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Introduction: Amblyopia is a common disease, and interventions like patching treatment are well studied. When standard therapy fails, sometimes uncommon treatment options become necessary. Methods: We present three cases of patients with severe strabismic amblyopia with initial visual acuities of 20/400, 20/2000 and 20/160 who failed conventional treatment and subsequently received treatment with high-powered contact lenses (HPCL) of either + 22D or + 25D strength. Results: Visual acuity markedly improved in all three cases: 20/20, 20/50 and 20/25, respectively. Conclusion: While amblyopia treatment with HPCL will never be first-line therapy, our results are encouraging and show that this form of penalization should be considered if conventional therapy fails. [ABSTRACT FROM AUTHOR]

Background: Analysis of electroencephalogram (EEG) visual-evoked potentials (VEPs) is important for assessing the general integrity of the visual pathway. Pathology in any portion of the visual pathway causes changes in VEP. Percentages of alpha, beta, delta and theta rhythms in the EEG record, frequencies and amplitudes of these waves, and the level of alpha-rhythm suppression are essential for characterizing the state of the visual system. Purpose: To indentify the features of the state of the visual system and changes in the background EEG in response to activation procedures in strabismic amblyopes depending on type of fixation in the amblyopic eye. Material and Methods: Fifty-two strabismic amblyopic patients aged 5-8 years and 15 healthy children of the same age underwent an examination. Of the amblyopic children, 32 had unilateral amblyopia with esotropia (6-15 degrees). Of these 32 children, 20 had eccentric fixation and 12 children, central fixation. The 10–20 system of electrode placement was employed to perform EEG in all children. Rhythms of the background EEG, interhemispheric asymmetry and alpha, theta and delta wave percentages were assessed. Brain potentials were recorded using standard activation procedures to activate deep brain structures. Results: Alpha rhythm was not discernable in the background EEG in the occipital areas in 3.0 ± 2.6 % of cases, and the alpha index was below the normal range in 48.6 ± 8.2 % of patients with a visual acuity worse than 0.3. Delta index was above the normal range (25%-45%) in 48.6 ± 8.2 %, and theta index was above the normal range (with a mean value of 48.4 ± 8.2 %) in 48.6 ± 8.2 % of children. Reduced percentage of alpha activity was found in almost half of strabismic amblyopic children, indicating immaturity of the synchronizing system and impaired oculomotor tuning in the eyes of these children. Abnormal bilateral EEG response to eye-opening stimulation and abnormal bilateral EEG rhythmic driving response (RDR) were seen in most children with eccentric fixation, but not in most children with central fixation. Photic stimulation in strabismic amblyopic children resulted in bilaterally asymmetrical and synchronous theta and delta waves in symmetric frontal (theta and delta percent time of 46.0 ± 8.4%) and occipital (theta and delta percent time of 50.0 ± 8.4%) responses. Conclusion: Increased theta and delta wave percentages in frontal and occipital derivations were found in strabysmic amblyopes (irrespective of type of fixation in the amblyopic eye) compared to healthy controls. Abnormal EEG response to eye opening and abnormal EEG RDR were found in strabysmic amblyopes. This indicates the presence of functional changes in the midline brain structures including the corpus callosum, which impedes the development of binocular vision in strabismic amblyopes.

To evaluate the associations of sociodemographic factors with pediatric strabismus diagnosis and outcomes. Retrospective cohort study. American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) patients with strabismus diagnosed before the age of 10 years. Multivariable regression models evaluated the associations of race and ethnicity, insurance, population density, and ophthalmologist ratio with age at strabismus diagnosis, diagnosis of amblyopia, residual amblyopia, and strabismus surgery. Survival analysis evaluated the same predictors of interest with the outcome of time to strabismus surgery. Age at strabismus diagnosis, rate of amblyopia and residual amblyopia, and rate of and time to strabismus surgery. The median age at diagnosis was 5 years (interquartile range, 3–7) for 106 723 children with esotropia (ET) and 54 454 children with exotropia (XT). Amblyopia diagnosis was more likely with Medicaid insurance than commercial insurance (odds ratio [OR], 1.05 for ET; 1.25 for XT; P < 0.01), as was residual amblyopia (OR, 1.70 for ET; 1.53 for XT; P < 0.01). For XT, Black children were more likely to develop residual amblyopia than White children (OR, 1.34; P < 0.01). Children with Medicaid were more likely to undergo surgery and did so sooner after diagnosis (hazard ratio [HR], 1.23 for ET; 1.21 for XT; P < 0.01) than those with commercial insurance. Compared with White children, Black, Hispanic, and Asian children were less likely to undergo ET surgery and received surgery later (all HRs < 0.87; P < 0.01), and Hispanic and Asian children were less likely to undergo XT surgery and received surgery later (all HRs < 0.85; P < 0.01). Increasing population density and clinician ratio were associated with lower HR for ET surgery (P < 0.01). Children with strabismus covered by Medicaid insurance had increased odds of amblyopia and underwent strabismus surgery sooner after diagnosis compared with children covered by commercial insurance. After adjusting for insurance status, Black, Hispanic, and Asian children were less likely to receive strabismus surgery with a longer delay between diagnosis and surgery compared with White children. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article. [ABSTRACT FROM AUTHOR]

Purpose: Amblyopic eyes show impaired visual functions such as poor visual acuity and reduced foveal sensitivity. The purpose of this study was to determine the association between foveal threshold and visual evoked potentials (VEP) in strabismic and anisometropic amblyopia. Methods: Forty-five subjects (age range: 7–28 years, 43.3% female) including 15 strabismic and 15 anisometropic amblyopes, and 15 age-similar control subjects participated in this study. Each subject had pattern visual evoked potentials and foveal threshold recorded in each eye using RetiScan (Roland Consult, Germany) and Humphrey Visual Field Analyzer II (HFA II; Carl Zeiss Meditec Inc., Dublin, CA), respectively. These outcomes were compared among the amblyopic eyes, their fellow eyes, and the control eyes. Results: Compared to the amblyopic eyes (Mean ± SD: 33.4 ± 3.48 dB), the foveal threshold was higher in fellow eyes (37.0 ± 2.04 dB, p = 0.0002) and in control eyes (38.7 ± 0.96 dB, p < 0.0001). Strabismic amblyopes had a lower foveal threshold than anisometropic amblyopes (31.8 ± 3.86 vs. 35.0 ± 2.17 dB, p = 0.005). Relative to the P100 peak time in fellow eyes (1° checks:116.1 ± 9.00 ms; 0.25° checks:118.8 ± 5.67 ms), amblyopic eyes had delayed P100 peak times for both 1° (122.7 ± 11.4 ms, p < 0.0001) and 0.25° (130.4 ± 11.2 ms, p < 0.0001) check sizes. There were also significant differences in P100 peak time between amblyopic and control eyes (1°:122.7 ± 11.4 vs.112.4 ± 5.01 ms, p = 0.15; 0.25°:130.4 ± 11.2 vs.113.9 ± 5.71 ms, p < 0.0001) and between fellow and control eyes (0.25°:118.8 ± 5.67 vs.113.9 ± 5.71 ms, p = 0.009). Amblyopic eyes exhibited lower N75-P100 amplitudes than fellow eyes (1°:12.6 ± 7.96 vs.15.9 ± 8.82 µV, p = 0.01; 0.25°:10.6 ± 6.11 vs. 15.8 ± 10.6 µV, p = 0.001) and control eyes (0.25°: p = 0.0008). Foveal threshold correlated negatively with P100 peak time (1°: r = -0.45, p = 0.002 and 0.25°: r = -0.58, p < 0.0001) and positively with N75-P100 amplitude responses (1°: r = 0.42, p = 0.004 and 0.25°: r = 0.52, p = 0.002). Conclusions: Amblyopic eyes showed reduced pattern VEP amplitudes and delayed peak times with significant associations with the foveal sensitivity. However, the VEP measures overlapped extensively between amblyopic and control eyes with no apparent criterion value for optimal discrimination, suggesting that foveal sensitivity might be a better discriminator of amblyopia than pattern VEP. [ABSTRACT FROM AUTHOR]

Aims: The aim was to report the incidence and types of amblyopia in a large series of patients with intermittent exotropia at a single institution. Materials and Methods: The medical records of consecutive patients 4–30 years of age diagnosed with intermittent exotropia at our institution between January 2000 and December 2017 were retrospectively reviewed for amblyopia. Results: A total of 2,058 patients diagnosed with intermittent exotropia during the study met the inclusion criteria. Of these patients, 40 (2%) had amblyopia and were the participants of this study. The mean patient age was 10.6 ± 4.2 years. Amblyopia was anisometropic in 35 (87%) patients and strabismic in 5 (13%) patients. Of the 35 patients with anisometropic amblyopia, 29 (83%) had spherical anisometropia and 6 (17%) had astigmatic anisometropia. There was no statistically significant difference in the number of patients and the mean anisometropia between patients with spherical anisomyopic and anisohyperopic amblyopia, and also between those with astigmatic anisomyopic and anisohyperopic amblyopia. There was no relation between the type of intermittent exotropia and anisometropic amblyopia. None of the patients with strabismic amblyopia had spherical or astigmatic anisometropia but had a preference for fixation with the nonamblyopic eye. There was no statistically significant difference in near and distance deviations between patients with anisometropic and strabismic amblyopia, and between those with anisomyopic and anisohyperopic amblyopia. Conclusions: Amblyopia was observed in 2% of our patients with intermittent exotropia. It was spherical anisometropic in a large majority of patients and strabismic in a few.

Aims and Objectives: To determine the choroidal thickness (mainly subfoveal) using spectral domain optical coherence tomography (SD-OCT) in amblyopic eyes and to compare it with the choroidal thickness (CT) of healthy fellow eyes. Materials and Methods: In this prospective study, 140 eyes of 70 patients (aged 5–40 years) with strabismic and anisometropic amblyopia were examined using enhanced depth imaging (EDI) mode in SD-OCT. The CT was measured directly below the fovea and six other locations: 500 μ, 1000 μ, and 1500 μ from fovea in both nasal and temporal quadrants. Results: The mean age of the patients was 22.5 ± 11.2 years. The mean Best Corrected Visual Acuity (BCVA) in the amblyopic eyes was 0.87 ± 0.47 logMAR and 0 ± 0.02 logMAR in control eyes. The average subfoveal CT was 341.73 ± 60.39 μm in the amblyopic eyes and 314.77 ± 48.12 μm in the fellow eyes. Subgroup analysis showed that the patients with anisometropic amblyopia had a significantly thicker choroid as compared to the fellow healthy eyes (P = 0.00), whereas in strabismic amblyopic eyes, this difference was not significantly significant (P = 0.064). Conclusion: Significant choroidal thickening was observed in subjects with amblyopia, which may contribute to the amblyopia pathogenesis and this could be used as a diagnostic parameter for amblyopia. These changes were more pronounced in patients with anisometropic amblyopia than strabismic amblyopia.

Aims and Objectives: To determine the choroidal thickness (mainly subfoveal) using spectral domain optical coherence tomography (SD-OCT) in amblyopic eyes and to compare it with the choroidal thickness (CT) of healthy fellow eyes. Materials and Methods: In this prospective study, 140 eyes of 70 patients (aged 5--40 years) with strabismic and anisometropic amblyopia were examined using enhanced depth imaging (EDI) mode in SD-OCT. The CT was measured directly below the fovea and six other locations: 500 µ, 1000 µ, and 1500 µ from fovea in both nasal and temporal quadrants. Results: The mean age of the patients was 22.5 ± 11.2 years. The mean Best Corrected Visual Acuity (BCVA) in the amblyopic eyes was 0.87 ± 0.47 logMAR and 0 ± 0.02 logMAR in control eyes. The average subfoveal CT was 341.73 ± 60.39 µm in the amblyopic eyes and 314.77 ± 48.12 µm in the fellow eyes. Subgroup analysis showed that the patients with anisometropic amblyopia had a significantly thicker choroid as compared to the fellow healthy eyes (P = 0.00), whereas in strabismic amblyopic eyes, this difference was not significantly significant (P = 0.064). Conclusion: Significant choroidal thickening was observed in subjects with amblyopia, which may contribute to the amblyopia pathogenesis and this could be used as a diagnostic parameter for amblyopia. These changes were more pronounced in patients with anisometropic amblyopia than strabismic amblyopia. [ABSTRACT FROM AUTHOR]

Background: Analysis of electroencephalogram (EEG) visual-evoked potentials (VEPs) is important for assessing the general integrity of the visual pathway. Pathology in any portion of the visual pathway causes changes in VEP. Percentages of alpha, beta, delta and theta rhythms in the EEG record, frequencies and amplitudes of these waves, and the level of alpha-rhythm suppression are essential for characterizing the state of the visual system. Purpose: To indentify the features of the state of the visual system and changes in the background EEG in response to activation procedures in strabismic amblyopes depending on type of fixation in the amblyopic eye. Material and Methods: Fifty-two strabismic amblyopic patients aged 5-8 years and 15 healthy children of the same age underwent an examination. Of the amblyopic children, 32 had unilateral amblyopia with esotropia (6-15 degrees). Of these 32 children, 20 had eccentric fixation and 12 children, central fixation. The 10–20 system of electrode placement was employed to perform EEG in all children. Rhythms of the background EEG, interhemispheric asymmetry and alpha, theta and delta wave percentages were assessed. Brain potentials were recorded using standard activation procedures to activate deep brain structures. Results: Alpha rhythm was not discernable in the background EEG in the occipital areas in 3.0 ± 2.6 % of cases, and the alpha index was below the normal range in 48.6 ± 8.2 % of patients with a visual acuity worse than 0.3. Delta index was above the normal range (25%-45%) in 48.6 ± 8.2 %, and theta index was above the normal range (with a mean value of 48.4 ± 8.2 %) in 48.6 ± 8.2 % of children. Reduced percentage of alpha activity was found in almost half of strabismic amblyopic children, indicating immaturity of the synchronizing system and impaired oculomotor tuning in the eyes of these children. Abnormal bilateral EEG response to eye-opening stimulation and abnormal bilateral EEG rhythmic driving response (RDR) were seen in most children with eccentric fixation, but not in most children with central fixation. Photic stimulation in strabismic amblyopic children resulted in bilaterally asymmetrical and synchronous theta and delta waves in symmetric frontal (theta and delta percent time of 46.0 ± 8.4%) and occipital (theta and delta percent time of 50.0 ± 8.4%) responses. Conclusion: Increased theta and delta wave percentages in frontal and occipital derivations were found in strabysmic amblyopes (irrespective of type of fixation in the amblyopic eye) compared to healthy controls. Abnormal EEG response to eye opening and abnormal EEG RDR were found in strabysmic amblyopes. This indicates the presence of functional changes in the midline brain structures including the corpus callosum, which impedes the development of binocular vision in strabismic amblyopes. [ABSTRACT FROM AUTHOR]

Purpose: To report retinal nerve fiber layer thickness (RNFLT) in eyes with amblyopia compared with contralateral healthy eyes. Methods: In this cross-sectional study, we included patients with anisometropic amblyopia, strabismic amblyopia, and mixed amblyopia. All subjects underwent complete ophthalmic examination, including RNFLT measurement with time-domain OCT (Stratus OCT) and scanning laser polarimeter (GDX VCC). A paired “t” test was used to compare average and quadrant-wise RNFL thickness between the amblyopic and contralateral normal eyes. In addition, an analysis of variance test was used to compare various RNFL thickness parameters between the three groups. Results: A total of 33 eyes of 33 subjects with anisometropic amblyopia, 20 eyes of 20 subjects with strabismic amblyopia, and 38 eyes of 38 subjects with mixed amblyopia were included. In the anisometropic amblyopia group, the average RNFLT in the amblyopic eye was 98.2 μm and 99.8 μm in the fellow normal eye (P = 0.5), the total foveal thickness was 152.82 μm (26.78) in the anisometropic eye and 150.42 μm (23.84) in the fellow eye (P = 0.38). The difference between amblyopic and contralateral normal eye for RNFL and macular parameters was statistically insignificant in all three groups. The RNFL thickness in four quadrants was similar in the amblyopic and non-amblyopic eye between all three groups and statistically non-significant. Conclusion: Our study showed that RNFL thickness was similar in amblyopic and non-amblyopic eyes between all three amblyopia groups.

Purpose: To report retinal nerve fiber layer thickness (RNFLT) in eyes with amblyopia compared with contralateral healthy eyes.Methods: In this cross-sectional study, we included patients with anisometropic amblyopia, strabismic amblyopia, and mixed amblyopia. All subjects underwent complete ophthalmic examination, including RNFLT measurement with time-domain OCT (Stratus OCT) and scanning laser polarimeter (GDX VCC). A paired "t" test was used to compare average and quadrant-wise RNFL thickness between the amblyopic and contralateral normal eyes. In addition, an analysis of variance test was used to compare various RNFL thickness parameters between the three groups.Results: A total of 33 eyes of 33 subjects with anisometropic amblyopia, 20 eyes of 20 subjects with strabismic amblyopia, and 38 eyes of 38 subjects with mixed amblyopia were included. In the anisometropic amblyopia group, the average RNFLT in the amblyopic eye was 98.2 μm and 99.8 μm in the fellow normal eye (P = 0.5), the total foveal thickness was 152.82 μm (26.78) in the anisometropic eye and 150.42 μm (23.84) in the fellow eye (P = 0.38). The difference between amblyopic and contralateral normal eye for RNFL and macular parameters was statistically insignificant in all three groups. The RNFL thickness in four quadrants was similar in the amblyopic and non-amblyopic eye between all three groups and statistically non-significant.Conclusion: Our study showed that RNFL thickness was similar in amblyopic and non-amblyopic eyes between all three amblyopia groups. [ABSTRACT FROM AUTHOR]

Abstract Background Previous studies have demonstrated that strabismus amblyopia can result in markedly brain function alterations. However, the differences in spontaneous brain activities of strabismus amblyopia (SA) patients still remain unclear. Therefore, the current study intended to employthe voxel-mirrored homotopic connectivity (VMHC) method to investigate the intrinsic brain activity changes in SA patients. Purpose To investigate the changes in cerebral hemispheric functional connections in patients with SA and their relationship with clinical manifestations using the VMHC method. Material and methods In the present study, a total of 17 patients with SA (eight males and nine females) and 17 age- and weight-matched healthy control (HC) groups were enrolled. Based on the VMHC method, all subjects were examined by functional magnetic resonance imaging. The functional interaction between cerebral hemispheres was directly evaluated. The Pearson’s correlation test was used to analyze the clinical features of patients with SA. In addition, their mean VMHC signal values and the receiver operating characteristic curve were used to distinguish patients with SA and HC groups. Results Compared with HC group, patients with SA had higher VMHC values in bilateral cingulum ant, caudate, hippocampus, and cerebellum crus 1. Moreover, the VMHC values of some regions were positively correlated with some clinical manifestations. In addition, receiver operating characteristic curves presented higher diagnostic value in these areas. Conclusion SA subjects showed abnormal brain interhemispheric functional connectivity in visual pathways, which might give some instructive information for understanding the neurological mechanisms of SA patients.

Purpose: To compare visual acuity and contrast sensitivity in different types of amblyopia and to see the effect of syntonic therapy on amblyopia in terms of visual acuity and contrast sensitivity. Study Design: A Quasi Experimental study. Place and Duration of Study: Madina Teaching Hospital Faisalabad, from August 2021 to November 2021. Methods: A total of 30 patients of either gender and age from 8 to 18 years were included. There were 15 patients with anisometropic amblyopia and 15 with strabismic amblyopia. The patients were recruited through non-probability purposive sampling technique. All the patients underwent assessment of visual acuity with Log MAR chart and contrast sensitivity with Pelli-Robsonchart. Syntonic phototherapy with red filter glasses was prescribed for 4 weeks. After 4 weeks, patients returned and underwent post-therapy assessment of visual acuity and contrast sensitivity. Paired sample t test and Independent sample t test was used with the help of IBM SPSS-23 to get a statistical result. Results: Syntonic phototherapy showed significant improvement in mean visual acuity of 0.223 (p = 0.00) and contrast sensitivity of -0.200 (p = 0.00) in amblyopia. Anisometropic amblyopia showed better improvement in visual acuity (p = 0.016) and contrast sensitivity (p = 0.035) by syntonic phototherapy as compared to patients with strabismic amblyopia. Conclusion: Significant improvement was seen in visual acuity and contrast sensitivity in patients with amblyopia after syntonic phototherapy. Anisometropic amblyopia showed better improvement as compared to strabismic amblyopia, in terms of visual acuity and contrast sensitivity. [ABSTRACT FROM AUTHOR]

Our previous study has shown impaired blood oxygen level-dependent (BOLD)/functional magnetic resonance imaging (fMRI) activation of the visual attention network in strabismic amblyopia (SA). However, there has been no comparison of resting state fMRI activation and functional connectivity (FC) in brain regions of interest (ROIs) along the visual attention network including visual cortex (V1), intraparietal sulcus (IPS), and frontal eye fields (FEFs) during closed eye resting across the SA (n = 20, 13LE), or anisometropic amblyopes (AA) (n = 20, 13LE) groups. Hence, we compared, gray matter volume (GMV), amplitude of low frequency fluctuations (ALFFs), regional homogeneity (ReHo), and FC in the left and right hemisphere ROIs of the visual attention network in SA, AA, and healthy controls (HCs) (n = 21). Correlation analyses of corrected visual acuity (cVA) of amblyopic eye and MRI results were also performed and showed that the LogMAR cVA of the amblyopic eye positively correlated with right zALFF and zReHo FEF of SA and right IPS of AA only. GMV of both left and right hemisphere V1 areas was significantly greater but ALFF was significantly lower for SA compared to AA and HC groups. zALFF and zReHo analyses in the AA and SA groups indicated significantly higher activation than that in the HC group in the right FEF and IPS but lower than that in the HC group in the left FEF, and only the SA group showed lower activation in both V1 areas than the HC group. FC values of the right FEF–left V1, right FEF–right V1, and right FEF–right IPS pathways in the SA and AA groups were also significantly higher than those in the HC group whereas all other FC values were non-significant. Thus, this study indicates that even during resting-state the visual attention network function is impaired in SA and AA participants with only right hemisphere FEF showing significant activation in SA and IPS in AA suggesting that the slower saccade activation times characteristic of amblyopic eyes lead to the dominant eye controlling activation of the visual attention network. [ABSTRACT FROM AUTHOR]

Our previous study has shown impaired blood oxygen level-dependent (BOLD)/functional magnetic resonance imaging (fMRI) activation of the visual attention network in strabismic amblyopia (SA). However, there has been no comparison of resting state fMRI activation and functional connectivity (FC) in brain regions of interest (ROIs) along the visual attention network including visual cortex (V1), intraparietal sulcus (IPS), and frontal eye fields (FEFs) during closed eye resting across the SA (n = 20, 13LE), or anisometropic amblyopes (AA) (n = 20, 13LE) groups. Hence, we compared, gray matter volume (GMV), amplitude of low frequency fluctuations (ALFFs), regional homogeneity (ReHo), and FC in the left and right hemisphere ROIs of the visual attention network in SA, AA, and healthy controls (HCs) (n = 21). Correlation analyses of corrected visual acuity (cVA) of amblyopic eye and MRI results were also performed and showed that the LogMAR cVA of the amblyopic eye positively correlated with right zALFF and zReHo FEF of SA and right IPS of AA only. GMV of both left and right hemisphere V1 areas was significantly greater but ALFF was significantly lower for SA compared to AA and HC groups. zALFF and zReHo analyses in the AA and SA groups indicated significantly higher activation than that in the HC group in the right FEF and IPS but lower than that in the HC group in the left FEF, and only the SA group showed lower activation in both V1 areas than the HC group. FC values of the right FEF–left V1, right FEF–right V1, and right FEF–right IPS pathways in the SA and AA groups were also significantly higher than those in the HC group whereas all other FC values were non-significant. Thus, this study indicates that even during resting-state the visual attention network function is impaired in SA and AA participants with only right hemisphere FEF showing significant activation in SA and IPS in AA suggesting that the slower saccade activation times characteristic of amblyopic eyes lead to the dominant eye controlling activation of the visual attention network.

Objective: Previous studies have demonstrated altered brain activity in strabismic amblyopia (SA). In this study, low-frequency repetitive transcranial magnetic stimulation (rTMS) was applied in children with strabismic amblyopia after they had undergone strabismus surgery. The effect of rTMS was investigated by measuring the changes of brain features using the amplitude of low-frequency fluctuation (ALFF). Materials and Methods: In this study, 21 SA patients (12 males and 9 females) were recruited based on their age (7–13 years old), weight, and sex. They all had SA in their left eyes and they received rTMS treatment one month after strabismus surgery. Their vision before and after surgery were categorized as pre-rTMS (PRT) and post-rTMS (POT). All participants received rTMS treatment, underwent magnetic resonance imaging (MRI), and their data were analyzed using the repeated measures t -test. The team used correlation analysis to explore the relationship between logMAR visual acuity and ALFF. Results: Pre- versus post-rTMS values of ALFF were significantly different within individuals. In the POT group, ALFF values were significantly decreased in the Angular_R (AR), Parietal_Inf_L (PIL), and Cingulum_Mid_R (CMR) while ALFF values were significantly increased in the Fusiform_R (FR) and Frontal_Inf_Orb_L(FIL) compared to the PRT stage. Conclusion: Our data showed that ALFF recorded from some brain regions was changed significantly after rTMS in strabismic amblyopes. The results may infer the pathological basis of SA and demonstrate that visual function may be improved using rTMS in strabismic amblyopic patients. [ABSTRACT FROM AUTHOR]

Strabismic amblyopia is characterized by a distorted spatial perception. In this condition, the neurofunctional disorder occurring during first years of life provoke several monocular and binocular anomalies such as crowding, deficits in the accommodative response, contrast sensitivity, and ocular motility abilities. The inhibition of the binocular function of the brain by the misaligned amblyopic eye induces a binocular imbalance leading to interocular suppression and the reduction or lack of stereoacuity. Passive treatments such as occlusion, optical and/or pharmacological penalization, and Bangerter foils has been demonstrated to be potentially useful treatments for strabismic amblyopia. Recent researches have proved new pharmacological options to improve and maintain visual acuity after occlusion treatment in strabismic amblyopia. Likewise, the active vision therapy, in the last years, is becoming a very relevant therapeutic option in combination with passive treatments, especially during and after monocular therapy, in the attempt of recovering the imbalanced binocular vision.

ObjectivePrevious studies have demonstrated altered brain activity in strabismic amblyopia (SA). In this study, low-frequency repetitive transcranial magnetic stimulation (rTMS) was applied in children with strabismic amblyopia after they had undergone strabismus surgery. The effect of rTMS was investigated by measuring the changes of brain features using the amplitude of low-frequency fluctuation (ALFF).Materials and MethodsIn this study, 21 SA patients (12 males and 9 females) were recruited based on their age (7–13 years old), weight, and sex. They all had SA in their left eyes and they received rTMS treatment one month after strabismus surgery. Their vision before and after surgery were categorized as pre-rTMS (PRT) and post-rTMS (POT). All participants received rTMS treatment, underwent magnetic resonance imaging (MRI), and their data were analyzed using the repeated measures t-test. The team used correlation analysis to explore the relationship between logMAR visual acuity and ALFF.ResultsPre- versus post-rTMS values of ALFF were significantly different within individuals. In the POT group, ALFF values were significantly decreased in the Angular_R (AR), Parietal_Inf_L (PIL), and Cingulum_Mid_R (CMR) while ALFF values were significantly increased in the Fusiform_R (FR) and Frontal_Inf_Orb_L(FIL) compared to the PRT stage.ConclusionOur data showed that ALFF recorded from some brain regions was changed significantly after rTMS in strabismic amblyopes. The results may infer the pathological basis of SA and demonstrate that visual function may be improved using rTMS in strabismic amblyopic patients.

Aim: To evaluate the changes of vessel densities and retinal nerve fiber layer thicknesses in strabismic amblyopia. Materials and Methods: Fifteen cases with unilateral strabismic amblyopia and 20 healthy subjects were enrolled. The vessel densities in the superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillary plexus (CCP), foveal avascular zone (FAZ) and foveal vessel density (FD-300) were assessed using OCT-A (AngioVue, RTVue XR Avanti; Optovue, Inc., Fremont, CA). Retinal nerve fiber layer thickness (RNFLT) measurements were evaluated using SS-OCT. Results: The mean foveal, parafoveal, and perifoveal vessel densities in SCP, DCP, CCP and FAZ area were similar between the amblyopic, fellow and healthy eyes. The RNFLT in all quadrants were higher in amblyopic eyes compared to fellow eyes and controls and the difference was statistically significant in the nasal quadrant (p<0.001). Conclusion: Our results indicate that the vessel densities in retinal vascular plexuses, CCP and FAZ area were similar in amblyopic eyes, fellow eyes and healthy controls. Further large scale studies will be valuable. [ABSTRACT FROM AUTHOR]

Background: Previous studies have demonstrated that strabismus amblyopia can result in markedly brain function alterations. However, the differences in spontaneous brain activities of strabismus amblyopia (SA) patients still remain unclear. Therefore, the current study intended to employthe voxel-mirrored homotopic connectivity (VMHC) method to investigate the intrinsic brain activity changes in SA patients.Purpose: To investigate the changes in cerebral hemispheric functional connections in patients with SA and their relationship with clinical manifestations using the VMHC method.Material and Methods: In the present study, a total of 17 patients with SA (eight males and nine females) and 17 age- and weight-matched healthy control (HC) groups were enrolled. Based on the VMHC method, all subjects were examined by functional magnetic resonance imaging. The functional interaction between cerebral hemispheres was directly evaluated. The Pearson's correlation test was used to analyze the clinical features of patients with SA. In addition, their mean VMHC signal values and the receiver operating characteristic curve were used to distinguish patients with SA and HC groups.Results: Compared with HC group, patients with SA had higher VMHC values in bilateral cingulum ant, caudate, hippocampus, and cerebellum crus 1. Moreover, the VMHC values of some regions were positively correlated with some clinical manifestations. In addition, receiver operating characteristic curves presented higher diagnostic value in these areas.Conclusion: SA subjects showed abnormal brain interhemispheric functional connectivity in visual pathways, which might give some instructive information for understanding the neurological mechanisms of SA patients. [ABSTRACT FROM AUTHOR]

Background: Treatment of amblyopia in esotropic subjects with accommodative component currently consists of optical correction and subsequent occlusion, or penalisation, of the dominant eye. This treatment obtains a good outcome in visual acuity but poor outcomes in binocular vision. An intervention protocol that could improve the outcome of conventional treatment is presented. Methods: A retrospective study in subjects with amblyopia associated with both fully accommodative and partially accommodative esotropia is presented. Subjects were refracted under cycloplegia and treated with occlusion (passive therapy). Subjects who did not achieve orthotropia through optical correction (partially accommodative esotropia) performed an active therapy (full‐time prismatic correction and subsequent fusional vergence therapy or surgery in larger angles > 12 prism dioptres). After treatment, the subjects were examined by a masked optometrist in an external ophthalmology clinic. Results: Twenty‐six subjects (12 males and 14 females) aged from six to 13 years (median 8.50; interquartile range [IQR] 3) were included. Median age of detection was three years (IQR 1). All the subjects were hyperopic. In the baseline, median best‐corrected visual acuity of the amblyopic eye was 0.40 logMAR (IQR 0.30) and 0.00 logMAR (IQR 0.01) in the dominant eye. After the treatment, the median best‐corrected visual acuity in the amblyopic eye was 0.06 logMAR (IQR 0.08). These differences were statistically significant (p < 0.001). All subjects acquired stereoacuity equal or better than 800′′ with the Randot Preschool Stereoacuity Test. Conclusions: The proposed treatment highlights the management of amblyopia in esotropic subjects with accommodative component. This intervention protocol could help to determine if the treatment has to be passive (in fully accommodative esotropia) or a combination of passive and active therapies (in partially accommodative esotropia). [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the superficial retinal vascular plexus density using optical coherence tomography angiography (OCTA) in cases of strabismic amblyopia. Methods: Ten eyes of 10 patients with purely strabismic amblyopia underwent detailed ocular evaluation followed by the assessment of the superficial retinal plexus vascular density using OCTA (Topcon DRI OCT Triton, Swept Source OCT, Topcon, Japan). Ten contralateral normal eyes of the same patients were considered as control. All these 20 eyes underwent a 4.5 × 4.5 mm cube scan OCTA centered at the fovea. Using the Topcon propriety software all 20 eyes were assessed for the capillary plexus density of the superficial retinal vascular plexus along the superior, inferior, nasal, and temporal quadrants centered at the fovea. The numerical values were statistically assessed using a paired t-test with respect to each quadrant between the normal and the pathological eyes. Results: The average age of patients was 16 years and eight patients were males. The mean superficial retinal vascular plexus density along the superior, inferior, nasal, and temporal quadrants in normal and pathological eyes were 49.25 ± 30.34 and 48.93 ± 2.85, 47.22 ± 4.11 and 47.37 ± 4.8, 45.54 ± 1.55 and 43.81 ± 4.21, and 46.26 ± 4.63 and 46.38 ± 5.40, respectively. Similarly, the capillary densities along the central were 17.84 ± 3.49 and 17.24 ± 2.44 in normal and pathological eyes. The differences among all these four quadrants and central area were not statistically significant (P-values > 0.05 for all four quadrants and central area) as compared with the normal eyes. Conclusion: The superficial retinal vascular plexus density of a 4.5 × 4.5 mm cube centered at the fovea of eyes of cases of strabismic amblyopia is similar to that of normal eyes.

The present study aimed to compare the regional homogeneity (ReHo) of resting-state brain function between subjects with strabismic amblyopia and normal controls. A total of 12 adult patients with strabismic amblyopia and 34 age- and gender-matched normal controls were enrolled in the present study. All patients were subjected to resting-state magnetic resonance imaging using a Siemens Trio 3.0T magnetic resonance scanner. ReHo values of the whole brain were calculated and standardized. An independent-samples t-test was used to analyze the differences in ReHo values between the two groups. Patients with strabismic amblyopia exhibited reduced ReHo values in certain parts of the occipital lobe, including the lingual gyrus, cuneus and superior occipital gyrus. Increased ReHo values were observed in the precuneus and certain parts of the prefrontal cortex of patients with strabismic amblyopia, including the superior frontal gyrus and middle frontal gyrus. The ReHo index of the precuneus was negatively correlated with age. However, there was no correlation between the ReHo values and the visual acuity of patients with strabismic amblyopia. ROC curve analysis demonstrated that the greatest area under curve (AUC) value was in the medial prefrontal cortex (AUC=0.864). The results of the present study suggested that visual information processing may be impaired in visual areas V1 and V2. Furthermore, adult patients with strabismic amblyopia exhibited brain plasticity that compensated for visuomotor coordination and visuospatial imagery deficits. [ABSTRACT FROM AUTHOR]

In this study, we aimed to explore an objective, sensitive and quantitative measurement of interocular suppression in strabismic amblyopia. We compared 11 strabismic subjects with 12 normal vision subjects to explore the different response characterizations in normal eyes, nondominant and dominant eyes of strabismic subjects by using steady-state motion visual evoked potentials (SSMVEPs). Stimulation at different temporal frequencies was presented to two eyes by using an interocular dichoptic technique. Furthermore, canonical correlation analysis (CCA), signal-to-noise ratio (SNR) and some statistical methods, such as the paired t-test, analysis of variance (ANOVA) and correlation analysis, were used to analyze electroencephalography (EEG) signals. We proposed two indices-divergence J and suppression imbalance (SI) to describe the deficits in interocular suppression-and one index - mask attenuation coefficient (MAC)- to describe the influence of a dichoptic mask from the dominant eyes to nondominant eyes of strabismic subjects. A significant difference was found between nondominant and dominant eyes of strabismic subjects in SSMVEP response and SNR value while no apparent difference was observed between the two eyes in subjects with normal vision. There was a strong linear correlation between divergence J, SI and visual acuity difference of two eyes both in strabismic amblyopia and normal vision. A linear correlation was also found between visual acuity difference and MAC in patients with strabismic amblyopia. Our findings suggest that SSMVEPs can be an objective and quantitative method for measuring the interocular suppression in strabismus and assessing the deficits of strabismic amblyopia. [ABSTRACT FROM AUTHOR]

Purpose: Strabismus and anisometropia are the most common causes of amblyopia. It can be easily prevented or treated if detected early. With the changing socio-cultural-economic milieu of the society, the perspectives of strabismus in society are gradually changing but still adequate knowledge, awareness, and attitude of parents toward strabismus will help in preventing amblyopia and aid in the proper psychosocial adaptation of such children. This study aimed to assess knowledge and attitude of parents toward children suffering from strabismus. Methods: A prospective study was carried out from January 1 to February 29, 2016, through a structured questionnaire to assess the level of knowledge and attitude of parents of children suffering from strabismus. Results: One hundred and twenty parents of children with strabismus were interviewed through a questionnaire. Education level of 78 parents was less than graduation (60%) and of 42 parents (40%) was graduation or higher. The majority of the parents, i.e., 116 (96.67%) were bothered due to strabismus. One hundred and one (84.17%) parents felt that their child's strabismus was noticed by others during interaction. Seventy-four (61.67%) parents felt that their children will have difficulty in making friends. Ninety (75%) parents felt uncomfortable if someone asked something about their child's strabismus. One hundred and ten (91.67%) parents considered strabismus as cosmetic stigma. Conclusion: Some parents, especially from the lower educated segment, had poor understanding of strabismus, thus resulting in late presentation and ineffective countermeasures. The key to prevent strabismic amblyopia and its psychosocial impacts is to provide health education regarding strabismus.

Background: Strabismic children develop early motor and/or sensory complications (amblyopia, poor fixation of the eye, impaired fusion, and impaired binocular vision). The major goals of treatment for strabismic amblyopia are to remove strabismus, to improve the vision of the amblyopic eye, and to restore the binocular vision. Prisms and apparatus-based orthoptics techniques have been used for a long time for the treatment of impairments in binocular vision. In Ukraine, the technology for manufacture of spheroprismatic lenses designed as microprismatic combination eyeglasses was developed in 2009. Purpose: To investigate the effect of microprismatic glasses versus apparatus-based pleoptics-and-orthoptics techniques on the character of binocular vision in children with strabismic amblyopia. Materials and Methods: One hundred and forty nine children with strabismic amblyopia aged 4 to 18 years were included into the study. Concomitant esotropia and exotropia were found in 77 children and 11 children, respectively, of the study group, versus 54 children and 7 children, respectively, of the control group. Six children (6.8%) of the study group, versus 13 children (21.3%) of the control group were those with partially accommodative strabismus, whereas the rest were those with non-accommodative strabismus. Children of the study group were treated with microprismatic glasses, whereas those of the control group were treated with apparatus-based techniques. Results: At 6 months, binocular single vision was obtained in 20 children (22.7%) of the study group versus only one child (3.0%) with low amblyopia of the control group. In addition, diplopia was present in 51 children (58.0%) of the study group versus 10 children (16.4%; 8 children (13.1%) at baseline) in the control group. Conclusion: The treatment proposed for strabismic amblyopia (a) requires no additional time, (b) has good outcomes, (c) is suitable for patients, and (c) is more efficacious than conventional apparatus-based pleoptics-and-orthoptics therapy.

To investigate the effect of anisometropic and strabismic amblyopia on the nerve fiber layer thickness. This cross-sectional study was done on 54 amblyopic subjects, equally in both strabismic and anisometropic groups. The thickness otonerve fiber layer measured in superior, inferior, nasal, temporal quadrants and as a whole in both eyes of both groups. The means of thickness were compared in amblyopic and sound eyes. In strabismus group, the average nerve fiber layer thickness of the sound eye , in superior, inferior, nasal and temporal quadrants and as a whole were 113.23±14, 117.37±25, 68.96±6, 69.55±14 and 93.40±8 microns respectively. In amblyopic eyes of the same group, these measurements were 103.11±18, 67.74±11, and 69.59±16 and 89.59±12 microns in superior, inferior, nasal, temporal quadrants and as whole respectively. In anisometropic groups, the sound eye measurements were as 130.96±22, 129.07±29, 80.62±12, and 83.88±20 and 107.7±13 microns in superior, inferior, nasal and temporal quadrants and as a whole orderly. In amblyopic eyes of this group the mean thicknesses were 115.63±29, 133.15±25, 78.8±15, 80.2±16 and 109.17±21 microns in superior, inferior, nasal, temporal quadrants and as a whole respectively. Statistically, there were no significant differences between amblyopic and sound eyes (P>0.5). Our study did not support any significant change in a nerve fiber layer thickness of amblyopic patients; however, decreased thickness in superior and nasal quadrants of strabismic amblyopia and except inferior quadrant and as a whole. These measurements may be a clue for management and prognosis of amblyopia in old age.

AIM: To detect the macular ganglion cell complex thickness in monocular strabismus amblyopia patients, in order to explore the relationship between the degree of amblyopia and retinal ganglion cell complex thickness, and found out whether there is abnormal macular ganglion cell structure in strabismic amblyopia. METHODS: Using a fourier-domain optical coherence tomography(FD-OCT)instrument iVue®(Optovue Inc, Fremont, CA), Macular ganglion cell complex(mGCC)thickness was measured and statistical the relation rate with the best vision acuity correction was compared Gman among 26 patients(52 eyes)included in this study. RESULTS: The mean thickness of the mGCC in macular was investigated into three parts: centrial, inner circle(3mm)and outer circle(6mm). The mean thicknesses of mGCC in central, inner and outer circle was 50.74±21.51μm, 101.4±8.51μm, 114.2±9.455μm in the strabismic amblyopia eyes(SAE), and 43.79±11.92μm,92.47±25.01μm, 113.3±12.88μm in the contralateral sound eyes(CSE)respectively. There was no statistically significant difference among the eyes(P>0.05). But the best corrected vision acuity had a good correlation rate between mGcc thicknesses, which was better relative for the lower part than the upper part.CONCLUSION:There is a relationship between the amblyopia vision acuity and the mGCC thickness. Although there has not statistically significant difference of the mGCC thickness compared with the SAE and CSE. To measure the macular center mGCC thickness in clinic may understand the degree of amblyopia.

Amblyopia is a developmental disorder of vision associated with abnormal visual stimulation during early childhood. It is known that amblyopia may affect not only spatial vision parameters but also oculomotor behavior. Several previous studies showed that increased saccadic reaction time (latency) may be present in amblyopic subjects. In our recent work, we have demonstrated that not only amblyopic but also a dominant eye may show increased saccadic latency in strabismic individuals. Since saccadic latency can be considered as a decision time, we have applied LATER (Linear Approach to Threshold with Ergodic Rate) decision model to find out how developmental impairment of visual input affects visual decision-making processes, as well as to verify whether amblyopia affects also the cortical ability to inhibit more primitive, early saccadic responses during our modified delayed saccade task. Ten subjects with strabismic amblyopia and twelve control subjects were examined. As we expected, strabismic amblyopes showed decreased rate of rise of the neural decision signal for all viewing conditions as compared to controls. In addition, the comparison between the strabismic and anisometropic groups revealed that the amblyopic eye in strabismic subjects showed decreased rate of rise of the decision signal as compared to amblyopic eye in anisometropic subjects. Although we speculated that amblyopia may reduce the ability of cortical control and favor more reflexive, early saccadic actions to occur, our findings did not confirm this hypothesis. This study provide further evidence that amblyopia is associated with cortical deficits which affect the cortical decision about saccade initiation. [ABSTRACT FROM AUTHOR]

Purpose: Strabismus and anisometropia are the most common causes of amblyopia. It can be easily prevented or treated if detected early. With the changing socio-cultural-economic milieu of the society, the perspectives of strabismus in society are gradually changing but still adequate knowledge, awareness, and attitude of parents toward strabismus will help in preventing amblyopia and aid in the proper psychosocial adaptation of such children. This study aimed to assess knowledge and attitude of parents toward children suffering from strabismus.Methods: A prospective study was carried out from January 1 to February 29, 2016, through a structured questionnaire to assess the level of knowledge and attitude of parents of children suffering from strabismus.Results: One hundred and twenty parents of children with strabismus were interviewed through a questionnaire. Education level of 78 parents was less than graduation (60%) and of 42 parents (40%) was graduation or higher. The majority of the parents, i.e., 116 (96.67%) were bothered due to strabismus. One hundred and one (84.17%) parents felt that their child's strabismus was noticed by others during interaction. Seventy-four (61.67%) parents felt that their children will have difficulty in making friends. Ninety (75%) parents felt uncomfortable if someone asked something about their child's strabismus. One hundred and ten (91.67%) parents considered strabismus as cosmetic stigma.Conclusion: Some parents, especially from the lower educated segment, had poor understanding of strabismus, thus resulting in late presentation and ineffective countermeasures. The key to prevent strabismic amblyopia and its psychosocial impacts is to provide health education regarding strabismus. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to compare the demographic features, visual acuities before and after treatment, amblyopia and strabismus degrees and binocular visual functions in cases with anisometropic, strabismic and/or anisometropic amblyopia. Material and Method: The study included 50 anisometropic, 50 strabismic and 50 anisometropic and strabismic cases that were followed up with the diagnosis of amblyopia, in our clinic, between January 2007 - September 2010. Amblyopia criteria was defined as the best corrected visual acuity of ≤0.8 and at least 2 lines difference between the visual acuities of two eyes. Anisometropia was defined as ≥1D difference in the spherical and cylindrical value between two eyes. Results: The groups were statistically similar in means of age and sex distribution. Visual acuities in amblyopic eyes before and after treatment were also statistically similar. There were no significant difference between 3 groups in means of compliance to occlusion therapy. In anisometropic cases, anisometropic spherical values were found to have position correlation with amblyopia degree. In hypermetropic and myopic cases, a strong correlation was shown between anisometropia and amblyopia, especially in hypermetropic cases, amblyopia degree increased as the anisometropia increased. In all strabismus cases, a positive correlation between strabismus and amblyopia degrees was shown even though it was statistically insignificant. In strabismic cases, esotropia was significantly higher than exotropia. In anisometropia group, stereopsis and fusion was found to be preserved better in comparison to the strabismic cases. It was concluded that deviation had a more profound effect on binocular function loss than anisometropia. Discussion: We recommend to follow the hypermetropic anisometropic cases and especially cases with high degree strabismus and esotropia more closely. And also we emphasize that strabismus affects binocular function loss more than anisometropia, even though the anisometropic cases had higher degree of amblyopia they had a better prognosis than the strabismus cases. (Turk J Ophthalmol 2013; 43: 326-34)

Pur po se: To measure the macular and retinal nerve fiber layer (RNFL) thicknesses using optical coherence tomography (OCT) in amblyopic eyes of unilateral strabismic and anisometropic patients and to compare the results with those of their normal eyes and with a control group. Ma te ri al and Met hod: 30 strabismic and 30 anisometropic amblyopic patients who were followed by Atatürk Training and Research Hospital Strabismus section between September 2009 and February 2010 and 30 healthy children who were examined in the out-patient clinic were included in the study. The amblyopic eyes of the amblyopic patients were compared with their normal eyes andwith the right eyes of the healthy patients. After detailed ophthalmologic examination, macular thickness, central foveal, parafoveal and perifoveal volumes and RNFL thickness of the cases were measured with OCT and compared statistically. A p-value of less than 0.05 was accepted as statistically significant. Re sults: Foveal volume of the amblyopic eyes of strabismic and anisometropic amblyopic cases (0.20mm3; 0.21mm3, respectively) was statistically higher than in the control group (0.19 mm3) (p=0.002).As the level of amblyopia increased, there was an increase in foveal volume. Central foveal thickness (CFT) of the amblyopic eyes of strabismic and amblyopic patients (258 μm and 260 μm, respectively) was higher than in the control group (244 μm), which was statistically significant difference (p=0.010). Similarly, as the level of amblyopia increased, there was an increase in CFT. When strabismic and amblyopic cases were compared, no statistical difference was observed between foveal volumes (central-parafoveal-perifoveal) and CFT results (p>0.05). There was no difference in RNFL thickness of strabismic, anisometropic and control cases (p>0.05). In addition, no significant difference was detected between the normal eyes of the amblyopic patients and the control group (p>0.05). Dis cus si on: Although the primary site of deficit is in the visual cortex in amblyopia, secondary changes occur in the retina as well. While RNFL thickness does not differ from that in normal eyes, the thickness and volume of the fovea of amblyopic eyes are higher than in normal individuals. As a result, amblyopia not only affects the visual cortex, but gives rise to secondary changes at retinal level. (Turk J Ophthalmol 2011; 41: 318-24)

To investigate the effect of anisometropic and strabismic amblyopia on the nerve fiber layer thickness. This cross-sectional study was done on 54 amblyopic subjects, equally in both strabismic and anisometropic groups. The thickness otonerve fiber layer measured in superior, inferior, nasal, temporal quadrants and as a whole in both eyes of both groups. The means of thickness were compared in amblyopic and sound eyes. In strabismus group, the average nerve fiber layer thickness of the sound eye , in superior, inferior, nasal and temporal quadrants and as a whole were 113.23±14, 117.37±25, 68.96±6, 69.55±14 and 93.40±8 microns respectively. In amblyopic eyes of the same group, these measurements were 103.11±18, 67.74±11, and 69.59±16 and 89.59±12 microns in superior, inferior, nasal, temporal quadrants and as whole respectively. In anisometropic groups, the sound eye measurements were as 130.96±22, 129.07±29, 80.62±12, and 83.88±20 and 107.7±13 microns in superior, inferior, nasal and temporal quadrants and as a whole orderly. In amblyopic eyes of this group the mean thicknesses were 115.63±29, 133.15±25, 78.8±15, 80.2±16 and 109.17±21 microns in superior, inferior, nasal, temporal quadrants and as a whole respectively. Statistically, there were no significant differences between amblyopic and sound eyes (P>0.5). Our study did not support any significant change in a nerve fiber layer thickness of amblyopic patients; however, decreased thickness in superior and nasal quadrants of strabismic amblyopia and except inferior quadrant and as a whole. These measurements may be a clue for management and prognosis of amblyopia in old age. [ABSTRACT FROM AUTHOR]