Optimizing the algorithm for assessing the efficacy of treatment for amblyopia in astigmats through the investigation of the features of meridional acuity characteristics as vector quantities
DOI:
https://doi.org/10.31288/oftalmolzh202363340Keywords:
astigmatism, integrative visual acuity, meridional acuity, pleoptic treatment, amblyopiaAbstract
Background: Refractive asymmetry associated with astigmatism may cause a special form of amblyopia, meridional amblyopia (MA). MA manifests itself as alterations in selective mechanisms of visual stimulus processing during recognition of contours of a certain orientation. Current routine examination of amblyopes does not include meridional acuity assessment and thus does not allow determining whether MA is present or not, as well as performing a more detailed evaluation of the efficacy of treatment for amblyopia in astigmats.
Purpose: To optimize the algorithm for assessing the efficacy of stand-alone and complex methods of treatment for amblyopia in astigmats through the determination of the features of changes in visual acuities in orthogonal retinal meridians as vector quantities.
Material and Methods: Twenty-four hyperopic astigmats with amblyopia (48 eyes) aged 5 to 12 years were involved in the study. Patients were treated by accommodative facility training only and, in 3 months, by complex therapy (accommodative facility training plus the use of device-based methods). Treatment course duration was 10 days. The results were assessed by changes in best-corrected visual acuity (Sivtsev Chart) and meridional separable visual acuity (MSVA) determined with the software which generates Landolt ring optotypes.
Results: The study sample was found to be heterogeneous regarding the features of asymmetries in MSVA. Separable visual acuity in the horizontal meridian was equal in magnitude to that in the vertical meridian in 16.65% of patients. Asymmetries in separable visual acuity that may be considered MA were found in dominant and non-dominant (fellow) eyes in 83.35% of astigmats with amblyopia. Two different clusters were determined in the group with asymmetries in MSVA. Separable visual acuity in the horizontal meridian was higher than that in the vertical meridian in 35.45% of eyes in cluster 1, and lower than that in the vertical meridian in 47.85% of eyes in cluster 2. After treatment, mean separable visual acuity value in the vertical meridian was practically similar to that in the horizontal meridian in both groups for the dominant and fellow eyes, which allowed concluding that both methods were equally effective in treating the disease. However, the number of eyes with the same MSVA in orthogonal meridians increased by 10.41% after MA treatment with accommodative facility training only versus 18.75% after complex treatment.
Conclusion: Assessing the features of changes in visual acuities in orthogonal retinal meridians as vector quantities enables obtaining principally new information on the performance of sensory functions in patients with amblyopia and assessing more reliably the efficacy of stand-alone and complex pleoptic methods as methods of treatment for MA.
References
Dobson V, Miller JM, Harvey EM, Mohan KM, et al. Amblyopia in astigmatic preschool children. Vision Res. 2003;43:1081-90. https://doi.org/10.1016/S0042-6989(03)00014-2
Gwiazda J, Bauer J, Thorn F, Held R. Meridional amblyopia does result from astigmatism in early childhood. Clin Vis Sci. 1986;1:145-52.
Hubel D H. Eye, brain, and vision. New York: Scientific American Library, 1988.
Freeman RD, Mitchell DE, Millodot M. A neural effect of partial visual deprivation in humans. Science. 1972;175(4028):1384-6. https://doi.org/10.1126/science.175.4028.1384
Mitchell DE, Freeman RD, Millodot M. Meridional amblyopia: evidence for modification of the human visual system by early visual experience. Vision Res. 1973;13 (3): 535-58. https://doi.org/10.1016/0042-6989(73)90023-0
Vit VV. [Structure of the human visual system]. Odesa: Astroprint; 2003. Russian.
Polat U, Bonneh Y, Ma-Naim T, Belkin MD. Spatial interactions in amblyopia: Effects of stimulus parameters and amblyopia type. Sagi Vision Research. 2005;45: 1471-9. https://doi.org/10.1016/j.visres.2004.12.014
Shamshinova AM, Volkov VV. [Functional methods of research in ophthalmology]. Moscow: Meditsina; 1999. Russian.
Lavrent'ev BF, Rozhentsov VV. [Instrumental treatment of amblyopia]. Ophthalmology in Russia. 2016;13(3):144-50. Russian. https://doi.org/10.18008/1816-5095-2016-3-144-150
Botabekova TK, Kurgambekova NS. [A comparative analysis of the efficiency of different methods in the treatment of amblyopia]. Vestn Oftalmol. 2004 Sep-Oct;120(5):40-1. Russian.
Abrahamsson M, Sjöstrand J. Astigmatic axis and amblyopia in childhood. Acta Ophthalmol Scand. 2003 Feb;81(1):33-7. https://doi.org/10.1034/j.1600-0420.2003.00022.x
Harvey EM, Dobson V, Miller JM, Clifford-Donaldson CE. Amblyopia in astigmatic children: patterns of deficits. Vision Res. 2007; 47: 315-26. https://doi.org/10.1016/j.visres.2006.11.008
Harvey EM. Development and Treatment of Astigmatism-Related Amblyopia. Optom Vis Sci. 2009 Jun;86(6):634-9. https://doi.org/10.1097/OPX.0b013e3181a6165f
Harvey EM, Dobson V, Clifford-Donaldson CE, Miller JM.Optical treatment of amblyopia in astigmatic children: the sensitive period for successful treatment. Ophthalmology. 2007 Dec;114(12):2293-301. https://doi.org/10.1016/j.ophtha.2007.03.021
Flynn JT. Amblyopia: its treatment today and its portent for the future. Binocul Vis Strabismus Q. 2000;15(2):109.
Flynn JT, Cassady JC. Current trends in amblyopia therapy. Ophthalmology. 1978;85:428-50. https://doi.org/10.1016/S0161-6420(78)35651-7
Kämpf U, Mascolus W, Muchamedjarow F, et al. Coherence induction via phase conjugate adaptive resonance coupling: Computer-generated sinusoidal grating patterns as a background stimulus in amblyopia treatment. J Psychophysiology. 2006; 20(2):149.
Kampf U, Shamshinova A, Kaschtschenko T, et al. Long-term application of computer-based pleoptics in home therapy: selected results of a prospective multicenter study. Strabismus. 2008;16(4):149-58. https://doi.org/10.1080/09273970802451125
Kempf W, Rychkova SI, Haim E, Mukhamedyarov F. [Comparative results of the application of moving and fixed sinusoidal framework in functional treatment of amblyopia]. Tochka zreniia. Vostok-Zapad. 2016;3:140-43. Russian.
Deshpande PG, Bhalchandra PC, Nalgirkar AR, Tathe SR. Improvement of visual acuity in residual meridional amblyopia by astigmatic axis video games. Indian J Ophthalmol. 2018 Aug; 66(8): 1156-60. https://doi.org/10.4103/ijo.IJO_1096_17
Аznaurjan IE, Gorlacheva LI. LASIK in complex treatment of meridional form of refractive amblyopia in children with astigmatism. Refractive Surgery Updates. Italy, Venice, June 2002. р.112-3.
Boubaker Hafedh ВA. [Significance of accommodation therapy in complex treatment of children with different kinds of hypermetropic amblyopia]. [Abstract of a Thesis for the Degree of Cand Sc (Med)]. Filatov Institute of Eye Diseases and Tissue Therapy. Odesa, Ukraine; 1998. Russian.
Serdiuchenko VI, Kuzhda IM. [Features of accommodation and their relationship with the state of visual acuity in children and adolescents with mixed and hyperopic astigmatism]. Oftalmol Zh. 2005;6 (407):35-9. Ukrainian.
Strogal AS. [Influence of chromatic light irritation on the reserves of accommodation in children with amblyopia]. Oftalmol Zh. 2002;3:96-8. Russian.
Serdiuchenko VI. [Accommodative facility training as an alternative or adjunct to spectacle]. Oftalmol Zh. 2000;2:30-33.Russian.
Kuzhda IM, Serdiuchenko VI. [Efficacy of accommodative facility training in the treatment of accommodative disorders in chidren with hyperopic astigmatism]. In: [Proceedings of the 3rd Conference on the Current Issues of Medical and Social Rehabilitation of Children with a Disabling Eye Condition]. 4-6 October, 2006, Evpatoriia, Ukraine. Kyiv: MAKROS; 2006; p. 118-22. Ukrainian.
Kuzhda IM, Serdiuchenko VI. [Treatment of accommodative disorders in children with mixed astigmatism]. In: [Proceedings of the Conference on the Surgical Treatment and Rehabilitation of Children with an Eye Condition]. 7-8 October, 2004. Kyiv: Schupik Medical Academy of Postgraduate Education; 2004. p. 154-6. Ukrainian.
Kolomiyets V, Bandura M, Kolomiyets N. [Meridional vernier visual acuity in children and adults with hypermetropic astigmatism]. Oftalmologiia. Vostochania Evropa. 2015; 3(26):27-34. Russian.
Kolomiyets V, Bandura M, Kolomiyets N. [Peculiarities of vernier monocular and binocular visual acuity in the retinal orthogonal meridians in patients with hypermetropic astigmatism]. Science Rise. 2015; 6/4(11):38-44. Russian. https://doi.org/10.15587/2313-8416.2015.45310
Goncharova SA, Panteleiev GV, Tyrlova EI. [Amblyopia. A Guide for a Practicing Physician]. Lugansk; 2006. Russian.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Kolomiyets V. O., Kachan O. V.
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) that allows users to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author as long as they cite the source.
COPYRIGHT NOTICE
Authors who publish in this journal agree to the following terms:
- Authors hold copyright immediately after publication of their works and retain publishing rights without any restrictions.
- The copyright commencement date complies the publication date of the issue, where the article is included in.
DEPOSIT POLICY
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) during the editorial process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work with an acknowledgement of its initial publication in this journal.
- Post-print (post-refereeing manuscript version) and publisher's PDF-version self-archiving is allowed.
- Archiving the pre-print (pre-refereeing manuscript version) not allowed.
