Factors affecting the total occlusion time in eyes with hyperopic anisometropic amblyopia.
Amblyopia
Anisometropic amblyopia
Microtropia
Occlusion therapy
Total occlusion time
Journal
BMC ophthalmology
ISSN: 1471-2415
Titre abrégé: BMC Ophthalmol
Pays: England
ID NLM: 100967802
Informations de publication
Date de publication:
20 Nov 2023
20 Nov 2023
Historique:
received:
16
11
2022
accepted:
07
11
2023
medline:
21
11
2023
pubmed:
20
11
2023
entrez:
20
11
2023
Statut:
epublish
Résumé
Amblyopia treatment by occluding the healthy eye is known to be effective during a sensitive critical period. This study aims to clarify the factors for the total occlusion time (TOT) required for the amblyopic eye to achieve a normal visual acuity (VA) level of 1.0 (0.0 logMAR equivalent). This could contribute to an efficient treatment plan for eyes with hyperopic anisometropic amblyopia. Subjects were 58 patients (26 boys and 32 girls; age range, 3.6-9.2, average, 5.8 ± 1.3 years) with hyperopic anisometropic amblyopia. All the subjects had initially visited and completed occlusion therapy with improved VA of 1.0 or better in the amblyopic eye at Kindai University Hospital between January 2007 and March 2017. Using the subjects' medical records, we retrospectively investigated five factors for the TOT: the age at treatment, the initial VA of the amblyopic eye, refraction of the amblyopic eye, anisometropic disparity, and the presence of microstrabismus. Patient's VA improvement at one month after treatment was also evaluated to confirm the effect of the occlusion therapy. The initial VA of the amblyopic eye ranged from 0.1 to 0.9 (median, 0.4). The TOT ranged from 140 to 1795 (median, 598) hours with an average daily occlusion time of 7 hours. The initial VA of the amblyopic eye and presence of microstrabismus were the significant factors for the TOT (p < 0.01). To achieve VA of 1.0 or better, patients with an initial VA of ≤ 0.3 in the amblyopic eye required a longer TOT. Moreover, patients with concomitant microstrabismus required a 1.7-fold longer TOT compared to those without microstrabismus. Longer daily occlusion hours and early start of the treatment will be necessary for patients with poor initial VA or microstrabismus to complete occlusion therapy within the sensitive critical period.
Sections du résumé
BACKGROUND
BACKGROUND
Amblyopia treatment by occluding the healthy eye is known to be effective during a sensitive critical period. This study aims to clarify the factors for the total occlusion time (TOT) required for the amblyopic eye to achieve a normal visual acuity (VA) level of 1.0 (0.0 logMAR equivalent). This could contribute to an efficient treatment plan for eyes with hyperopic anisometropic amblyopia.
METHODS
METHODS
Subjects were 58 patients (26 boys and 32 girls; age range, 3.6-9.2, average, 5.8 ± 1.3 years) with hyperopic anisometropic amblyopia. All the subjects had initially visited and completed occlusion therapy with improved VA of 1.0 or better in the amblyopic eye at Kindai University Hospital between January 2007 and March 2017. Using the subjects' medical records, we retrospectively investigated five factors for the TOT: the age at treatment, the initial VA of the amblyopic eye, refraction of the amblyopic eye, anisometropic disparity, and the presence of microstrabismus. Patient's VA improvement at one month after treatment was also evaluated to confirm the effect of the occlusion therapy.
RESULTS
RESULTS
The initial VA of the amblyopic eye ranged from 0.1 to 0.9 (median, 0.4). The TOT ranged from 140 to 1795 (median, 598) hours with an average daily occlusion time of 7 hours. The initial VA of the amblyopic eye and presence of microstrabismus were the significant factors for the TOT (p < 0.01). To achieve VA of 1.0 or better, patients with an initial VA of ≤ 0.3 in the amblyopic eye required a longer TOT. Moreover, patients with concomitant microstrabismus required a 1.7-fold longer TOT compared to those without microstrabismus.
CONCLUSION
CONCLUSIONS
Longer daily occlusion hours and early start of the treatment will be necessary for patients with poor initial VA or microstrabismus to complete occlusion therapy within the sensitive critical period.
Identifiants
pubmed: 37981663
doi: 10.1186/s12886-023-03206-7
pii: 10.1186/s12886-023-03206-7
pmc: PMC10658919
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
469Informations de copyright
© 2023. The Author(s).
Références
Strabismus. 2018 Sep;26(3):118-121
pubmed: 30060696
J Physiol. 1962 Jan;160:106-54
pubmed: 14449617
Optometry. 2011 Nov;82(11):657-61
pubmed: 21908238
Br Med Bull. 2016 Sep;119(1):75-86
pubmed: 27543498
Invest Ophthalmol Vis Sci. 2007 Jun;48(6):2589-94
pubmed: 17525188
Arch Ophthalmol. 2003 May;121(5):603-11
pubmed: 12742836
Ophthalmology. 2003 Nov;110(11):2075-87
pubmed: 14597512
J Physiol. 1963 Mar;165:559-68
pubmed: 13955384
Eye (Lond). 1991;5 ( Pt 5):576-84
pubmed: 1794423
J Curr Ophthalmol. 2017 Mar 06;29(2):76-84
pubmed: 28626815
Arch Ophthalmol. 1969 Jun;81(6):758-62
pubmed: 5783747
Br J Ophthalmol. 1974 Mar;58(3):281-92
pubmed: 4834601
Biomed J. 2015 Dec;38(6):510-6
pubmed: 27013450
Jpn J Ophthalmol. 2002 Jan-Feb;46(1):52-8
pubmed: 11853714
Vis Neurosci. 2018 Jan;35:E014
pubmed: 29905116