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Fixation stability improvement after occlusion treatment for severe amblyopia

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Abstract

Background

To investigate the improvement of fixation stability of severe amblyopia with traditional patching treatment by the MP-1 microperimeter.

Methods

Eighteen patients with severe unilateral amblyopia were enrolled and received prescribed 6 h per day of patching of the fellow eye with optical correction if needed. Fixation test was performed on eighteen severe unilateral amblyopia patients by the MP-1 microperimeter in baseline, 3-month and 6-month after treatment. The bivariate contour ellipse area (BCEA, deg2) was used to quantify fixation stability.

Results

The RMANOVA showed that significant differences were found in best-corrected visual acuity (BCVA) between amblyopia eyes/fellow eyes (AE/FE) group (F = 113.52, p < 0.001) and among follow-up time (F = 74.684, p < 0.001). Moreover, a significant interaction could be found between AE/FE group and follow-up time (baseline/3-month/6-month, F = 60.189, p < 0.001). Post hoc analysis by Bonferroni showed significant improvement of BCVA in AE at 3-month (p < 0.001) and 6-month (p < 0.001), compared to baseline, and also significant between 3-month and 6-month (p = 0.002). The RMANOVA showed that significant differences were found in BCEA between AE/FE group (F = 8.432, p = 0.006) and among follow-up time (F = 10.431, p = 0.003). Moreover, a significant interaction could be found between AE/FE group and follow-up time (F = 9.099, p = 0.005). The mean BCEA of AE changed from 13.14 ± 17.97 deg2 at baseline to 6.03 ± 7.27 deg2 at 3-month (p = 0.084) and 3.38 ± 6.40 deg2 at 6-month (p = 0.018). No significant difference of BCEA in fellow eyes was found during the follow-up period (between baseline and 3-month: p = 0.230; between baseline and 6-month: p = 0.692. 0.89 ± 1.02, 0.58 ± 0.40, and 0.03 ± 0.04 deg2 for baseline, 3-month and 6-month, respectively). No significant correlation could be found between BCEA and BCVA of AE, both in enrollment and follow-up (p > 0.05).

Conclusions

The fixation stability in the amblyopic eyes is significantly worse than that of the fellow eyes in patients with unilateral severe amblyopia. The fixation stability became better after 6-month occlusion treatment, but the change of fixation stability was not correlated with visual acuity improvement. These quantitative results highlight the importance of fixation in the mechanism of amblyopia.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

BCEA:

Bivariate contour ellipse area

BCVA:

Best-corrected visual acuity

AE:

Amblyopia eye

FE:

Fellow eye

VA:

Visual acuity

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Funding

This work was supported by the National Nature Science Foundation of China [Grant Numbers 81770957; 81500752], Shanghai Hospital Development Center (SHDC12020116), Pudong New Area Municipal Health Bureau (PW2020E-3), the National Health and Family Planning Commission of China [Grant Numbers 201302015].

Author information

Author notes

  1. Shu Wang and Leilei Zou both authors contributed equally to this work.

Authors and Affiliations

  1. Department of Ophthalmology, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Shu Wang, Leilei Zou & Hong Liu

  2. Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China

    Shu Wang, Tian Tian, Yan Liu, Wen Wen & Hong Liu

  3. State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China

    Shu Wang, Tian Tian, Yan Liu, Wen Wen & Hong Liu

  4. Key Laboratory of Myopia, Fudan University, Ministry of Health, Shanghai, China

    Shu Wang, Tian Tian, Yan Liu, Wen Wen & Hong Liu

  5. Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China

    Shu Wang, Tian Tian, Yan Liu, Wen Wen & Hong Liu

  6. Jinshan Tinglin Hospital, Shanghai, China

    Aiqin Zhan

Authors
  1. Shu Wang
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  2. Leilei Zou
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  3. Tian Tian
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  4. Aiqin Zhan
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  5. Yan Liu
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  6. Wen Wen
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  7. Hong Liu
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Contributions

WS performed the fixation test for the patients and was a major contributor in writing the manuscript. ZLL analyzed and interpreted the patient data. TT, ZAQ and LY provided assistance in data analysis and writing of the manuscript. LH and WW made primary contributions to the design of this study and acquisition of patients. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Wen Wen or Hong Liu.

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Conflict of interest

The authors declare that they have no competing interests.

Consent for publication

Consent for publication was obtained from all participants.

Ethical approval

This study was approved by the Ethics Committee of Eye & ENT Hospital and followed the tenets of the Declaration of Helsinki. Informed consent was obtained from all participants.

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Wang, S., Zou, L., Tian, T. et al. Fixation stability improvement after occlusion treatment for severe amblyopia. Int Ophthalmol 42, 1007–1012 (2022). https://doi.org/10.1007/s10792-021-02084-6

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  • DOI: https://doi.org/10.1007/s10792-021-02084-6

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