introduction of a novel penalization therapy that enhances and expedites recovery outcomes over conventional treatments could offer a significant advancement in the remediation of amblyopia.…”

Prevalence of amblyopia and refractive errors among primary school children

“…The visual cortex needs continuous, clear and focused visual impulses to develop normally. [ 1 2 3 4 5 6 7 ] Children with amblyogenic risk factors, if not treated, are vulnerable to functional reduction of visual acuity (VA), causing amblyopia. [ 1 2 3 ] The prevalence of amblyopia in the literature ranges from 0.7% to 5%, depending on the characteristics of study population, visual acuity criteria and measurement methods.…”

Prevalence of amblyopia in primary school children in Qassim province, Kingdom of Saudi Arabia

“…3 Congenital cataract, congenital ptosis and corneal injury or corneal dystrophy can also cause amblyopia but are less common. 4 Amblyopia is a public health problem and is relatively common, affecting approximately 2 to 3% of children depending on the population studied and the definition used. 5 6 7 8 9 Its prevalence is usually underestimated, often due to lack of awareness and detection.…”