Shu Wang1,2,3,4,5, Leilei Zou1, Tian Tian2,3,4,5, Aiqin Zhan6, Yan Liu2,3,4,5, Wen Wen7,8,9,10, Hong Liu11,12,13,14,15. 1. Department of Ophthalmology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 2. Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China. 3. State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China. 4. Key Laboratory of Myopia, Fudan University, Ministry of Health, Shanghai, China. 5. Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China. 6. Jinshan Tinglin Hospital, Shanghai, China. 7. Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China. wenweneye@126.com. 8. State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China. wenweneye@126.com. 9. Key Laboratory of Myopia, Fudan University, Ministry of Health, Shanghai, China. wenweneye@126.com. 10. Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China. wenweneye@126.com. 11. Department of Ophthalmology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. liuhongzef@263.net. 12. Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China. liuhongzef@263.net. 13. State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China. liuhongzef@263.net. 14. Key Laboratory of Myopia, Fudan University, Ministry of Health, Shanghai, China. liuhongzef@263.net. 15. Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China. liuhongzef@263.net.
Abstract
BACKGROUND: To investigate the improvement of fixation stability of severe amblyopia with traditional patching treatment by the MP-1 microperimeter. METHODS: Eighteen patients with severe unilateral amblyopia were enrolled and received prescribed 6 h per day of patching of the fellow eye with optical correction if needed. Fixation test was performed on eighteen severe unilateral amblyopia patients by the MP-1 microperimeter in baseline, 3-month and 6-month after treatment. The bivariate contour ellipse area (BCEA, deg2) was used to quantify fixation stability. RESULTS: The RMANOVA showed that significant differences were found in best-corrected visual acuity (BCVA) between amblyopia eyes/fellow eyes (AE/FE) group (F = 113.52, p < 0.001) and among follow-up time (F = 74.684, p < 0.001). Moreover, a significant interaction could be found between AE/FE group and follow-up time (baseline/3-month/6-month, F = 60.189, p < 0.001). Post hoc analysis by Bonferroni showed significant improvement of BCVA in AE at 3-month (p < 0.001) and 6-month (p < 0.001), compared to baseline, and also significant between 3-month and 6-month (p = 0.002). The RMANOVA showed that significant differences were found in BCEA between AE/FE group (F = 8.432, p = 0.006) and among follow-up time (F = 10.431, p = 0.003). Moreover, a significant interaction could be found between AE/FE group and follow-up time (F = 9.099, p = 0.005). The mean BCEA of AE changed from 13.14 ± 17.97 deg2 at baseline to 6.03 ± 7.27 deg2 at 3-month (p = 0.084) and 3.38 ± 6.40 deg2 at 6-month (p = 0.018). No significant difference of BCEA in fellow eyes was found during the follow-up period (between baseline and 3-month: p = 0.230; between baseline and 6-month: p = 0.692. 0.89 ± 1.02, 0.58 ± 0.40, and 0.03 ± 0.04 deg2 for baseline, 3-month and 6-month, respectively). No significant correlation could be found between BCEA and BCVA of AE, both in enrollment and follow-up (p > 0.05). CONCLUSIONS: The fixation stability in the amblyopic eyes is significantly worse than that of the fellow eyes in patients with unilateral severe amblyopia. The fixation stability became better after 6-month occlusion treatment, but the change of fixation stability was not correlated with visual acuity improvement. These quantitative results highlight the importance of fixation in the mechanism of amblyopia.
BACKGROUND: To investigate the improvement of fixation stability of severe amblyopia with traditional patching treatment by the MP-1 microperimeter. METHODS: Eighteen patients with severe unilateral amblyopia were enrolled and received prescribed 6 h per day of patching of the fellow eye with optical correction if needed. Fixation test was performed on eighteen severe unilateral amblyopia patients by the MP-1 microperimeter in baseline, 3-month and 6-month after treatment. The bivariate contour ellipse area (BCEA, deg2) was used to quantify fixation stability. RESULTS: The RMANOVA showed that significant differences were found in best-corrected visual acuity (BCVA) between amblyopia eyes/fellow eyes (AE/FE) group (F = 113.52, p < 0.001) and among follow-up time (F = 74.684, p < 0.001). Moreover, a significant interaction could be found between AE/FE group and follow-up time (baseline/3-month/6-month, F = 60.189, p < 0.001). Post hoc analysis by Bonferroni showed significant improvement of BCVA in AE at 3-month (p < 0.001) and 6-month (p < 0.001), compared to baseline, and also significant between 3-month and 6-month (p = 0.002). The RMANOVA showed that significant differences were found in BCEA between AE/FE group (F = 8.432, p = 0.006) and among follow-up time (F = 10.431, p = 0.003). Moreover, a significant interaction could be found between AE/FE group and follow-up time (F = 9.099, p = 0.005). The mean BCEA of AE changed from 13.14 ± 17.97 deg2 at baseline to 6.03 ± 7.27 deg2 at 3-month (p = 0.084) and 3.38 ± 6.40 deg2 at 6-month (p = 0.018). No significant difference of BCEA in fellow eyes was found during the follow-up period (between baseline and 3-month: p = 0.230; between baseline and 6-month: p = 0.692. 0.89 ± 1.02, 0.58 ± 0.40, and 0.03 ± 0.04 deg2 for baseline, 3-month and 6-month, respectively). No significant correlation could be found between BCEA and BCVA of AE, both in enrollment and follow-up (p > 0.05). CONCLUSIONS: The fixation stability in the amblyopic eyes is significantly worse than that of the fellow eyes in patients with unilateral severe amblyopia. The fixation stability became better after 6-month occlusion treatment, but the change of fixation stability was not correlated with visual acuity improvement. These quantitative results highlight the importance of fixation in the mechanism of amblyopia.
Authors: P Carpineto; M Ciancaglini; M Nubile; G Di Marzio; L Toto; L Di Antonio; L Mastropasqua Journal: Eur J Ophthalmol Date: 2007 Nov-Dec Impact factor: 2.597