J Korean Ophthalmol Soc.  2019 Jan;60(1):62-68. 10.3341/jkos.2019.60.1.62.

Clinical Features of Amblyopic Children with Myopic Anisometropia at a Tertiary Center

• Choi SY
• Chung SA

• KMID: 2431841
• DOI: http://doi.org/10.3341/jkos.2019.60.1.62

Abstract

PURPOSE
To evaluate the clinical features of unilateral amblyopia with myopic anisometropia at a tertiary center.
METHODS
The medical records of 102 children wearing spectacles due to myopic anisometropia with an interocular difference in spherical equivalent (SE) ≥ 1.00 diopters (D) with a follow-up ≥ 1 year were reviewed. Patients were classified into mild or severe groups according to an interocular SE difference ≥ 3.00D. The frequency of amblyopia (interocular difference ≥ two lines of visual acuity [VA]) and response to patching, the magnitude of anisometropia, and the frequency of combined ocular or systemic disorders except refractive errors were compared between the two groups. The VA and refractive errors were measured four months and one year after spectacle correction and at the last follow-up.
RESULTS
In all, 61 patients with mild myopic anisometropia and 41 patients with severe myopic anisometropia started to wear spectacles at a mean age of 5.2 years old and were followed-up during a mean period of 34.6 months. The frequency of amblyopia decreased more prominently in the mild group: 82.0% in the mild group vs. 92.7% in the severe group four months after spectacle correction and 45.9% in the mild group vs. 87.8% in the severe group at the last follow-up. At baseline, the mild group had anisometropia of 1.42 ± 0.66D, while the severe group had anisometropia of 5.47 ± 2.09D. The magnitude of anisometropia tended to increase by 0.42D but not significantly: +0.78D in the mild group and −0.02D in the severe group. More than half of the patients had combined disorders: 57.4% in the mild group and 53.7% in the severe group.
CONCLUSIONS
Severe myopic anisometropic amblyopia at a tertiary center showed little improvement and the magnitude of anisometropia did not change.

Keyword

Amblyopia treatment; Mild anisometropia; Myopic anisometropia; Severe anisometropia; Unilateral amblyopia

MeSH Terms

Amblyopia
Anisometropia*
Child*
Eyeglasses
Follow-Up Studies
Humans
Medical Records
Refractive Errors
Visual Acuity

Figure

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  Figure 1 Change in prevalence of amblyopia according to severity of anisometropia. The prevalence of amlyopia decreased more prominently in the mild group than in the severe group 1 year after spectacle correction and at the last follow-up. *Chi-square test.

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  Figure 2 Change in mean difference in SE between both eyes. The magnitude of anisometropia tended to increase by 0.42D but not significantly during the follow-up period: +0.78D in the mild group and −0.02D in the severe group. SE = spherical equivalent; D = diopters.

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