Characteristics of Patients With Amblyopia Who Were Unable to Achieve Corrected Visual Acuity of 1.0 After Treatment

• Published in: JAPANESE ORTHOPTIC JOURNAL Vol. 41; pp. 123 - 128
• Main Authors: kimura, Akiko, Shimada, Yuko, Okita, Yoichi, Mimura, Osamu
• Format: Journal Article
• Language: Japanese
• Published: JAPANESE ASSOCIATION OF CERTIFIED ORTHOPTISTS 2012
• Subjects: ametropic amblyopia; anisometropic amblyopia; form vision deprivation amblyopia; strabismic amblyopia
• ISSN: 0387-5172; 1883-9215
• DOI: 10.4263/jorthoptic.041F109

Purpose: In patients with amblyopia who could not achieve corrected visual acuity (VA) of 1.0 regardless of treatment for more than two years, we investigated the characteristics of these patients and causes for the unsatisfactory visual outcomes. Subjects and Methods: Subjects were 313 eyes of 223 patients who were under the age of 9 years (age range, 0-8.7 years) and diagnosed as amblyopia at Hyogo College of Medicine Hospital during the 9 years since June 2000. All the subjects were followed up for at least two years. Of 313, 166 eyes of 83 patients had ametropic amblyopia , 65 eyes of 65 patients had strabismic amblyopia, 63 eyes of 63 patients had anisometropic amblyopia and 19 eyes of 12 patients had form vision deprivation amblyopia. VA was measured by a Landolt ring test. We retrospectively investigated the risk factors for VA prognosis. Results: Of 313, 41 (13.1%) eyes could not achieve VA of 1.0. Although no significant correlation was seen between the age at the initial visit and the final VA outcome, the average initial VA in those 41 eyes with poor VA outcome was 0.21 as compared to 0.42 in other eyes achieving VA of 1.0 and the difference was significant (p<0.001). Of the 41 eyes with poor VA outcome, 4 (2.4%) eyes had ametropic amblyopia (2 eyes with high myopia of -10.00 D and over of spherical equivalent), 12 (18.5%) eyes had strabismic amblyopia, 12 (19.0%) eyes had anisometropic amblyopia and 13 (68.4%) eyes had form vision deprivation amblyopia. Of those with strabismic amblyopia, 5 patients also had anisometropia and 4 of them had poor final VA. In spite of occlusion training, two patients with anisometropic amblyopia who also had hypermetropic anisometropia of > 5.50 D could not achieve good final VA. In patients with form vision deprivation amblyopia and congenital ptosis, the presence of ametropia could affect the final VA outcome. Conclusion: Initial VA of < 0.2 and high myopia of ≥ -10.00 D of spherical equivalent, strabismic amblyopia with anisometropia, hypermetropic anisometropia of > 5.50 D, congential ptosis with ametropia were the causes for the unsatisfactory VA outcomes and could be factors in VA prognosis.