Toor Sonia, Horwood Anna, Riddell Patricia
Academic Unit of Ophthalmology and Orthoptics, University of Sheffield, United Kingdom.
Infant Vision Laboratory, School of Psychology & Clinical Language Sciences, University of Reading, United Kingdom; Orthoptic Department, Royal Berkshire Hospital, Reading, United Kingdom.
J AAPOS. 2019 Aug;23(4):203.e1-203.e5. doi: 10.1016/j.jaapos.2019.05.010. Epub 2019 Jul 10.
Previous research has revealed that the majority of children with anisometropic amblyopia have asymmetrical accommodation. The aim of this preliminary study was to determine whether the type of accommodation response was associated with a poor amblyopia treatment outcome in the same patients.
The type of accommodation response of 26 children with anisometropic amblyopia was determined in a previous study. The final visual acuity in the amblyopic eye, after treatment, was compared between those with symmetrical, aniso-, and anti-accommodation.
The difference in final visual acuity between the three accommodation groups was significant (P = 0.023). Subjects with anisometropic amblyopia with anti-accommodation had the poorest final visual acuity (0.42 ± 0.25 logMAR) with a statistically significant difference compared with those who had aniso-accommodation (0.14 ± 0.08 logMAR; P = 0.023). However, the difference failed to reach significance compared to those with symmetrical accommodation (0.20 ± 0.12 logMAR; P = 0.234), probably due to the small sample size. The initial visual acuity in the amblyopic eye and the degree of anisometropia were also significantly positively correlated with final visual acuity (P < 0.001 for both).
In this study cohort, the presence of anti-accommodation in anisometropic amblyopia was associated with a poorer amblyopia treatment outcome. The initial visual acuity in the amblyopic eye and the degree of anisometropia were also associated with a poorer outcome. It is possible that all these factors are associated, but further research is required to determine causal relationships.
先前的研究表明，大多数屈光参差性弱视儿童存在不对称调节。这项初步研究的目的是确定调节反应类型是否与同一患者弱视治疗效果不佳有关。
在先前的一项研究中确定了26例屈光参差性弱视儿童的调节反应类型。比较了对称调节、非对称调节和反调节患者治疗后弱视眼的最终视力。
三个调节组之间的最终视力差异具有统计学意义（P = 0.023）。有反调节的屈光参差性弱视患者最终视力最差（0.42±0.25 logMAR），与有非对称调节的患者（0.14±0.08 logMAR；P = 0.023）相比有统计学显著差异。然而，如果与对称调节的患者（0.20±0.12 logMAR；P = 0.234）相比，差异未达到显著水平，可能是由于样本量小。弱视眼的初始视力和屈光参差程度也与最终视力显著正相关（两者P均<0.001）。
在本研究队列中，屈光参差性弱视中存在反调节与弱视治疗效果较差有关。弱视眼的初始视力和屈光参差程度也与较差的治疗效果有关。所有这些因素可能相互关联，但需要进一步研究来确定因果关系。
