Jia Yu, Ye Qingqing, Liu Jing, Feng Lei, Xu Zixuan, He Yunsi, Zhou Yusong, Chen Xiaolan, Yao Ying, Thompson Benjamin, Li Jinrong
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Centre for Eye and Vision Research, 17W Science Park, Hong Kong.
Heliyon. 2024 Mar 29;10(7):e28857. doi: 10.1016/j.heliyon.2024.e28857. eCollection 2024 Apr 15.
To explore the association between the cause of amblyopia and pre-treatment contrast sensitivity, stereoacuity, fixation and nystagmus.
Retrospective cohort study.
A retrospective review was conducted for 3408 patients with amblyopia who had not yet started amblyopia treatment utilizing a large amblyopia patient database maintained at Zhongshan Ophthalmic Centre. Six amblyogenic factor subtypes were identified: anisometropia, isoametropia, strabismus, anisometropia and strabismus, monocular visual deprivation, and binocular visual deprivation amblyopia. Monocular best corrected visual acuity (BCVA), the contrast sensitivity function (CSF), fixation, and stereopsis were compared between the subtypes before and after propensity score matching (PSM) for age and sex.
The two deprivation groups had poorer BCVA and CSF than the other groups. There were no systematic differences in CSF between the non-deprivation groups. Nystagmus was more common in the bilateral amblyopia groups compared to the monocular amblyopia groups. Eccentric fixation was uncommon with the exception of the anisometropia and strabismus group which had an eccentric fixation rate of 20%. Distance stereoacuity measured without monocular cues was absent for almost all patients. The results were consistent when analyzed using PSM.
Visual deprivation causes more severe amblyopia than other amblyogenic factors. For non-deprivation amblyopia subtypes, individual differences such as variation in the severity of the amblyogenic factor might be more important in determining pre-treatment vision than whether amblyopia was caused by refractive error, strabismus or both.
探讨弱视病因与治疗前对比敏感度、立体视锐度、注视和眼球震颤之间的关联。
回顾性队列研究。
利用中山大学中山眼科中心维护的大型弱视患者数据库，对3408例尚未开始弱视治疗的患者进行回顾性分析。确定了六种弱视病因亚型：屈光参差性、等屈光不正性、斜视性、屈光参差合并斜视性、单眼视觉剥夺性和双眼视觉剥夺性弱视。在按年龄和性别进行倾向得分匹配（PSM）前后，比较各亚型之间的单眼最佳矫正视力（BCVA）、对比敏感度函数（CSF）、注视和立体视。
两个剥夺性组的BCVA和CSF比其他组差。非剥夺性组之间的CSF没有系统性差异。与单眼弱视组相比，眼球震颤在双侧弱视组中更常见。除屈光参差合并斜视组的偏心注视率为20%外，偏心注视并不常见。几乎所有患者在无单眼线索情况下测量的远距离立体视锐度均缺失。使用PSM分析时结果一致。
视觉剥夺比其他弱视病因导致更严重的弱视。对于非剥夺性弱视亚型，在决定治疗前视力方面，诸如弱视病因严重程度差异等个体差异可能比弱视是由屈光不正、斜视或两者共同引起更为重要。
