Clinical Course and Response to Therapy in Different Types of Amblyopia

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)