Macular and nerve fiber layer
thickness in amblyopia: the Sydney Childhood Eye Study.
(Epaisseur maculaire et épaisseur des fibres optiques en cas d'amblyopie)
Agervi P, Kugelberg U,
Kugelberg M, Simonsson G, Fornander M, Zetterström C.
St. Erik's Eye Hospital, Department of Clinical Neuroscience, Karolinska
Institutet, Stockholm, Sweden.
pia.agervi@sankterik.se
PURPOSE: To compare
spectacle correction alone with spectacle correction with Bangerter filters to
treat anisometropic amblyopia in children.
DESIGN: Prospective, randomized clinical trial. PARTICIPANTS: Eighty
children (mean age, 4.4 years) with untreated anisometropic amblyopia and a
median best-corrected visual acuity (BCVA) in the amblyopic eye of 0.4 logarithm
of the minimum angle of resolution (logMAR).
METHODS: Optimal refractive correction was provided, and the children
were assigned to treatment with either spectacles or spectacles in combination
with a Bangerter filter worn on the spectacle lens of the better eye. The BCVA,
binocular function, and refractive errors were measured repeatedly over the
course of 1 year.
MAIN OUTCOME MEASURES: The time course to resolution of the amblyopia (interocular
difference, < or =1 line).
RESULTS: The difference in the mean time to the resolution of amblyopia
was 3.9+/-3.2 months for the spectacles group versus 2.2+/-1.9 months for the
filter group, and the difference reached significance (P<0.05). The BCVA in the
amblyopic eye improved significantly (P<0.001 for both comparisons) in both
groups. After 1 year, there was no significant difference in the BCVA between
the groups. The binocular function improved in both groups; at 1 year there was
no significant difference between the groups. The median spherical equivalent
refractive error increased significantly during the study in the amblyopic eyes
(P<0.05) and the fellow eyes (P<0.001). The median anisometropia decreased
significantly from the first visit to the 1-year visit in both groups (P<0.001
for both comparisons).
CONCLUSIONS: In children aged predominantly 6 and 12 years, central
macular thickness may be increased in eyes with amblyopia, although it is
uncertain if this precedes or follows the development of amblyopia. No
differences in peripapillary RNFL thickness were found when compared with normal
eyes.
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