Korean J Ophthalmol.  2010 Aug;24(4):225-229. 10.3341/kjo.2010.24.4.225.

Factors Influencing the Prevalence of Amblyopia in Children with Anisometropia

• Lee CE
• Lee YC
• Lee SY

• KMID: 949060
• DOI: http://doi.org/10.3341/kjo.2010.24.4.225

Abstract

PURPOSE
To evaluate factors that can influence the prevalence of amblyopia in children with anisometropia.
METHODS
We retrospectively reviewed the records of 63 children 2 to 13 years of age who had anisometropic amblyopia with a difference in the refractive errors between the eyes of at least two diopters (D). The type of anisometropia (myopia, hyperopia, and astigmatism), degree of anisometropia (<2-3 D, <3-4 D, or >4 D), best corrected visual acuity (BCVA) of the amblyopic eye at the time of initial examination, BCVA differences between sound and amblyopic eyes, whether or not occlusion therapy was performed, compliance with occlusion therapy, and the patient's age when eyeglasses were first worn were investigated.
RESULTS
There was an increase in the risk of amblyopia with increased magnitude of anisometropia (p=0.021). The prevalence of amblyopia was higher in the BCVA <20/40 group and in patients with BCVA differences >4 lines between sound and amblyopic eyes (p=0.008 and p=0.045, respectively). There was no statistical relationship between the prevalence of amblyopia and the type of anisometropia or the age when eyeglasses were first worn. Poor compliance with occlusion therapy was less likely to achieve successful outcome (p=0.015).
CONCLUSIONS
Eyes with poor initial visual acuities of <20/40, a high magnitude of anisometropia, and a >4 line difference in the BCVA between sound and amblyopic eyes at the initial visit may require active treatment.

Keyword

Amblyopia; Anisometropia; Prevalence

MeSH Terms

Angiogenesis Inhibitors/*administration & dosage
Animals
Antibodies, Monoclonal/*administration & dosage
Cornea/metabolism/*pathology
Corneal Neovascularization/*drug therapy/metabolism/pathology
Disease Models, Animal
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Follow-Up Studies
Male
Ophthalmic Solutions
Rabbits
Treatment Outcome
Vascular Endothelial Growth Factor A/antagonists & inhibitors/metabolism

Reference

1. von Noorden GK, Campos EC, editors. Binocular vision and ocular motility: theory and management of strabismus. 2001. 6th ed. St. Louis: Mosby;246–247.

2. Sjostrand J, Abrahamsson M. Risk factors in amblyopia. Eye (Lond). 1990. 4:787–793.

3. Shaw DE, Fielder AR, Minshull C, Rosenthal AR. Amblyopia: factors influencing age of presentation. Lancet. 1988. 2:207–209.

4. Woodruff G, Hiscox F, Thompson JR, Smith LK. The presentation of children with amblyopia. Eye (Lond). 1994. 8:623–626.

5. Chua BE, Johnson K, Martin F. A retrospective review of the associations between amblyopia type, patient age, treatment compliance and referral patterns. Clin Experiment Ophthalmol. 2004. 32:175–179.

6. Scheiman MM, Hertle RW, Beck RW, et al. Randomized trial of treatment of amblyopia in children aged 7 to 17 years. Arch Ophthalmol. 2005. 123:437–447.

7. Weakley DR. The association between anisometropia, amblyopia, and binocularity in the absence of strabismus. Trans Am Ophthalmol Soc. 1999. 97:987–1021.

8. Weakley DR Jr. The association between nonstrabismic anisometropia, amblyopia, and subnormal binocularity. Ophthalmology. 2001. 108:163–171.

9. Hussein MA, Coats DK, Muthialu A, et al. Risk factors for treatment failure of anisometropic amblyopia. J AAPOS. 2004. 8:429–434.

10. Attebo K, Mitchell P, Cumming R, et al. Prevalence and causes of amblyopia in an adult population. Ophthalmology. 1998. 105:154–159.

11. de Vries J. Anisometropia in children: analysis of a hospital population. Br J Ophthalmol. 1985. 69:504–507.

12. Leon A, Donahue SP, Morrison DG, et al. The age-dependent effect of anisometropia magnitude on anisometropic amblyopia severity. J AAPOS. 2008. 12:150–156.

13. McMullen WH. Some points in anisometropia in discussion on problem in refraction. Trans Ophthalmol Soc UK. 1939. 59:119.

14. Kim JB, Moon CS, Chang YH, et al. The amblyopia and strabismus accompanied with anisometropia. J Korean Ophthalmol Soc. 2007. 48:411–417.

15. Kim EK, Choi MY, Kim YH. Clinical analysis of successfully treated amblyopia with anisometropia, strabismis, and combined cause. J Korean Ophthalmol Soc. 2008. 49:303–308.

16. Chen P, Chen J, Tai M, et al. Anisometropic amblyopia treated with spectacle correction alone: possible factors predicting success and time to start patching. Am J Opthalmol. 2007. 143:54–60.

17. Rho SS, Yang HS, Chang YH, et al. The effect on outcome of amblyopia treatment in children with anisometropic amblyopia. J Korean Ophthalmol Soc. 2007. 48:535–540.

18. Choi MY, Kim YH. Clinical analysis of anisometropic amblyopia with monocular vision 0.1 or worse. J Korean Ophthalmol Soc. 2008. 49:973–978.

19. Lee CS, Shin MK, Paik HJ. Evaluation of factors affecting the outcome of occlusion treatment for amblyopia. J Korean Ophthalmol Soc. 2001. 42:1740–1746.