Palani Subashree, Rangasami Sathiskumar, Baskaran Antony A
Department of Ophthalmology, Karpaga Vinayaga Institute of Medical Sciences and Research Center, Madurantakam, Tamil Nadu, India.
Department of Ophthalmology, Government Mohan Kumaramangalam Medical College Hospital, Salem, Tamil Nadu, India.
Saudi J Ophthalmol. 2023 Oct 24;38(3):286-290. doi: 10.4103/sjopt.sjopt_105_23. eCollection 2024 Jul-Sep.
The purpose is to compare visual parameters between normal and amblyopic eyes in anisometropic amblyopia and to find predictive factors for occlusion therapy.
Sixty patients with anisometropic amblyopia between the ages of 5 and 25 years were enrolled in the prospective, longitudinal, and interventional study. Patients were selected based on no improvement with spectacle correction alone after 1 month of follow-up. Baseline parameters such as LogMAR visual acuity, LEA contrast sensitivity, TNO stereopsis test, online Farnsworth D-15 test for color vision, accommodation with RAF ruler, +2.00/-2.00 flipper test, and dynamic retinoscopy were recorded. All patients were treated with occlusion therapy depending on their grades of amblyopia. After 6 months of follow-up, improvement in visual acuity was recorded with a LogMAR chart and correlated with initial visual parameters. Paired "t" test, Chi-square test, independent "t" test, analysis of variance test were used as statistical analysis.
Visual functions such as contrast sensitivity, accommodative facility, near point of accommodation, and accommodative amplitude showed a statistically significant difference between normal and amblyopic eyes of anisometropic amblyopia patients, whereas color vision did not differ significantly between normal and amblyopic eyes. Sixty-seven percentage of patients had poor stereopsis. Eighty percentage of patients who were younger had improvement in final best-corrected visual acuity and these patients had better stereopsis, contrast sensitivity, and mild-to-moderate amblyopia on initial testing.
The age of the patient, degree of anisometropia, spherical equivalent in amblyopic eyes, stereopsis, contrast sensitivity values at initial presentation, and compliance to occlusion therapy were found to be positive predictive factors of occlusion therapy.
比较屈光参差性弱视患者正常眼与弱视眼的视觉参数，并找出遮盖疗法的预测因素。
纳入60例年龄在5至25岁之间的屈光参差性弱视患者，进行前瞻性、纵向和干预性研究。患者入选标准为随访1个月后仅戴眼镜矫正无改善。记录基线参数，如LogMAR视力、LEA对比敏感度、TNO立体视测试、在线Farnsworth D - 15色盲测试、用RAF尺测量调节、+2.00/-2.00翻转镜测试和动态检影。所有患者根据弱视程度接受遮盖疗法。随访6个月后，用LogMAR视力表记录视力改善情况，并与初始视觉参数进行相关性分析。采用配对“t”检验、卡方检验、独立“t”检验、方差分析进行统计学分析。
屈光参差性弱视患者正常眼与弱视眼之间，对比敏感度、调节功能、近点调节和调节幅度等视觉功能存在统计学显著差异，而正常眼与弱视眼之间的色觉无显著差异。67%的患者立体视较差。80%年龄较小的患者最终最佳矫正视力有改善，这些患者在初始测试时立体视更好、对比敏感度更高且弱视程度为轻度至中度。
患者年龄、屈光参差程度、弱视眼等效球镜度、立体视、初始就诊时的对比敏感度值以及对遮盖疗法的依从性被发现是遮盖疗法的阳性预测因素。
