title: Impact of cylinder axis on the treatment for astigmatic amblyopia.
abstract: OBJECTIVE
  To compare the effects of oblique astigmatism on refractive amblyopia in children aged 3-7 years with those having orthogonal astigmatism.
  
  
  METHODS
  A retrospective review of medical records.
  
  
  METHODS
  The medical records of patients attending Tri-Service General Hospital in Taiwan from January 2003 to December 2010 were reviewed and summarized. Seventy-two children with oblique astigmatism-related refractive amblyopia (Group 1) and 82 children with orthogonal astigmatism (Group 2) were chosen. Characteristics such as baseline visual acuity (VA), the time course of VA improvement, refractive error, and family history were assessed.
  
  
  RESULTS
  Group 1 showed a worse baseline mean VA (±SD) of 0.61 (0.13) vs 0.52 (0.16) logMAR (P = .01), a slower rate of amblyopia improvement, and higher prevalence of parental oblique astigmatism (29% vs 5.5%; P < .01) than did Group 2. The cylinder power of astigmatism (in D) causing amblyopia in Group 1 of 2.48 (0.82) was lower than that in Group 2: 2.93 (0.71) (P = .006). However, Group 1 achieved a noninferior resolution of amblyopia (mean final VA 0.18 vs 0.16 logMAR) after longer treatment of 6.45 (2.44) vs 5.86 (2.92) months (P = .039).
  
  
  CONCLUSIONS
  A smaller degree of initial oblique astigmatism caused amblyopia than did orthogonal astigmatism. Although the children with oblique astigmatism achieved equal resolution rates after treatment, this took longer. Therefore, we should pay more attention to children with mild oblique astigmatism, as they are more likely to develop oblique astigmatism-related amblyopia. Moreover, early diagnosis and prompt treatment might help visual improvement.
authors.affiliation: Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Ophthalmology, Tri-Service General Hospital Penghu Branch, Penghu, Taiwan.
authors.forename: Yen-Shou
authors.initials: YS
authors.lastname: Chou
authors.affiliation: Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Ming-Cheng
authors.initials: MC
authors.lastname: Tai
authors.affiliation: Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Hau-Ming Eye Clinic Center, Taipei, Taiwan.
authors.forename: Po-Liang
authors.initials: PL
authors.lastname: Chen
authors.affiliation: Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Da-Wen
authors.initials: DW
authors.lastname: Lu
authors.affiliation: Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan. Electronic address: yred8530@gmail.com.
authors.forename: Ke-Hung
authors.initials: KH
authors.lastname: Chien
mesh_terms: D000550:Amblyopia / Q000503:physiopathology / Q000628:therapy*; D001251:Astigmatism / Q000503:physiopathology / Q000628:therapy*; D001458:Bandages; D002648:Child; D002675:Child, Preschool; D005139:Eyeglasses; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000503:physiopathology*; D008297:Male; D009216:Myopia / Q000503:physiopathology*; D012189:Retrospective Studies; D012683:Sensory Deprivation; D014792:Visual Acuity / Q000502:physiology