AIM:To compare the retinal nerve fiber layer (RNFL) thickness and macular thickness in the amblyopic eye with that in the sound eye of children with hyperopic anisometropic amblyopia using optical coherence tomography...AIM:To compare the retinal nerve fiber layer (RNFL) thickness and macular thickness in the amblyopic eye with that in the sound eye of children with hyperopic anisometropic amblyopia using optical coherence tomography (OCT). METHODS:A prospective, nonrandom, intraindividual comparative cohort study includes 72 children with hyperopic anisometropic amblyopia in a single center. Macular thickness, macular foveola thickness, and peripapillary RNFL thickness were compared between the amblyopia eyes and the contralateral sound eyes. ·RESULTS:There were 38 male and 34 female patients, with a mean age as 9.7 ±1.9 years (range, 5-16 years). Hyperopic was +3.62±1.16D (range +2.00D to +6.50D) in the amblyopic eyes, which was significantly higher in the control eyes with +0.76±0.90D (range 0D to +2.00D) (P 【 0.01). The mean peripapillary RNFL thickness was 113.9± 7.2μm and 109.2 ±6.9μm in the amblyopic eye and the normal eye, respectively, reaching statistical significance (P = 0.02). The mean macular foveola thickness was significantly thicker in the amblyopic eyes than the contralateral sound eyes (181.4±14.2μm vs 175.2±13.3μm, P 【0.01), but the 1mm, 3mm or 6mm macular thickness central macular thickness was not significantly different. Degree of anisometropia in the contralateral eyes was not significantly correlated with differences of peripapillary RNFL, macular foveola thickness or central macular thickness. CONCLUSION:Eyes with hyperopic anisometropic amblyopia are found thicker macular foveola and peripapillary RNFL than the contralateral eyes in children.展开更多
Uncorrected refractive error(URE) is a major health problem among school children. This study was aimed to determine the frequency and patterns of URE across 4 gradients of residential densities(urban, exurban, sub...Uncorrected refractive error(URE) is a major health problem among school children. This study was aimed to determine the frequency and patterns of URE across 4 gradients of residential densities(urban, exurban, suburban and rural). This was a cross-sectional study of school children from 3 districts in Yogyakarta and 1 district near Yogyakarta, Indonesia. The information regarding age, sex, school and school grader were recorded. The Snellen's chart was used to measure the visual acuity and to perform the subjective refraction. The district was then divided into urban, suburban, exurban and rural area based on their location and population. In total, 410 school children were included in the analyses(urban=79, exurban=73, suburban=160 and rural=98 school children). Urban school children revealed the worst visual acuity(P〈0.001) and it was significant when compared with exurban and rural. The proportion of URE among urban, suburban, exurban and rural area were 10.1%, 12.3%, 3.8%, and 1%, respectively, and it was significant when compared to the proportion of ametropia and corrected refractive error across residential densities(P=0.003). The risk of URE development in urban, suburban, exurban, and rural were 2.218(95%CI: 0.914-5.385), 3.019(95%CI: 1.266-7.197), 0.502(95%CI: 0.195-1.293), and 0.130(95%CI:0.017-0.972), respectively. Urban school children showed the worst visual acuity. The school children in urban and suburban residential area had 2 and 3 times higher risk of developing the URE.展开更多
●AIM:To develop a novel approach called the Autoacuity Tester,and to evaluate its validity,especially the sensitivity and specificity for detecting amblyopia.●METHODS:Children aged from 3 to 12 y(n=552)were enrolled...●AIM:To develop a novel approach called the Autoacuity Tester,and to evaluate its validity,especially the sensitivity and specificity for detecting amblyopia.●METHODS:Children aged from 3 to 12 y(n=552)were enrolled in the study.The validity of the Autoacuity Tester was evaluated by comparing it to the Tumbling E Early Treatment Diabetic Retinopathy Study(ETDRS)acuity chart for school age children,and Lea Symbols and Teller acuity card(TAC)for preschool children.The repeatability was assessed by coefficient of repeatability(COR).The sensitivity and specificity for detecting amblyopia were calculated.●RESULTS:The mean difference(95%limits of agreement)between the Autoacuity Tester and the ETDRS tests were-0.03(-0.24,0.19)logMAR for the school age group.In preschool children,the mean difference was 0.04(-0.14,0.21)logMAR between the Autoacuity Tester and the TAC and 0.00(-0.17,0.18)logMAR between the Autoacuity Tester and the Lea Symbols.For the school age group,the COR was 0.20 logMAR for the Autoacuity Tester and 0.18 logMAR for the ETDRS.For the preschool group,the COR was 0.13 logMAR for the Autoacuity Tester and 0.21 logMAR for TAC.The Autoacuity Tester(88%)is more sensitive than TAC(72%)in detecting amblyopia(P=0.04),while had similar specificity(92%vs 90%,P=0.20).●CONCLUSION:The Autoacuity Tester provides a reliable alternative for assessing visual acuity,and offers advantage of higher testability and repeatability for preschool children.展开更多
Purpose of Review: Amblyopia is the reduction in the best-corrected visual acuity of one or both eyes and the most common cause of the loss of vision in children. Previously, amblyopia was thought to have no organic l...Purpose of Review: Amblyopia is the reduction in the best-corrected visual acuity of one or both eyes and the most common cause of the loss of vision in children. Previously, amblyopia was thought to have no organic lesions. However, the latest “Amblyopia Preferred Practice Pattern” of 2017 points out that in amblyopia, the eye structure is abnormal with a defective eye function, with few differences from the structure of contralateral non-amblyopic eyes. With the development of optical coherence tomography and optical coherence tomography angiography, it has been observed that even the ocular structure of amblyopic eyes is different from that of normal eyes. Here, we review studies investigating the changes in amblyopic eye structure upon treatment. Review Findings: The pathogenesis of amblyopia is controversial and not well-understood. The retina, choroid, and blood vessels of amblyopic eyes are different from those of normal eyes. Further, the various types of amblyopia are affected differently upon treatment. Because of the scarcity of studies and long-term follow-up observations, the underlying reason for such differences is unclear. Age, gender, and axial length are the influencing factors of the retina and choroid, and the relationship of these factors with amblyopia needs to be investigated further. Conclusion: This review will help us understand the pathogenesis of amblyopia and the underlying mechanism for the changes that occur upon treatment. Further, knowledge of the changes in ocular structure summarized here will be helpful for the diagnosis and treatment of amblyopia.展开更多
文摘AIM:To compare the retinal nerve fiber layer (RNFL) thickness and macular thickness in the amblyopic eye with that in the sound eye of children with hyperopic anisometropic amblyopia using optical coherence tomography (OCT). METHODS:A prospective, nonrandom, intraindividual comparative cohort study includes 72 children with hyperopic anisometropic amblyopia in a single center. Macular thickness, macular foveola thickness, and peripapillary RNFL thickness were compared between the amblyopia eyes and the contralateral sound eyes. ·RESULTS:There were 38 male and 34 female patients, with a mean age as 9.7 ±1.9 years (range, 5-16 years). Hyperopic was +3.62±1.16D (range +2.00D to +6.50D) in the amblyopic eyes, which was significantly higher in the control eyes with +0.76±0.90D (range 0D to +2.00D) (P 【 0.01). The mean peripapillary RNFL thickness was 113.9± 7.2μm and 109.2 ±6.9μm in the amblyopic eye and the normal eye, respectively, reaching statistical significance (P = 0.02). The mean macular foveola thickness was significantly thicker in the amblyopic eyes than the contralateral sound eyes (181.4±14.2μm vs 175.2±13.3μm, P 【0.01), but the 1mm, 3mm or 6mm macular thickness central macular thickness was not significantly different. Degree of anisometropia in the contralateral eyes was not significantly correlated with differences of peripapillary RNFL, macular foveola thickness or central macular thickness. CONCLUSION:Eyes with hyperopic anisometropic amblyopia are found thicker macular foveola and peripapillary RNFL than the contralateral eyes in children.
基金Supported by Department of Ophthalmology, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
文摘Uncorrected refractive error(URE) is a major health problem among school children. This study was aimed to determine the frequency and patterns of URE across 4 gradients of residential densities(urban, exurban, suburban and rural). This was a cross-sectional study of school children from 3 districts in Yogyakarta and 1 district near Yogyakarta, Indonesia. The information regarding age, sex, school and school grader were recorded. The Snellen's chart was used to measure the visual acuity and to perform the subjective refraction. The district was then divided into urban, suburban, exurban and rural area based on their location and population. In total, 410 school children were included in the analyses(urban=79, exurban=73, suburban=160 and rural=98 school children). Urban school children revealed the worst visual acuity(P〈0.001) and it was significant when compared with exurban and rural. The proportion of URE among urban, suburban, exurban and rural area were 10.1%, 12.3%, 3.8%, and 1%, respectively, and it was significant when compared to the proportion of ametropia and corrected refractive error across residential densities(P=0.003). The risk of URE development in urban, suburban, exurban, and rural were 2.218(95%CI: 0.914-5.385), 3.019(95%CI: 1.266-7.197), 0.502(95%CI: 0.195-1.293), and 0.130(95%CI:0.017-0.972), respectively. Urban school children showed the worst visual acuity. The school children in urban and suburban residential area had 2 and 3 times higher risk of developing the URE.
基金Supported by National Key Research and Development Program of China(No.2017YFC1104600)National Natural Science Foundation of China(No.81770909)the Production&Education and Research Key Project of Guangdong Provincial Program(No.2011B090400499).
文摘●AIM:To develop a novel approach called the Autoacuity Tester,and to evaluate its validity,especially the sensitivity and specificity for detecting amblyopia.●METHODS:Children aged from 3 to 12 y(n=552)were enrolled in the study.The validity of the Autoacuity Tester was evaluated by comparing it to the Tumbling E Early Treatment Diabetic Retinopathy Study(ETDRS)acuity chart for school age children,and Lea Symbols and Teller acuity card(TAC)for preschool children.The repeatability was assessed by coefficient of repeatability(COR).The sensitivity and specificity for detecting amblyopia were calculated.●RESULTS:The mean difference(95%limits of agreement)between the Autoacuity Tester and the ETDRS tests were-0.03(-0.24,0.19)logMAR for the school age group.In preschool children,the mean difference was 0.04(-0.14,0.21)logMAR between the Autoacuity Tester and the TAC and 0.00(-0.17,0.18)logMAR between the Autoacuity Tester and the Lea Symbols.For the school age group,the COR was 0.20 logMAR for the Autoacuity Tester and 0.18 logMAR for the ETDRS.For the preschool group,the COR was 0.13 logMAR for the Autoacuity Tester and 0.21 logMAR for TAC.The Autoacuity Tester(88%)is more sensitive than TAC(72%)in detecting amblyopia(P=0.04),while had similar specificity(92%vs 90%,P=0.20).●CONCLUSION:The Autoacuity Tester provides a reliable alternative for assessing visual acuity,and offers advantage of higher testability and repeatability for preschool children.
文摘Purpose of Review: Amblyopia is the reduction in the best-corrected visual acuity of one or both eyes and the most common cause of the loss of vision in children. Previously, amblyopia was thought to have no organic lesions. However, the latest “Amblyopia Preferred Practice Pattern” of 2017 points out that in amblyopia, the eye structure is abnormal with a defective eye function, with few differences from the structure of contralateral non-amblyopic eyes. With the development of optical coherence tomography and optical coherence tomography angiography, it has been observed that even the ocular structure of amblyopic eyes is different from that of normal eyes. Here, we review studies investigating the changes in amblyopic eye structure upon treatment. Review Findings: The pathogenesis of amblyopia is controversial and not well-understood. The retina, choroid, and blood vessels of amblyopic eyes are different from those of normal eyes. Further, the various types of amblyopia are affected differently upon treatment. Because of the scarcity of studies and long-term follow-up observations, the underlying reason for such differences is unclear. Age, gender, and axial length are the influencing factors of the retina and choroid, and the relationship of these factors with amblyopia needs to be investigated further. Conclusion: This review will help us understand the pathogenesis of amblyopia and the underlying mechanism for the changes that occur upon treatment. Further, knowledge of the changes in ocular structure summarized here will be helpful for the diagnosis and treatment of amblyopia.