Amblyopia – standard or modern therapy

Main Article Content

Magdalena Derebecka
Andrzej Grzybowski

Abstract

According to the World Health Organization, amblyopia and associated uncorrected refractive errors are the most common causes of visual disorders. Amblyopia is defined as the reduction of the best-corrected visual acuity in one or, less frequently, in both eyes. It is a neurodevelopmental disorder that occurs in childhood and results in the discontinuation of normal cortical visual pathways. Until recently, it was believed that due to the lack of sufficient plasticity of the central nervous system in adults, amblyopia is incurable after the end of the critical period, i.e. around 7 years of age. However, recent research results undermined this view, revealing underestimated recovery potential even in adulthood. Traditional methods of amblyopia treatment include correction of refractive errors and stimulation of the visually impaired eye by covering the dominant eye, most often by obturation or pharmacological penalisation with atropine. Preliminary results of research on modern methods of therapy, such as video games, perceptual learning or dichoptic training, provide opportunities not only to improve visual acuity, but also to relieve other visual deficiencies associated with ambliopia, such as reduced sensitivity to contrast or spatial vision.

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How to Cite
1.
Derebecka M, Grzybowski A. Amblyopia – standard or modern therapy. Ophthatherapy [Internet]. 2019Dec.31 [cited 2024Apr.20];6(4):244-50. Available from: https://journalsmededu.pl/index.php/ophthatherapy/article/view/958
Section
Conservative treatment

References

1. Attebo K, Mitchell P, Cumming R et al. Prevalence and causes of amblyopia in an adult population. Ophthalmology 1998; 105: 154-9.
2. WHO: Global data on visual impairments 2010. Geneva, Switzerland, 2012. Online: https://www.who.int/blindness/GLOBALDATAFINALforweb.pdf.
3. Elflein HM. Amblyopie. Ophthalmologe 2016; 113: 283-8. https://doi.org/10.1007/s00347-016-0247-3.
4. Ramkumar VA, Agarkar S, Mukherjee B. Nasolacrimal duct obstruction: Does it really increase the risk of amblyopia in children? Indian J Ophthalmol 2016; 64(7): 496-499.
5. Mocanu V, Horhat R. Prevalence and Risk Factors of Amblyopia among Refractive Errors in an Eastern European Population. Medicina (Kaunas) 2018; 54(1): 6. https://doi:10.3390/medicina54010006.
6. Williams C. Amblyopia. BMJ Clin Evid 2009; 2009: 0709.
7. von Noorden GK, Crawford ML. The sensitive period. Trans Ophthalmol Soc U K 1979; 99: 442-6.
8. Barrett BT, Bradley A, Candy TR. The relationship between anisometropia and amblyopia. Prog Retin Eye Res 2013; 36: 120-158. https://doi.org/10.1016/j.preteyeres.2013.05.001.
9. Levi DM, McKee SP, Movshon JA. Visual deficits in anisometropia. Vision Res 2011; 51(1): 48-57.
10. Gawęcki M. Threshold Values of Myopic Anisometropia Causing Loss of Stereopsis. J Ophthalmol 2019; 2019: 2654170. https://doi.org/10.1155/2019/2654170.
11. Wallace DK, Lazar EL, Melia M et al. Stereoacuity in children with anisometropic amblyopia. J AAPOS 2011; 15(5): 455-61. https://doi.org/10.1016/j.jaapos.2011.06.007.
12. Gaier ED, Gise R, Heidary G. Imaging Amblyopia: Insights from Optical Coherence Tomography (OCT), Seminars in Ophthalmology 2019. https://doi.org/10.1080/08820538.2019.1620810.
13. Bloch D, Wick B. Differences between strabismic and anisometropic amblyopia: research findings and impact on management. Problems Optom 1991; 3: 276-92.
14. Taylor K, Elliott S. Interventions for strabismic amblyopia. Cochrane Database Syst 2014; Rev 7: CD006461.
15. Stewart CE, Moseley MJ, Fielder AR et al. Cooperative MOTAS Refractive adaptation in amblyopia: quantification of effect and implications for practice. Br J Ophthalmol 2004a; 88: 1552-6.
16. Chen PL, Chen JT, Tai MC et al. Anisometropic amblyopia treated with spectacle correction alone: possible factors predicting success and time to start patching. Am J Ophthalmol 2007; 143: 54-60.
17. Writing Committee for the Pediatric Eye Disease Investigator Group; Cotter SA, Foster NC, Holmes JM et al. Optical treatment of strabismic and combined strabismic anisometropic amblyopia. Ophthalmology 2012; 119: 150-8.
18. Scheiman MM, Hertle RW, Beck RW et al. Randomized trial of treatment of amblyopia in children aged 7 to 17 years. Arch Ophthalmol 2005; 123: 437-47.
19. Tan JH, Thompson JR, Gottlob I. Differences in the management of amblyopia between European countries. Br J Ophthalmol 2003; 87: 291-6.
20. Repka MX, Beck RW, Holmes JM et al. A randomized trial of patching regimens for treatment of moderate amblyopia in children. Arch Ophthalmol 2003; 121: 603-11.
21. Holmes JM, Kraker RT, Beck RW et al. A randomized trial of prescribed patching regimens for treatment of severe amblyopia in children. Ophthalmology 2003; 110: 2075-87.
22. Dixon-Woods M, Awan M, Gottlob I. Why is compliance with occlusion therapy for amblyopia so hard? A qualitative study. Arch Dis Child 2006; 91: 491-4.
23. Holmes JM, Edwards AR, Beck RW et al. A randomized pilot study of near activities versus non-near activities during patching therapy for amblyopia. J AAPOS 2005; 9: 129-36.
24. Foley-Nolan A, McCann A, O’Keefe M. Atropine penalisation versus occlusion as the primary treatment for amblyopia. Br J Ophthalmol 1997; 81: 54-7.
25. Pediatric Eye Disease Investigator Group: A randomized trial of atropine vs. patching for treatment of moderate amblyopia in children. Arch Ophthalmol 2002; 120: 268-78.
26. Pediatric Eye Disease Investigator Group Pharmacological plus optical penalization treatment for amblyopia: results of a randomized trial. Arch Ophthalmol 2009; 127: 22-30.
27. Laria C, Piñero DP, Alió JL. Characterization of Bangerter filter effect in mild and moderate anisometropic amblyopia: predictive factors for the visual outcome. Graefes Arch Clin Exp Ophthalmol 2011; 249: 759-66.
28.Wang J, Neely DE, Galli J et al. A pilot randomized clinical trial of intermittent occlusion therapy liquid crystal glasses versus traditional patching for treatment of moderate unilateral amblyopia. J AAPOS 2016; 20(4): 326-31. https://doi.org/10.1016/j.jaapos.2016.05.014.
29.Bonaccorsi J, Berardi N, Sale A. Treatment of amblyopia in the adult: insights from a new rodent model of visual perceptual learning. Front Neural Circuits 2014; 8: 82. https://doi.org/10.3389/fncir.2014.00082.
30. Levi DM, Li RW. Perceptual learning as a potential treatment for amblyopia: a mini-review. Vision Res 2009; 49(21): 2535-49. https://doi.org/10.1016/j.visres.2009.02.010.
31. Foss AJ. Use of video games for the treatment of amblyopia. Curr Opin Ophthalmol 2017; 28: 276-81.
32. Li RW, Ngo C, Nguyen J, Levi DM. Video-game play induces plasticity in the visual system of adults with amblyopia. PLoS Biol 2011; 9: 1001135.
33. Li J, Thompson B, Deng D, Chan LY et al. Dichoptic training enables the adult amblyopic brain to learn. Curr Biol 2013; 23: 308-9.
34. Lee HJ, Kim SJ. BMC Ophthalmol 2018; 18: 253. https://doi.org/10.1186/s12886-018-0922-z.
35. Papageorgiou E, Asproudis I, Maconachie G et al. The treatment of amblyopia: current practice and emerging trends. Graefe’s Archive for Clinical and Experimental Ophthalmology 2019. https://doi.org/10.1007/s00417-019-04254.
36. Thompson B, Mansouri B, Koski L et al. Brain plasticity in the adult: modulation of function in amblyopia with rTMS. Curr Biol 2008; 18: 1067-71.