Visual prognosis of amblyopia associated with myelinated retinal nerve fibers

To investigate the visual prognosis of amblyopia associated with anisomyopia and myelinated nerve fibers.

Retrospective noncomparative case series.

Twelve children with amblyopia associated with anisomyopia and myelinated nerve fibers were treated with spectacle correction after cycloplegic refraction and occlusion therapy for amblyopia. Their visual acuity was measured at each visit to the clinic. The patients were divided into three groups according to their final visual acuity, and statistical analyses were performed to evaluate the differences among these groups in terms of the initial age, spherical equivalent, anisometropia, the area of myelination, final age, and follow-up period.

The mean refractive error of the 12 children in spherical equivalents was -8.16 diopters (range -1.50 to approximately -13.00 diopters). The mean age at the initiation of therapy was 4.2 years (range 2.1 to 8.6) and the mean follow-up period was 2.6 years (range 0.5 to 5.1). After the occlusion treatment, visual acuity improved to 20/30 in four patients, and to 20/60 in one patient. In the remaining six patients, visual acuity remained at 20/200 or worse. The amount of anisometropia and the area of myelination were significantly different between the group with a final visual acuity of 20/40 or better and the group with a final visual acuity of worse than 20/200.

The visual acuity of about one third of the amblyopes with myelinated nerve fibers improved to 20/30. The prognostic factors for the visual improvement were the amount of anisometropia and the area of myelination.