title: Visual outcome in isoametropic amblyopic children with high hyperopia and the effect of therapy on retinal thickness.
abstract: OBJECTIVE
  To assess correlations between associated factors and treatment outcome of isoametropic amblyopia attributable to high hyperopia in children and to evaluate changes in retinal thickness during amblyopic treatment.
  
  
  METHODS
  Retrospective (visual outcome) and prospective (retinal thickness) study.
  
  
  METHODS
  Isoametropic (spherical equivalent ≥5.00 diopters in both eyes) amblyopic subjects (n = 217) with corrected visual acuity (VA) ≤0.5 (20/40) for children <5 years old and VA ≤0.6 (20/32) for children 6-10 years old were included. Sixty-nine of these children had refractive accommodative esotropia. All subjects were treated by full-time wearing of optical correction. The magnitude of spherical equivalent hyperopia, age at first treatment, VA, treatment duration, and binocular alignment were analyzed. Thicknesses of the retinal macula and nerve fiber layer were measured using optical coherence tomography in selected amblyopic children (n = 27) during treatment and in control subjects (n = 31).
  
  
  RESULTS
  The mean follow-up was 28.8 months. The age at first optical correction ranged from 3 to 10 years. The mean VA improved from 0.38 to 0.82, with 74.7% having acuity ≥0.8 and 28.6% having acuity ≥1.0. VA improvement was positively correlated with duration of treatment and negatively correlated with age at first correction. Foveal thickness slightly decreased after treatment; however, it was not correlated with visual improvement.
  
  
  CONCLUSIONS
  Visual acuity of isoametropic amblyopia improved satisfactorily with spectacle correction and vision therapy. Treatment duration had the greatest impact on VA improvement. Age at first correction also influenced VA improvement but was not a good clinical predictor. Foveal thinning occurring with treatment was not correlated with visual improvement.
authors.affiliation: School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical College, Wenzhou, Zhejiang, China.
authors.forename: Wuhe
authors.initials: W
authors.lastname: Chen
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.forename: Fang
authors.initials: F
authors.lastname: Zhang
authors.forename: Xixi
authors.initials: X
authors.lastname: Zhu
authors.forename: Fan
authors.initials: F
authors.lastname: Lu
mesh_terms: D000550:Amblyopia / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005139:Eyeglasses; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia / Q000150:complications*; D008297:Male; D008405:Massage; D011446:Prospective Studies; D012160:Retina / Q000503:physiopathology*; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D015348:Vision, Binocular; D014792:Visual Acuity / Q000502:physiology*