Korean J Ophthalmol.  2014 Feb;28(1):66-75. 10.3341/kjo.2014.28.1.66.

The Relationship between Higher-order Aberrations and Amblyopia Treatment in Hyperopic Anisometropic Amblyopia

• Lee SH
• Chang JW

• KMID: 1792095
• DOI: http://doi.org/10.3341/kjo.2014.28.1.66

Abstract

PURPOSE
To investigate the relationship between higher-order aberrations (HOAs) and amblyopia treatment in children with hyperopic anisometropic amblyopia.
METHODS
The medical records of hyperopic amblyopia patients with both spherical anisometropia of 1.00 diopter (D) or more and astigmatic anisometropia of less than 1.00 D were reviewed retrospectively. Based on the results of the amblyopia treatment, patients were divided into two groups: treatment successes and failures. Using the degree of spherical anisometropia, subjects were categorized into mild, moderate, or severe groups. Ocular, corneal, and internal HOAs were measured using a KR-1W aberrometer at the initial visit, and at 3-month, 6-month, and 12-month follow-ups.
RESULTS
The results of the 45 (21 males and 24 females) hyperopic anisometropic amblyopia patients who completed the 12-month follow-up examinations were analyzed. The mean patient age at the initial visit was 70.3 months. In total, 28 patients (62.2%) had successful amblyopia treatments and 17 patients (37.8%) failed treatment after 12 months. Among the patient population, 24 (53.3%) had mild hyperopic anisometropia and 21 (46.7%) had moderate hyperopic anisometropia. When comparing the two groups (i.e., the success and failure groups), ocular spherical aberrations and internal spherical aberrations in the amblyopic eyes were significantly higher in the failure group at every follow-up point. There were no significant differences in any of the HOAs between mild and moderate cases of hyperopic anisometropia at any follow-up. When the amblyopic and fellow eyes were compared between the groups there were no significant differences in any of the HOAs.
CONCLUSIONS
HOAs, particularly ocular spherical aberrations and internal spherical aberrations, should be considered as reasons for failed amblyopia treatment.

Keyword

Amblyopia; Anisometropia; Higher order aberration; Hyperopia; Spherical aberration

MeSH Terms

Aged
Amblyopia/complications/physiopathology/*therapy
Anisometropia/complications/physiopathology/*therapy
Cornea/*pathology/physiopathology
*Eyeglasses
Female
Follow-Up Studies
Humans
Hyperopia/complications/physiopathology/*therapy
Male
Middle Aged
Refraction, Ocular/*physiology
Retrospective Studies
Treatment Outcome
*Visual Acuity

Figure

• 

  Fig. 1 Compiled patients of successful amblyopia treatment. Asterisk indicates that this follow-up period had the highest success rate among the total follow-up periods in both mild hyperopic anisometropia (HA) and moderate HA. The indicated percentages (%) are proportions of cumulative patients who had successful treatments compared to all of patients with successful treatments at each follow-up.

• 

  Fig. 2 Comparisons of ocular and internal spherical aberrations (SAs) in amblyopic eyes according to the results of amblyopia treatment (A, ocular SA root mean square [RMS]; B, internal SA RMS). When comparing the two groups (success and failure groups), the ocular SA and internal SA of amblyopic eyes were significantly higher in the failure group at every follow-up (*p < 0.05, statistically significant, Mann-Whitney U-test).

• 

  Fig. 3 Comparisons of ocular total higher-order aberrations (HOAs), ocular trefoil, and ocular coma of amblyopic eyes according to the results of amblyopia treatment (A, ocular total HOA root mean square [RMS]; B, ocular trefoil RMS; C, ocular coma RMS). There were no significant differences in the ocular total HOAs, trefoil, or coma of the amblyopic eyes between the success and failure group (Mann-Whitney U-test).

• 

  Fig. 4 Comparisons of ocular higher-order aberrations (HOAs) between amblyopic and fellow eyes in the failed amblyopia treatment group (A, ocular total HOA root mean square [RMS]; B, ocular trefoil RMS; C, ocular coma RMS; D, ocular spherical aberration [SA] RMS). There were no significant differences in the ocular total HOAs, trefoil, coma, or SA between the amblyopic eyes and fellow eyes (Mann-Whitney U-test).

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