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Comparison of the amblyopia treatment study HOTV and the electronic-early treatment of diabetic retinopathy study visual acuity protocols in amblyopic children aged 5 to 11 years.

ABSTRACT: As part of the long-term follow-up of amblyopic children who were enrolled in the Amblyopia Treatment Study, we tested visual acuity in both eyes of 142 patients by using 2 established visual acuity protocols, the Amblyopia Treatment Study HOTV (ATS HOTV) visual acuity protocol and the Electronic-Early Treatment of Diabetic Retinopathy Study (E-ETDRS) protocol, at one of the annual visits. Mean age at the time of testing was 9.0 years (range, 5.6-11.9 years). The ATS-HOTV protocol resulted in a slight mean overestimate of visual acuity relative to the E-ETDRS protocol (0.68 lines for amblyopic eyes; 0.25 lines for fellow eyes). The overestimation occurred primarily when the E-ETDRS visual acuity was poorer than 0.3 logMAR. ATS-HOTV acuity also underestimated interocular visual acuity differences by 0.42 lines. When one uses the ATS-HOTV protocol, it may be wise to exercise caution when interpreting "near-normal" visual acuity or interocular differences as "within normal" because the ATS-HOTV method may have a slight bias toward better performance of amblyopic eyes than E-ETDRS.

SUBMITTER: Birch EE

PROVIDER: S-EPMC2721221 | biostudies-literature | 2009 Feb

REPOSITORIES: biostudies-literature

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Comparison of the amblyopia treatment study HOTV and the electronic-early treatment of diabetic retinopathy study visual acuity protocols in amblyopic children aged 5 to 11 years.

Birch Eileen E EE Strauber Samara F SF Beck Roy W RW Holmes Jonathan M JM

Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus 20081010 1

As part of the long-term follow-up of amblyopic children who were enrolled in the Amblyopia Treatment Study, we tested visual acuity in both eyes of 142 patients by using 2 established visual acuity protocols, the Amblyopia Treatment Study HOTV (ATS HOTV) visual acuity protocol and the Electronic-Early Treatment of Diabetic Retinopathy Study (E-ETDRS) protocol, at one of the annual visits. Mean age at the time of testing was 9.0 years (range, 5.6-11.9 years). The ATS-HOTV protocol resulted in a ...[more]

PMID: 18848480

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Project description:Dichoptic movie viewing has been shown to significantly improve visual acuity in amblyopia in children. Moreover, short-term occlusion of the amblyopic eye can transiently increase its contribution to binocular fusion in adults. In this study, we first asked whether dichoptic movie viewing could improve the visual function of amblyopic subjects beyond the critical period. Secondly, we tested if this effect could be enhanced by short-term monocular occlusion of the amblyopic eye. 17 subjects presenting stable functional amblyopia participated in this study. 10 subjects followed 6 sessions of 1.5 hour of dichoptic movie viewing (nonpatched group), and 7 subjects, prior to each of these sessions, had to wear an occluding patch over the amblyopic eye for two hours (patched group). Best-corrected visual acuity, monocular contrast sensitivity, interocular balance, and stereoacuity were measured before and after the training. For the nonpatched group, mean amblyopic eye visual acuity significantly improved from 0.54 to 0.46 logMAR (p < 0.05). For the patched group, mean amblyopic eye visual acuity significantly improved from 0.62 to 0.43 logMAR (p < 0.05). Stereoacuity improved significantly when the data of both groups were combined. No significant improvement was observed for the other visual functions tested. Our training procedure combines modern video technologies and recent fundamental findings in human plasticity: (i) long-term plasticity induced by dichoptic movie viewing and (ii) short-term adaptation induced by temporary monocular occlusion. This passive dichoptic movie training approach is shown to significantly improve visual acuity of subjects beyond the critical period. The addition of a short-term monocular occlusion to the dichoptic training shows promising trends but was not significant for the sample size used here. The passive movie approach combined with interocular contrast balancing even over such a short period as 2 weeks has potential as a clinical therapy to treat amblyopia in older children and adults.

Project description:PurposeTo evaluate the relationship of anisometropia with unilateral amblyopia, interocular acuity difference (IAD), and stereoacuity among Head Start preschoolers using both clinical notation and vector notation analyses.DesignMulticenter, cross-sectional study.ParticipantsThree- to 5-year-old participants in the Vision in Preschoolers (VIP) study (n = 4040).MethodsSecondary analysis of VIP data from participants who underwent comprehensive eye examinations, including monocular visual acuity testing, stereoacuity testing, and cycloplegic refraction. Visual acuity was retested with full cycloplegic correction when retest criteria were met. Unilateral amblyopia was defined as IAD of 2 lines or more in logarithm of the minimum angle of resolution (logMAR) units. Anisometropia was defined as a 0.25-diopter (D) or more difference in spherical equivalent (SE) or in cylinder power and 2 approaches using power vector notation. The percentage with unilateral amblyopia, mean IAD, and mean stereoacuity were compared between anisometropic and isometropic children.Main outcomes measuresThe percentage with unilateral amblyopia, mean IAD, and mean stereoacuity.ResultsCompared with isometropic children, anisometropic children had a higher percentage of unilateral amblyopia (8% vs. 2%), larger mean IAD (0.07 vs. 0.05 logMAR), and worse mean stereoacuity (145 vs. 117 arc sec; all P<0.0001). Larger amounts of anisometropia were associated with higher percentages of unilateral amblyopia, larger IAD, and worse stereoacuity (P<0.001 for trend). The percentage of unilateral amblyopia increased significantly with SE anisometropia of more than 0.5 D, cylindrical anisometropia of more than 0.25 D, vertical and horizontal meridian (J0) or oblique meridian (J45) of more than 0.125 D, or vector dioptric distance of more than 0.35 D (all P<0.001). Vector dioptric distance had greater ability to detect unilateral amblyopia than cylinder, SE, J0, or J45 (P<0.001).ConclusionsThe presence and amount of anisometropia were associated with the presence of unilateral amblyopia, larger IAD, and worse stereoacuity. The threshold level of anisometropia at which unilateral amblyopia became significant was lower than current guidelines. Vector dioptric distance is more accurate than spherical equivalent anisometropia or cylindrical anisometropia in identifying preschoolers with unilateral amblyopia.

Dataset Information

Comparison of the amblyopia treatment study HOTV and the electronic-early treatment of diabetic retinopathy study visual acuity protocols in amblyopic children aged 5 to 11 years.

Publications

Comparison of the amblyopia treatment study HOTV and the electronic-early treatment of diabetic retinopathy study visual acuity protocols in amblyopic children aged 5 to 11 years.

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