Aldebasi Hind Ibrahem, Fawzy Samah Mahmoud, Alsaleh Ahmad A
Lecturer, Optometry Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
Consultant Ophthalmologist, Ophthalmology Department, Ain Shams University, Cairo, Egypt.
Saudi J Ophthalmol. 2013 Oct;27(4):253-8. doi: 10.1016/j.sjopt.2013.07.007. Epub 2013 Jul 15.
To study the pattern of ocular aberrations in amblyopic children, and evaluate a possible relation to etiology and treatment outcomes of amblyopia.
The WaveScan Wavefront System (AMO, Santa Ana, CA, USA) aberrometer was used to assess 75 eyes (60 children) after instillation of 1% cyclopentolate eyedrops. There were 29 males and 31 females with a mean age of 9.23 ± 2.55 years (range, 5-14 years). The study sample was subdivided into four groups; 16 emmetropic non-amblyopic eyes (control group); 24 pre-treatment newly diagnosed amblyopic eyes; 16 eyes of treated amblyopes and; 19 eyes with refractory amblyopia.
Amblyopes had statistically significant greater root mean square (RMS) values for whole eye aberrations, 2nd order aberrations, defocus ([Formula: see text]) and astigmatism ([Formula: see text]) compared to emmetropes (P < 0.0001). The refractory amblyopic group showed statistically significant differences in whole eye RMS, 2nd order- aberrations, defocus ([Formula: see text]) and astigmatism ([Formula: see text]) when compared to treated amblyopic groups (P < 0.0001). Apart from a statistically significant difference in 5th order RMS of pre-treated amblyopes versus the control group, no other significant differences were found in higher order aberrations (HOAs: coma, spherical, higher-order astigmatism, trefoil, or 3rd, 4th, 5th or 6th order terms) between emmetropes and any of the amblyopic groups.
Lower order aberrations remain the major factor that affect retinal image quality and hence amblyopia development especially in ametropic eyes. This can be corrected optically. Studying HOA profile in amblyopic eyes failed to explain why refractory amblyopia does not respond to orthoptic treatments. This outcome indicates that theories of central problems in image processing and binocular interaction are likely the main cause of refractory amblyopia.
研究弱视儿童的眼像差模式，并评估其与弱视病因及治疗效果之间的可能关系。
使用WaveScan波前系统（美国加利福尼亚州圣安娜市AMO公司）像差仪，在滴入1%环喷托酯滴眼液后评估75只眼（60名儿童）。其中男性29名，女性31名，平均年龄9.23±2.55岁（范围5 - 14岁）。研究样本分为四组：16只正视非弱视眼（对照组）；24只新诊断的弱视治疗前眼；16只已治疗弱视眼；19只难治性弱视眼。
与正视眼相比，弱视眼的全眼像差、二阶像差、离焦（[公式：见原文]）和散光（[公式：见原文]）的均方根（RMS）值在统计学上有显著更高（P < 0.0001）。与已治疗弱视组相比，难治性弱视组在全眼RMS、二阶像差、离焦（[公式：见原文]）和散光（[公式：见原文]）方面有统计学显著差异（P < 0.0001）。除了治疗前弱视眼与对照组在五阶RMS上有统计学显著差异外，正视眼与任何弱视组之间在高阶像差（HOAs：彗差、球差、高阶散光、三叶形像差或三阶、四阶、五阶或六阶项）方面未发现其他显著差异。
低阶像差仍然是影响视网膜图像质量以及弱视发展的主要因素，尤其是在屈光不正眼中。这可以通过光学方法矫正。研究弱视眼中的高阶像差分布未能解释难治性弱视为何对视光学治疗无反应。这一结果表明，图像处理和双眼相互作用的中枢问题理论可能是难治性弱视的主要原因。
