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Refractive error change and vision improvement in moderate to severe hyperopic amblyopia after spectacle correction: Restarting the emmetropization process?

PURPOSE: The aims of the study were to develop guidelines for prescribing spectacles for patients with moderate to severe hyperopic amblyopia and to demonstrate how emmetropization progresses. METHODS: Children with hyperopic amblyopia who had a spherical equivalent of ≥ +4.0 diopters (D) or more we...

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Autor principal: Chang, Ji Woong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5397024/
https://www.ncbi.nlm.nih.gov/pubmed/28423020
http://dx.doi.org/10.1371/journal.pone.0175780
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author Chang, Ji Woong
author_facet Chang, Ji Woong
author_sort Chang, Ji Woong
collection PubMed
description PURPOSE: The aims of the study were to develop guidelines for prescribing spectacles for patients with moderate to severe hyperopic amblyopia and to demonstrate how emmetropization progresses. METHODS: Children with hyperopic amblyopia who had a spherical equivalent of ≥ +4.0 diopters (D) or more were included, while those who had astigmatism of > 2.0 D or anisometropia of > 2.0 D were excluded. The patients were divided into a full correction group and an under-correction group according to the amount of hyperopia correction applied. The under-correction group was further subdivided into a fixed under-correction group and a post-cycloplegic refraction (PCR) under-correction group. The duration of amblyopia treatment and changes in initial hyperopia were compared between the groups. RESULTS: In total, 76 eyes of 38 patients were analyzed in this study. The full correction group and under-correction group were subjected to 5.5 months and 5.9 months of amblyopia treatment, respectively (P = 0.570). However, the PCR under-correction group showed more rapid improvement (2.9 months; P = 0.001). In the under-correction group, initial hyperopia was decreased by -0.28 D and -0.49 D at 6 months and 12 months, respectively, after initial cycloplegic refraction. Moreover, the amount of hyperopia under-correction was correlated with the amount of hyperopia reduction (P = 0.010). CONCLUSION: The under-correction of moderate to severe hyperopic amblyopia has beneficial effects for treating amblyopia and activating emmetropization. PCR under-correction can more rapidly improve visual acuity, while both fixed under-correction and PCR under-correction can induce emmetropization and effectively reduce initial hyperopia.
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spelling pubmed-53970242017-05-04 Refractive error change and vision improvement in moderate to severe hyperopic amblyopia after spectacle correction: Restarting the emmetropization process? Chang, Ji Woong PLoS One Research Article PURPOSE: The aims of the study were to develop guidelines for prescribing spectacles for patients with moderate to severe hyperopic amblyopia and to demonstrate how emmetropization progresses. METHODS: Children with hyperopic amblyopia who had a spherical equivalent of ≥ +4.0 diopters (D) or more were included, while those who had astigmatism of > 2.0 D or anisometropia of > 2.0 D were excluded. The patients were divided into a full correction group and an under-correction group according to the amount of hyperopia correction applied. The under-correction group was further subdivided into a fixed under-correction group and a post-cycloplegic refraction (PCR) under-correction group. The duration of amblyopia treatment and changes in initial hyperopia were compared between the groups. RESULTS: In total, 76 eyes of 38 patients were analyzed in this study. The full correction group and under-correction group were subjected to 5.5 months and 5.9 months of amblyopia treatment, respectively (P = 0.570). However, the PCR under-correction group showed more rapid improvement (2.9 months; P = 0.001). In the under-correction group, initial hyperopia was decreased by -0.28 D and -0.49 D at 6 months and 12 months, respectively, after initial cycloplegic refraction. Moreover, the amount of hyperopia under-correction was correlated with the amount of hyperopia reduction (P = 0.010). CONCLUSION: The under-correction of moderate to severe hyperopic amblyopia has beneficial effects for treating amblyopia and activating emmetropization. PCR under-correction can more rapidly improve visual acuity, while both fixed under-correction and PCR under-correction can induce emmetropization and effectively reduce initial hyperopia. Public Library of Science 2017-04-19 /pmc/articles/PMC5397024/ /pubmed/28423020 http://dx.doi.org/10.1371/journal.pone.0175780 Text en © 2017 Ji Woong Chang http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Chang, Ji Woong
Refractive error change and vision improvement in moderate to severe hyperopic amblyopia after spectacle correction: Restarting the emmetropization process?
title Refractive error change and vision improvement in moderate to severe hyperopic amblyopia after spectacle correction: Restarting the emmetropization process?
title_full Refractive error change and vision improvement in moderate to severe hyperopic amblyopia after spectacle correction: Restarting the emmetropization process?
title_fullStr Refractive error change and vision improvement in moderate to severe hyperopic amblyopia after spectacle correction: Restarting the emmetropization process?
title_full_unstemmed Refractive error change and vision improvement in moderate to severe hyperopic amblyopia after spectacle correction: Restarting the emmetropization process?
title_short Refractive error change and vision improvement in moderate to severe hyperopic amblyopia after spectacle correction: Restarting the emmetropization process?
title_sort refractive error change and vision improvement in moderate to severe hyperopic amblyopia after spectacle correction: restarting the emmetropization process?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5397024/
https://www.ncbi.nlm.nih.gov/pubmed/28423020
http://dx.doi.org/10.1371/journal.pone.0175780
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