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Slow reading in children with anisometropic amblyopia is associated with fixation instability and increased saccades.

ABSTRACT: Previous studies show slow reading in strabismic amblyopia. We recently identified amblyopia, not strabismus, as the key factor in slow reading in children. No studies have focused on reading in amblyopic children without strabismus. We examined reading in anisometropic children and evaluated whether slow reading was associated with ocular motor dysfunction in children with amblyopia.Anisometropic children (7-12 years) with or without amblyopia were compared to age-similar normal controls. Children silently read a grade-appropriate paragraph during binocular viewing. Reading rate (words/min), number of forward and regressive saccades (per 100 words) and fixation duration were recorded with the ReadAlyzer. Binocular fixation instability was also evaluated (EyeLink 1000).Amblyopic anisometropic children read more slowly (n = 25; mean with standard deviation, 149 ± 42 words/min) than nonamblyopic anisometropic children (n = 15; 196 ± 80 words/min; P = 0.024) and controls (n = 25; 191 ± 65 words/min; P = 0.020). Nonamblyopic anisometropic children read at a comparable rate to controls (P = 0.81). Slow reading in amblyopic anisometropic children was correlated with increased forward saccades (r = -0.84, P < 0.001), increased regressive saccades (r = -0.85, P < 0.001), and fellow eye instability during binocular viewing (r = -0.52, P = 0.019).Slow reading in school-age children with anisometropic amblyopia is related to increased frequency of saccades and fixation instability of the fellow eye. Further research should consider the effects of slower reading on academic performance.

SUBMITTER: Kelly KR

PROVIDER: S-EPMC5722702 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Slow reading in children with anisometropic amblyopia is associated with fixation instability and increased saccades.

Kelly Krista R KR Jost Reed M RM De La Cruz Angie A Dao Lori L Beauchamp Cynthia L CL Stager David D Birch Eileen E EE

Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus 20171009 6

<h4>Background</h4>Previous studies show slow reading in strabismic amblyopia. We recently identified amblyopia, not strabismus, as the key factor in slow reading in children. No studies have focused on reading in amblyopic children without strabismus. We examined reading in anisometropic children and evaluated whether slow reading was associated with ocular motor dysfunction in children with amblyopia.<h4>Methods</h4>Anisometropic children (7-12 years) with or without amblyopia were compared to ...[more]

PMID: 29024763

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Project description:Cognition is very important in our daily life. However, amblyopia has abnormal visual cognition. Physiological changes of the brain during processes of cognition could be reflected with ERPs. So the purpose of this study was to investigate the speed and the capacity of resource allocation in visual cognitive processing in orientation discrimination task during monocular and binocular viewing conditions of amblyopia and normal control as well as the corresponding eyes of the two groups with ERPs. We also sought to investigate whether the speed and the capacity of resource allocation in visual cognitive processing vary with target stimuli at different spatial frequencies (3, 6 and 9 cpd) in amblyopia and normal control as well as between the corresponding eyes of the two groups. Fifteen mild to moderate anisometropic amblyopes and ten normal controls were recruited. Three-stimulus oddball paradigms of three different spatial frequency orientation discrimination tasks were used in monocular and binocular conditions in amblyopes and normal controls to elicit event-related potentials (ERPs). Accuracy (ACC), reaction time (RT), the latency of novelty P300 and P3b, and the amplitude of novelty P300 and P3b were measured. Results showed that RT was longer in the amblyopic eye than in both eyes of amblyopia and non-dominant eye in control. Novelty P300 amplitude was largest in the amblyopic eye, followed by the fellow eye, and smallest in both eyes of amblyopia. Novelty P300 amplitude was larger in the amblyopic eye than non-dominant eye and was larger in fellow eye than dominant eye. P3b latency was longer in the amblyopic eye than in the fellow eye, both eyes of amblyopia and non-dominant eye of control. P3b latency was not associated with RT in amblyopia. Neural responses of the amblyopic eye are abnormal at the middle and late stages of cognitive processing, indicating that the amblyopic eye needs to spend more time or integrate more resources to process the same visual task. Fellow eye and both eyes in amblyopia are slightly different from the dominant eye and both eyes in normal control at the middle and late stages of cognitive processing. Meanwhile, abnormal extents of amblyopic eye do not vary with three different spatial frequencies used in our study.

Project description:PurposeTo evaluate macular microvascular changes in the form of foveal avascular zone (FAZ) area and vessel density in the superficial, deep capillary plexuses, and choriocapillaris using optical coherence tomography angiography (OCTA) in children with anisometropic myopic amblyopia before and after treatment.MethodsThis prospective observational study included 32 patients younger than 12 years old with anisomyopic amblyopia. OCTA was done before patients' treatment with optical correction with or without patching and was repeated after successful amblyopia treatment. Outcomes included superficial, deep, and choriocapillaris vessel density (VD) and superficial and deep FAZ areas.ResultsThe study included 13 males (40.6%) and 19 females (59.4%), and the mean age was 9.52 ± 1.33 years. Fifty-three percent (53%) of patients needed only optical correction, and the remaining 47% needed additional patching therapy. After successful treatment, there was a significant improvement in amblyopic eyes in best-corrected visual acuity (p < 0.001), with higher VD values in superficial capillary plexuses (p < 0.001), deep capillary plexuses (p < 0.001), and foveal choriocapillaris (p = 0.030). In the glasses with patching subgroup, the difference between pre-treatment and post-treatment parameters revealed a significant improvement in vessel density in superficial retinal plexuses (foveal and parafoveal; p values 0.023 and < 0.001, respectively) and deep retinal plexuses (whole image, foveal, and parafoveal; p values 0.003, < 0.001, and 0.002, respectively). While amblyopic eyes treated with glasses alone had a significantly greater difference in choriocapillaris foveal VD (p value = 0.022).ConclusionAfter effective amblyopia treatment, amblyopic eyes exhibited improved best-corrected visual acuity and better macular perfusion along the superficial, deep vascular density, and choriocapillaris foveal VD.Clinical trial registrationCinicalTrials.gov Identifier: NCT05223153.

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Slow reading in children with anisometropic amblyopia is associated with fixation instability and increased saccades.

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Slow reading in children with anisometropic amblyopia is associated with fixation instability and increased saccades.

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