Fatma YÜLEK, Mücella YORGUN ARIKAN, Nurullah ÇAĞIL, Nagihan UĞURLU

Effects of different types of refractive errors on bilateral amblyopia

Amaç: Bilateral ambliyopi olan hastalarda farklı tiplerdekirefraktif kusurun görme keskinliği ve stereopsis üzerine olan etkilerinin belirlenmesi amaçlanmıştır. Metod: Bilateral ambliyopi olup ≥1,5 D anizometropisiolmayan hastalar çalışmaya alınmıştır. Hastalar sferik eşdeğer seviyeleri (0-4 D ve >4 D hipermetropi), astigmatizm düzeyleri (pozitif silindirde 2D’nin altı ve üstü) vekırma kusurunun cinsine [ 4 D hipermetropi ve < 2 D astigmatizm (grup II), ve < 4 D hipermetropi ve > 2 D astigmatizm (grup III)] göre gruplandırılmıştır. Gruplar arasında ilk vesonuç en iyi düzeltilmiş görme keskinliği (EDGK) karşılaştırılmıştır. Bulgular: > 4 D hipermetropisi olan hastalarda başlangıç EDGK belirgin olarak düşük bulunmuştur (p=0,028) ancak gözlük tedavisi sonrası ölçülen sonuç EDGK değerleri farkı istatistiksel olarak anlamlı bulunmadı (p=0.235). Astigmatizm değerlerine göre sınıflanan gruplarda (

Farklı refraktif bozuklukların bilateral ambliyopiye etkileri

Objectives: Identifying effects of different types of refractive errors on final visual acuity and stereopsis levels inpatients with bilateral amblyopia.Materials and methods: Patients with bilateral amblyopia lower than ≥1.5 D anisometropia were included. The patients were classified according to the level of spherical equivalent (0-4 D and >4 D of hypermetropia), the level of astigmatism (below and above 2D in positive cylinder) and type of composed refractive error [ 4 D of hypermetropia and < 2 D of astigmatism (group II), and < 4 D hypermetropia and > 2 D of astigmatism (group III)]. Initial and final binocular best corrected visual acuities (BCVA) were compared between groups.Results: The initial binocular BCVA levels were significantly lower in patients with > 4 D of hypermetropia (p=0.028), without correction after treatment (p=0.235). The initial binocular BCVA was not different between astigmatism groups, but final BCVA levels were significantly lower in 4-6D of astigmatism compared with 2-4 D of astigmatism (p=0.001). During comparison of com- posed refractive errors, only the initial binocular BCVA was significantly lower in group I compared to group II (p=0.015). The final binocular BCVA levels were not different between groups I and III (p>0.05). Conclusions: Although the initial BCVA is lower in patients with higher levels of hypermetropia, the response of patients to treatment with glasses is good. The response of patients with high levels of astigmatism seems to be limited.

PDF

___

1. Friedman Z, Neumann E, Hyams SW, Peleg B. Ophthalmic screening of 38,000 children, age 1 to 2 1/2 years, in child welfare clinics. J Pediatr Ophthalmol Strabismus 1980;17(4):261-7.
2. von Noorden GK. [Treatment of amblyopia]. Fortschr Ophthalmol 1990;87 Suppl:S149-54.
3. Chekitaan, Karthikeyan B, Meenakshi S. The results of treatment of anisomyopic and anisohypermetropic amblyopia. Int Ophthalmol 2009;29(4):231-7.
4. Haase W, Muhlig HP. [The incidence of squinting in school beginners in Hamburg (author’s transl)]. Klin Monbl Augenheilkd 1979;174(2):232-5.
5. Wallace DK, Chandler DL, Beck RW, et al. Treatment of bilateral refractive amblyopia in children three to less than 10 years of age. Am J Ophthalmol 2007;144(4):487-96.
6. Dobson V, Miller JM, Clifford-Donaldson CE, Harvey EM. Associations between anisometropia, amblyopia, and reduced stereoacuity in a school-aged population with a high prevalence of astigmatism. Invest Ophthalmol Vis Sci 2008;49(10):4427-36.
7. Fern KD. Visual acuity outcome in isometropic hyperopia. Optom Vis Sci 1989; 66(10): 649-58.
8. Schoenleber DB, Crouch ER, Jr. Bilateral hypermetropic amblyopia. J Pediatr Ophthalmol Strabismus 1987;24(2):75-7.
9. Harvey EM, Dobson V, Miller JM, Clifford-Donaldson CE. Changes in visual function following optical treatment of astigmatismrelated amblyopia. Vision Res 2008;48(6):773-87.
10. Ziylan S, Yabas O, Zorlutuna N, Serin D. Isoametropic amblyopia in highly hyperopic children. Acta Ophthalmol Scand 2007;85(1):111-3.
11. Klimek DL, Cruz OA, Scott WE, Davitt BV. Isoametropic amblyopia due to high hyperopia in children. J AAPOS 2004;8(4):310-3.
12. Rutstein RP, Corliss DA. Long-term changes in visual acuity and refractive error in amblyopes. Optom Vis Sci 2004;81(7):510-5.