Subthreshold Amblyopia : Characterization of a New Cohort
Copyright © 2022 Elsevier Inc. All rights reserved..
PURPOSE: Published studies of amblyopia include only patients with visual acuity (VA) worse than 20/40 in one or both eyes. The purpose of this study is to evaluate patients diagnosed and treated as amblyopic despite not meeting traditional VA criteria for amblyopia.
DESIGN: Retrospective clinical cohort study.
METHODS: Setting: Institutional practice.
PATIENT POPULATION: All patients diagnosed with amblyopia at Boston Children's Hospital between 2010 and 2014.
INCLUSION CRITERIA: VA better than 20/40 but not correctable to 20/20 in one or both eyes; age 2 to 12 years.
OBSERVATIONS: Demographics, VA, baseline characteristics.
OUTCOME MEASURES: Resolution, defined as VA 20/20 in both eyes; stereopsis at the last follow-up.
RESULTS: Of 2311 patients reviewed, 464 (20.1%) had subthreshold amblyopia. A majority (61.7%) had an amblyogenic factor, most commonly anisometropia (32.8%). Patients were followed for a median of 3.1 years; nearly all (97.5%) were treated. Of 318 patients who returned for follow-up, 47.8% achieved resolution, including 55.7% of treatment-naïve patients, and 62.5% (5 of 8 patients) offered observation alone. Median stereopsis improved by 0.4 log units in those who achieved resolution, with no change in those with persistent amblyopia. In the multivariate analysis, a longer length of follow-up was significantly associated with resolution of subthreshold amblyopia (odds ratio: 1.38; 95% confidence interval: 1.22-1.57, P < .001).
CONCLUSIONS: Patients with subthreshold amblyopia represent a sizeable cohort in real-world amblyopia practice. When offered treatment, half achieved 20/20 vision in both eyes with improved stereopsis as well. Further studies are needed to assess whether observation alone would result in similar outcomes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:251 |
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| Enthalten in: |
American journal of ophthalmology - 251(2023) vom: 10. Juli, Seite 156-164 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Michalak, Suzanne M [VerfasserIn] |
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| Links: |
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| Themen: |
Amblyopia |
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| Anmerkungen: |
Date Completed 06.06.2023 Date Revised 20.06.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ajo.2022.12.015 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM350548986 |
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| 100 | 1 | |a Michalak, Suzanne M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Subthreshold Amblyopia |b Characterization of a New Cohort |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Revised 20.06.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Elsevier Inc. All rights reserved. | ||
| 520 | |a PURPOSE: Published studies of amblyopia include only patients with visual acuity (VA) worse than 20/40 in one or both eyes. The purpose of this study is to evaluate patients diagnosed and treated as amblyopic despite not meeting traditional VA criteria for amblyopia | ||
| 520 | |a DESIGN: Retrospective clinical cohort study | ||
| 520 | |a METHODS: Setting: Institutional practice | ||
| 520 | |a PATIENT POPULATION: All patients diagnosed with amblyopia at Boston Children's Hospital between 2010 and 2014 | ||
| 520 | |a INCLUSION CRITERIA: VA better than 20/40 but not correctable to 20/20 in one or both eyes; age 2 to 12 years | ||
| 520 | |a OBSERVATIONS: Demographics, VA, baseline characteristics | ||
| 520 | |a OUTCOME MEASURES: Resolution, defined as VA 20/20 in both eyes; stereopsis at the last follow-up | ||
| 520 | |a RESULTS: Of 2311 patients reviewed, 464 (20.1%) had subthreshold amblyopia. A majority (61.7%) had an amblyogenic factor, most commonly anisometropia (32.8%). Patients were followed for a median of 3.1 years; nearly all (97.5%) were treated. Of 318 patients who returned for follow-up, 47.8% achieved resolution, including 55.7% of treatment-naïve patients, and 62.5% (5 of 8 patients) offered observation alone. Median stereopsis improved by 0.4 log units in those who achieved resolution, with no change in those with persistent amblyopia. In the multivariate analysis, a longer length of follow-up was significantly associated with resolution of subthreshold amblyopia (odds ratio: 1.38; 95% confidence interval: 1.22-1.57, P < .001) | ||
| 520 | |a CONCLUSIONS: Patients with subthreshold amblyopia represent a sizeable cohort in real-world amblyopia practice. When offered treatment, half achieved 20/20 vision in both eyes with improved stereopsis as well. Further studies are needed to assess whether observation alone would result in similar outcomes | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Amblyopia | |
| 650 | 4 | |a Residual amblyopia | |
| 650 | 4 | |a Stereopsis | |
| 650 | 4 | |a Strabismus | |
| 650 | 4 | |a Subthreshold amblyopia | |
| 700 | 1 | |a Chinn, Ryan N |e verfasserin |4 aut | |
| 700 | 1 | |a Shoshany, Talia N |e verfasserin |4 aut | |
| 700 | 1 | |a Bishop, Kaila |e verfasserin |4 aut | |
| 700 | 1 | |a Staffa, Steven J |e verfasserin |4 aut | |
| 700 | 1 | |a Hunter, David G |e verfasserin |4 aut | |
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