Korean J Ophthalmol.  2007 Sep;21(3):159-162. 10.3341/kjo.2007.21.3.159.

Reduction of Deviation Angle During Occlusion Therapy: In Partially Accommodative Esotropia with Moderate Amblyopia

• Chun BY
• Kwon SJ
• Chae SH
• Kwon JY

• KMID: 1099032
• DOI: http://doi.org/10.3341/kjo.2007.21.3.159

Abstract

PURPOSE: To evaluate changes in ocular alignment in partially accommodative esotropic children age ranged from 3 to 8 years during occlusion therapy for amblyopia. METHODS: Angle measurements of twenty-two partially accommodative esotropic patients with moderate amblyopia were evaluated before and at 2 years after occlusion therapy. RESULTS: Mean deviation angle with glasses at the start of occlusion treatment was 19.45+/-5.97 PD and decreased to 12.14+/-12.96 PD at 2 years after occlusion therapy (p<0.01). After occlusion therapy, 9 (41%) cases were indications of surgery for residual deviation but if we had planned surgery before occlusion treatment, 18 (82%) of patients would have had surgery. There was a statistical relationship between increase of visual acuity ratio and decrease of deviation angle (r=-0.479, p=0.024). CONCLUSIONS: There was a significant reduction of deviation angle of partially accommodative esotropic patients at 2 years after occlusion therapy. Our results suggest that occlusion therapy has an influence on ocular alignment in partially accommodative esotropic patients with amblyopia.

Keyword

Amblyopia; Occlusion therapy; Ocular alignment; Partially accommodative esotropia; Visual acuity ratio

MeSH Terms

*Accommodation, Ocular
Adult
Aged
Amblyopia/*etiology/*physiopathology
Esotropia/*physiopathology/*therapy
Female
Humans
Male
Middle Aged
Occlusive Dressings/adverse effects
Retrospective Studies
*Sensory Deprivation
Treatment Outcome

Figure

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  Fig. 1 Changes of deviation angle during occlusion period. PD*= prism diopter.

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  Fig. 2 Correlation between the amount of VA ratio increase and the amount of change of deviation angle. Spearman's correlation coefficient r=-0.479, p=0.024 PD*= prism diopter. VA ratio†=Snellen visual acuity of the amblyopic eye/Snellen visual acuity of the sound eye.

Reference

1. Von Noorden GK, Campos EC. Binocular Vision and Ocular Motility. 2002. 6th ed. St. Louis: Mosby;311–355.

2. Lee JB, Han SH, Kwon JY, et al. Current Concepts in Strabismus. 2004. Seoul: Naewaehaksul;chap. 7.

3. Wright KW, Edelman PM, Walonker F, Yin S. Reliability of fixation preference testing in diagnosing amblyopia. Arch Ophthalmol. 1986. 104:549–553.

4. Lam GC, Repka MX, Guyton DL. Timing of amblyopia therapy relative to strabismus surgery. Ophthalmology. 1993. 100:1751–1756.

5. Koc F, Ozal H, Yasar H, Firat E. Resolution in partially accommodative esotropia during occlusion treatment for amblyopia. Eye. 2006. 20:325–328.

6. Holbach HT, Von Noorden GK, Avilla CW. Changes in esotropia after occlusion therapy in patients with strabismic amblyopia. J Pediatr Ophthalmol Strabismus. 1991. 28:6–9.

7. Kim S, Kim S, Cho YA. Deterioration of accommodative esotropia during part-time occlusion therapy. Korean J Ophthalmol. 2005. 19:77–79.

8. Repka MX, Holmes JM, Melia M, et al. The effect of amblyopia therapy on ocular alignment. J AAPOS. 2005. 9:542–545.