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Alis MG, Alis A, Acikalin B. How do the amblyopic and fellow eyes differ in adults? J Fr Ophtalmol 2021; 45:74-80. [PMID: 34801272 DOI: 10.1016/j.jfo.2021.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/26/2021] [Accepted: 06/04/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To investigate the differences between the amblyopic eye and the fellow eye in adults with anisometropic amblyopia. MATERIALS AND METHODS Measurements of the central macular thickness [CMT], subfoveal choroidal thickness [SFCT], and retinal nerve fiber layer [RNFL] in patients with anisometropic amblyopia were obtained using optical coherence tomography [OCT]. Axial length [AL], anterior chamber depth [ACD], and central corneal thickness [CCT] were measured with optical biometry. All 12 parameters were compared between the amblyopic eye [Group 1] and the fellow eye [Group 2]. RESULTS A total of 110 eyes of 55 patients [9 myopic, 46 hypermetropic] were analyzed retrospectively. The ages of the patients ranged from 17 to 55 years, with a mean of 30.8±10.7 years. 56.4% [n=31] of the patients were female, and 43.6% [n=24] were male. The mean spherical equivalent [SE] was 1.96±3.79 in Group 1 and 1.28±2.45 in Group 2. SFCT was 312.00±53.03 in Group 1 and 283.47±51.91 in Group 2. AL was 22.53±1.40 in Group 1 and 22.79±1.18 in Group 2. SE, SFCT, and AL were statistically significantly different between the two groups. There was no difference between the two groups in terms of CMT, RNFL, ACD and CCT values. CONCLUSION In adults with anisometric amblyopia, the SFCT of the amblyopic eye is greater than that of the fellow eye. The choroid plays an important role in the nutrition of the retinal layers, the development of ocular function and refractive error, and its development may be affected by the refractive error. Since the majority of our patients were hyperopic, the AL was found to be shorter in the amblyopic eye. CMT, RNFL, ACD and CCT values were the similar in both groups. There was no clinically significant relationship between biometric parameters and OCT parameters.
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Affiliation(s)
- M G Alis
- Fatih Sultan Mehmet Training and Research Hospital, Atasehir, Istanbul, Turkey.
| | - A Alis
- Fatih Sultan Mehmet Training and Research Hospital, Atasehir, Istanbul, Turkey.
| | - B Acikalin
- Fatih Sultan Mehmet Training and Research Hospital, Atasehir, Istanbul, Turkey.
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Kepez Yildiz B, Erdem ZG, Demir G, Yildirim Y, Agca A, Aygit ED, Kandemir Besek N, Fazil K, Demirok A. Effect of keratorefractive surgery on choroidal thickness in anisometropic amblyopia. J Fr Ophtalmol 2020; 43:996-1001. [PMID: 32972758 DOI: 10.1016/j.jfo.2020.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 02/06/2020] [Accepted: 02/25/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate postoperative change in choroidal thickness (CT) in patients with anisometropic amblyopia undergoing keratorefractive surgery. METHODS Anisometropic amblyopic patients and nonamblyopic patients who underwent keratorefractive surgery were included in the study. The eyes were divided into three groups. Group 1 consisted of eyes with anisometropic amblyopia, group 2 were the nonamblyopic fellow eyes, and group 3 (control group) were nonamblyopic eyes which had undergone keratorefractive surgery. At the third postoperative month, the CT of these eyes were measured by Enhanced Depth Imaging OCT (EDI-OCT). The choroidal thickness (CT) was measured in the subfoveal area and at 500 micron intervals nasally and temporally. RESULTS Twenty-three anisometropic amblyopia patients with amblyopic and fellow eyes and 23 control eyes were enrolled. The mean subfoveal choroidal thickness (CT) was 387.3±168.8μm in group 1, 412.2±88.8μm in group 2 and 337.3±99μm in group 3 (P: 0.019). Group 1 and group 2 showed higher choroidal thickness (CT) in the nasal and temporal quadrants than group 3 (P: 0.03, P: 0.04). At the third postoperative month, central foveal choroidal thickness was 356.6±115.5μm in group 1, 375.1±112.5μm in group 2 and 284.4±98.9μm in group 3 (P: 0.071). Choroidal thickness (CT) in the nasal and temporal quadrants at the third postoperative month was also similar (P: 0.210, P: 0.103). CONCLUSIONS The macular choroid is thicker in amblyopic eyes and non-amblyopic fellow eyes than in the nonamblyopic controls. Improved fixation after refractive surgery may normalize CT.
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Affiliation(s)
- B Kepez Yildiz
- Prof Dr N Reşat-Belger Beyoğlu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Z G Erdem
- Prof Dr N Reşat-Belger Beyoğlu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - G Demir
- Prof Dr N Reşat-Belger Beyoğlu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
| | - Y Yildirim
- Prof Dr N Reşat-Belger Beyoğlu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - A Agca
- Prof Dr N Reşat-Belger Beyoğlu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - E D Aygit
- Prof Dr N Reşat-Belger Beyoğlu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - N Kandemir Besek
- Prof Dr N Reşat-Belger Beyoğlu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - K Fazil
- Prof Dr N Reşat-Belger Beyoğlu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - A Demirok
- Department of Ophthalmology, Medeniyet University School of Medicine, Istanbul, Turkey
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Fard AM, Patel SP, Sorkhabi RD, Salekzamani S, Pezzino E, Nader ND. Posterior pole retinal thickness distribution pattern in keratoconus. Int Ophthalmol 2020; 40:2807-2816. [PMID: 32556673 DOI: 10.1007/s10792-020-01464-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 06/02/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate the pattern of retinal thickness distribution in patients with keratoconus (KCN) and its correlation with disease severity. METHODS For this cross-sectional cohort study, the study subjects with documented keratoconus and normal eyes were prospectively enrolled. All subjects had anterior segment (Pentacam HR) and posterior segment (Spectralis) imaging. Posterior segment imaging by optical coherence tomography included the posterior pole asymmetry analysis map. Data were analyzed with multiple linear regression models and correlation tests to examine the mean and variance of the measured thickness of the retina and its distribution relative to the presence and severity of KCN. RESULTS A total of 24 subjects with keratoconus (48 eyes) and 14 normal subjects (28 eyes) enrolled in this study. The posterior pole retinal thickness, both superior and inferior hemifields, as well as the overall retinal thickness in KCN patients was greater than the control group. There was a direct correlation between the overall retinal thickness of the posterior pole and the severity of KCN (R2 = 0.422, P < 0.001). However, the variability of the retinal thickness showed no difference between KCN-afflicted and healthy eyes. CONCLUSION Although KCN is a disease of the anterior segment of the eye, we found an orderly increase in posterior pole retinal thickness that is correlated with the severity of disease in KCN eyes compared to control. These findings suggest that the retina may maintain some degree of plasticity to respond to the degraded optical system of the eye.
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Affiliation(s)
- Ali Mahdavi Fard
- Department of Ophthalmology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Sangita P Patel
- Department of Ophthalmology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA.,Research and Ophthalmology Services, Veterans Administration of Western New York Healthcare System, Buffalo, NY, USA
| | - Raana Daei Sorkhabi
- Department of Ophthalmology, Tabriz university of Medical Sciences, Tabriz, Iran
| | - Sara Salekzamani
- Department of Ophthalmology, Tabriz university of Medical Sciences, Tabriz, Iran
| | - Elena Pezzino
- Department of Anesthesiology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, UB-Gateway Bldg Suite 550, 77 Goodell Street, Buffalo, NY, 14203, USA
| | - Nader D Nader
- Department of Anesthesiology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, UB-Gateway Bldg Suite 550, 77 Goodell Street, Buffalo, NY, 14203, USA.
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Nishi T, Ueda T, Mizusawa Y, Semba K, Shinomiya K, Mitamura Y, Sonoda S, Uchino E, Sakamoto T, Ogata N. Effect of optical correction on choroidal structure in children with anisohypermetropic amblyopia. PLoS One 2020; 15:e0231903. [PMID: 32324782 PMCID: PMC7179822 DOI: 10.1371/journal.pone.0231903] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 04/02/2020] [Indexed: 02/06/2023] Open
Abstract
The aim of this study was to assess the effect of wearing optical correction on the choroidal structure in eyes of children with anisohypermetropic amblyopia. This study was conducted at the Nara Medical University Hospital and at the Tokushima University Hospital. Twenty-nine anisohypermetropic amblyopic eyes and their fellow eyes of 29 amblyopic patients (mean age, 5.7 ± 1.7 years, range 3- to 8-years) and twenty eyes of 20 age-similar control children (4.9 ± 0.8 years, range 4- to 6-years) were studied. All patients wore optical correction and 15 patients had both optical correction and patching. The values at the baseline were compared to that at one year later. The binarization method was used to determine the total, luminal, and stromal areas of the choroid in the enhanced depth imaging optical coherence tomographic images. The best-corrected visual acuity (BCVA) of the amblyopic eyes was significantly improved after the one-year period. A large luminal area was characteristic of the amblyopic eye at the baseline, and it was significantly reduced after the optical treatment. The stromal area widened significantly in the amblyopic and fellow eyes after one year whereas there were no significant changes in the choroid of the control eyes after one year. After one-year of optical correction, the luminal/stromal ratios in the amblyopic and fellow eyes were decreased and were then not significantly different from that of the normal control eyes. There was a significant and positive correlation between the improvement of the BCVA and the stromal area at the baseline (r = 0.64, P = 0.001). Wearing corrective lenses on the amblyopic eyes improves the BCVA, and the choroidal structure of the amblyopic eye becomes closer to that of the control eyes. The narrowed luminal area is a specific response of the amblyopic eye associated with the correction of the refractive error. The larger stromal area in the amblyopic eyes at the baseline is a predictive factor for improvements of the BCVA.
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Affiliation(s)
- Tomo Nishi
- Department of Ophthalmology, Nara Medical University, Nara, Japan
- * E-mail:
| | - Tetsuo Ueda
- Department of Ophthalmology, Nara Medical University, Nara, Japan
| | - Yuutaro Mizusawa
- Department of Ophthalmology, Nara Medical University, Nara, Japan
| | - Kentaro Semba
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Kayo Shinomiya
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Yoshinori Mitamura
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Shozo Sonoda
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Eisuke Uchino
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Nahoko Ogata
- Department of Ophthalmology, Nara Medical University, Nara, Japan
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Abstract
Amblyopia refers to visual impairment resulting from perturbations in visual experience during visual development, typically secondary to strabismus, uncorrected refractive error, and/or deprivation. Amblyopia has traditionally been considered a cortical disease, but the depth of our understanding of this complex neurodevelopmental condition is limited by our ability to appreciate structural pathophysiology in the visual pathway. Recent advances in Optical Coherence Tomography (OCT) have facilitated numerous studies of the structural changes in the retina and optic nerve, thereby expanding our appreciation for the pathogenesis of this condition. In this review, we summarize findings from studies evaluating retinal, retinal nerve fiber layer, and choroidal thickness changes in patients with amblyopia. Focusing on the largest and most recent studies, we discuss common limitations and confounding variables in these studies. We summarize recent advances in ocular imaging technology and reconcile the findings of early histological reports with those of structural OCT in amblyopia.
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Affiliation(s)
- Eric D Gaier
- a Department of Ophthalmology , Boston Children's Hospital , Boston , MA , USA.,b Harvard Medical School , Boston , MA , USA
| | - Ryan Gise
- b Harvard Medical School , Boston , MA , USA.,c Neuro-Ophthalmology Service, Department of Ophthalmology , Massachusetts Eye and Ear , Boston , MA , USA
| | - Gena Heidary
- a Department of Ophthalmology , Boston Children's Hospital , Boston , MA , USA.,b Harvard Medical School , Boston , MA , USA
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Araki S, Miki A, Goto K, Yamashita T, Takizawa G, Haruishi K, Yoneda T, Ieki Y, Kiryu J, Maehara G, Yaoeda K. Effect of amblyopia treatment on choroidal thickness in hypermetropic anisometropic amblyopia using swept-source optical coherence tomography. BMC Ophthalmol 2018; 18:227. [PMID: 30170555 PMCID: PMC6119334 DOI: 10.1186/s12886-018-0894-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 08/21/2018] [Indexed: 11/10/2022] Open
Abstract
Background Recent studies using optical coherence tomography (OCT) have indicated that choroidal thickness (CT) in the anisometropic amblyopic eye is thicker than that of the fellow and normal control eyes. However, it has not yet been established as to how amblyopia affects the choroid thickening. The purpose of the present study was to investigate the effect of amblyopia treatment on macular CT in eyes with anisometropic amblyopia using swept-source OCT. Methods Thirteen patients (mean age: 6.2 ± 2.4 years) with hypermetropic anisometropic amblyopia were included in this study. Visual acuity (VA), axial length (AL), and CT were measured at the enrollment visit and at the final visit, after at least 6 months of treatment. CT measurements were corrected for magnification error and were automatically analyzed using built-in software and divided into three macular regions (subfoveal choroidal thickness (SFCT), center 1 mm, and center 6 mm). A one-way analysis of covariance using AL as a covariate was performed to determine whether CT in amblyopic eyes changed after amblyopia treatment. Results The average observation period was 22.2 ± 11.0 months. After treatment, VA (logMAR) improvement in the amblyopic eyes was 0.41 ± 0.19 (p < 0.001). SFCT, center 1 mm CT, and center 6 mm CT were significantly thicker in the amblyopic eyes compared with the fellow eyes both before and after treatment (p < 0.05 for all comparisons). There were no significant changes in SFCT, center 1 mm CT, or center 6 mm CT before and after treatment in the amblyopic (p = 0.25, 0.21, and 0.84, respectively) and fellow (p = 0.75, 0.84, and 0.91, respectively) eyes. The correlation between changes in logMAR versus changes in CT after treatment was not significant. Conclusions Although VA in amblyopic eyes was significantly improved after treatment, the choroid thickening of anisometropic amblyopic eyes persisted, and there was no significant change found in the CT after the treatment. Our findings suggest that thickening of the CT in amblyopia is not directly related to visual dysfunction.
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Affiliation(s)
- Syunsuke Araki
- Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Atsushi Miki
- Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan. .,Department of Sensory Science, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama, 701-0193, Japan.
| | - Katsutoshi Goto
- Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Tsutomu Yamashita
- Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.,Department of Sensory Science, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama, 701-0193, Japan
| | - Go Takizawa
- Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Kazuko Haruishi
- Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Tsuyoshi Yoneda
- Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.,Department of Sensory Science, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama, 701-0193, Japan
| | - Yoshiaki Ieki
- Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Junichi Kiryu
- Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Goro Maehara
- Department of Human Sciences, Kanagawa University, 3-27-1 Rokkakubashi, Yokohama, Kanagawa, 221-8686, Japan
| | - Kiyoshi Yaoeda
- Yaoeda Eye Clinic, 2-1649-1 Naga-Chou, Nagaoka, Niigata, 940-0053, Japan
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