The Effect of asymmetrical accommodation on anisometropic amblyopia treatment outcomes
The effect of asymmetrical accommodation on anisometropic amblyopia treatment outcomes. S. Toor, A. Horwood and P. Riddell J AAPOS 2019 Vol. 23 Issue 4 Pages 203-205
- most anisometropic amblyopes accommodate asymmetrically , with a few “anti-accommodating”, so accommodating for distance and less for near
- final visual acuity outcomes after treatment were worse the more atypical the accommodation was
Abstract
Background
Previous research has revealed that the majority of children with anisometropic amblyopia have asymmetrical accommodation. The aim of this preliminary study was to determine whether the type of accommodation response was associated with a poor amblyopia treatment outcome in the same patients.
Methods
The type of accommodation response of 26 children with anisometropic amblyopia was determined in a previous study. The final visual acuity in the amblyopic eye, after treatment, was compared between those with symmetrical, aniso-, and anti-accommodation.
Results
The difference in final visual acuity between the three accommodation groups was significant (P= 0.023). Subjects with anisometropic amblyopia with anti-accommodation had the poorest final visual acuity (0.42 +/- 0.25 logMAR) with a statistically significant difference compared with those who had aniso-accommodation (0.14 +- 0.08 logMAR; P= 0.023). However, the difference failed to reach significance compared to those with symmetrical accommodation (0.20 +/- 0.12 logMAR; P = 0.234), probably due to the small sample size. The initial visual acuity in the amblyopic eye and the degree of
anisometropia were also significantly positively correlated with final visual acuity(P < 0.001 for both).
Conclusions
In this study cohort, the presence of anti-accommodation in anisometropic amblyopia was associated with a poorer amblyopia treatment outcome. The initial visual acuity in the amblyopic eye and the degree of anisometropia were also associated with a poorer outcome. It is possible that all these factors are associated, but further research is required to determine causal relationships. ( J AAPOS 2019;23:203.e1-5