Annals of Optometry and Contact Lens 2020;19(1):11-17.
Published online March 25, 2020.
안과병원으로 내원한 굴절부등약시 환자의 굴절이상 분포와 임상양상 분석
조수연, 김대희, 김응수, 백승희
김안과병원 사시 & 소아안과센터
Anisometropic Amblyopia: Distribution of Refractive Errors and Clinical Characteristics of Patients from an Eye Hospital
Soo-Yeon Cho, Dae Hee Kim, Ungsoo Samuel Kim, Seung-Hee Baek
Strabismus & Pediatric Ophthalmology Center, Kim's Eye Hospital, Seoul, Korea
Received: 16 August 2019   • Revised: 10 October 2019   • Accepted: 19 October 2019
Abstract
Purpose: To investigate clinical characteristics and visual prognosis of anisometropic amblyopia patients in a secondary referral eye hospital in Seoul, South Korea.
Methods: Medical records of 561 patients with anisometropic amblyopia between 3 and 12 years of age were retrospectively reviewed and 450 patients who followed up ≥ 2 times were included for comprehensive analysis. Amblyopia was defined as best corrected visual acuity difference of ≥ 0.2 logarithm of the minimum angle of resolution (logMAR) between the sound and amblyopic eyes. Anisometropia was defined by ≥ 1 diopter (D) difference in spherical equivalents (SE), or ≥ 1.5 D difference of cylindrical error in any meridian between the eyes. Baseline clinical characteristics, best corrected visual acuity and cycloplegic refraction of both eyes at the first visit were collected. According to the SE of amblyopic eyes, patients were categorized into hyperopia (SE ≥ 1 D), emmetropia (-1 < SE < +1) and myopia groups (SE ≤ -1 D). Treatment success was defined as achieving interocular logMAR visual acuity difference < 0.2. Treatment success rates and time to reach treatment success were compared among the SE groups.
Results: Median age of patients was 5.0 years. Median follow-up period was 25.8 months. The proportions of hyperopia, emmetropia and myopia groups were 68.9%, 14.4%, and 16.7%, respectively. Emmetropia group showed anisometropia mostly due to cylindrical error difference between the eyes, rather than SE difference. Treatment success rates were the highest in emmetropia group (95.4%), followed by hyperopia group (85.8%) and then myopia group (77.3%, p = 0.010). Among the patients who fulfilled the success criteria, median time to reach treatment success was the shortest in emmetropia group (3.0 months) followed by hyperopia group (3.6 months) and then myopia group (4.0 months, p < 0.001).
Conclusions: Hyperopia was the most common refractive error of the amblyopic eyes in anisometropic amblyopia patients who presented to an eye hospital in Seoul. Treatment success rate was the best in emmetropia group, followed by hyperopia group, and then by myopia group. Time to reach treatment success was the shortest in emmetropia group.
Key Words: Anisometropic amblyopia; Astigmatism; Hyperopia; Myopia
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