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Assessing amblyogenic factors in 100 patients with congenital ptosis
Abolfazl Kasaee1, Alireza Yazdani-Abyaneh, Syed Ziaeddin Tabatabaie
1Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Congenital ptosis in children frequently leads to amblyopia, particularly refractive amblyopia. Early detection and management of all amblyogenic factors are crucial for preserving vision in affected individuals.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Vision Science
Background:
- Congenital ptosis is a common eyelid malformation in children.
- Amblyopia, or
- lazy eye,
- can develop if vision is not properly stimulated during early childhood.
- Understanding the relationship between congenital ptosis and amblyogenic factors is vital for timely intervention.
Purpose of the Study:
- To determine the frequency of various amblyogenic factors contributing to amblyopia in children diagnosed with congenital ptosis.
- To compare the incidence of different types of amblyopia based on ptosis severity and laterality.
Main Methods:
- A cross-sectional study included 114 eyes from 100 pediatric patients (age > 1 year) with congenital ptosis.
- Amblyopia was diagnosed based on best-corrected visual acuity (BCVA) or fixation behavior in younger children.
- Classifications included anisometropic, strabismic, and stimulus deprivation amblyopia (SDA), with specific refractive error criteria.
Main Results:
- The overall incidence of amblyopia in eyes with congenital ptosis was 34.2%.
- Refractive amblyopia was the most common type (29.8%), followed by SDA (10.5%) and strabismic amblyopia (4.3%).
- Amblyopia was significantly more frequent in cases with covered optical axes (76%) compared to non-covered axes (22.5%).
Conclusions:
- Refractive anisometropic amblyopia is the predominant cause of amblyopia in children with congenital ptosis.
- Comprehensive assessment for all potential amblyogenic factors, including refractive errors and visual deprivation, is essential for effective prevention and treatment strategies.
Aim:
To study the frequency of amblyogenic factors in patients with congenital ptosis.
Methods:
In this cross-sectional study, 114 eyes of 100 patients with congenital ptosis more than 1 year old were included. Amblyopia was defined as best-corrected visual acuity (BCVA) less than 10/10 or a difference between the two eyes of at least 2/10. In patients too young to be measured by the linear Snellen E test, fixation behavior was observed. Different types of amblyopia were assessed for each patient as: 1) anisometropic amblyopia: astigmatic anisometropia ≥1 dpt, hyperopic spherical anisometropia ≥1 dpt, myopic spherical anisometropia ≥-3 dpt (with cycloplegia); 2) strabismic amblyopia, and 3) stimulus deprivation amblyopia (SDA). Then the total incidence of amblyopia and each type of it were obtained. Patients with uni- and bi-lateral ptosis were also compared.
Results:
The incidence of amblyopia in ptotic eyes was 39/114 (34.2 %), and for each specific cause was: refractive amblyopia in 29.8%, SDA in 10.5%, strabismic amblyopia in 4.3%. Amblyopia was more frequent in severe ptosis, 76% in patients with covered optical axes (OA), compared to non-covered OA (22.5%). In unilateral ptosis with covered OA, astigmatic anisometropic amblyopia was more frequent, and in bilateral ptosis with at least one eye covered OA, spherical anisometropic amblyopia was more frequent. In both unilateral and bilateral ptosis, SDA was more common if the OA was covered.
Conclusion:
As refractive anisometropic amblyopia is more prevalent than SDA, paying attention to all causes of amblyopia may be important in preventing amblyopia in a child with a ptotic eye.
