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Dysfunction in the fellow eyes of strabismic and anisometropic amblyopic children assessed by visually evoked
Eric Pinheiro Andrade1, Adriana Berezovsky1, Paula Yuri Sacai1
1Department of Opththalmology and Visual Sciences, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
Insights
The fellow eyes of children with amblyopia exhibit reduced visual acuity and subtle pattern reversal visual evoked potential (PR-VEP) abnormalities, indicating broader visual function deficits. These findings highlight the impact of amblyopia on spatial vision in unaffected eyes.
Area of Science:
- Ophthalmology
- Neuroscience
- Vision Science
Background:
- Amblyopia, often termed 'lazy eye,' affects visual development and can be caused by strabismus (eye misalignment) or anisometropia (unequal refractive error).
- The fellow eye, typically considered 'normal' in amblyopia, may also experience subtle visual processing deficits.
- Understanding these deficits is crucial for comprehensive amblyopia management.
Purpose of the Study:
- To assess visual acuity and pattern reversal visual evoked potentials (PR-VEPs) in the fellow eyes of children diagnosed with strabismic and/or anisometropic amblyopia.
- To compare these visual functions between amblyopic children's fellow eyes and healthy controls.
Main Methods:
- Recruited 40 children with amblyopia and 19 healthy controls for electrophysiological assessment using VEPs.
- Measured monocular grating and optotype acuity using sweep-VEPs and an Early Treatment Diabetic Retinopathy Study chart.
- Recorded transient PR-VEPs with stimuli of varying visual angles (60', 15', 7.5') to determine amplitude and latency.
Main Results:
- Fellow eyes of amblyopic children showed significantly worse optotype and grating acuity compared to controls (p=0.021 and p=0.016, respectively).
- Prolonged PR-VEP latency was observed in the strabismic group for 15' and 7.5' stimuli (p=0.018 and p=0.002).
- All fellow eyes of amblyopic children exhibited prolonged latency for the smallest stimulus (7.5', p<0.001).
Conclusions:
- The fellow eyes of amblyopic children demonstrate reduced visual acuity and subtle PR-VEP abnormalities, specifically prolonged latencies for smaller stimuli.
- These findings underscore the widespread impact of amblyopia on visual functions, particularly spatial vision, even in the non-affected eye.
- Subtle visual processing deficits in the fellow eye warrant further investigation and consideration in treatment strategies.
Purpose::
To evaluate visual acuity and transient pattern reversal (PR) visual evoked potentials (VEPs) in the fellow eyes of children with strabismic and/or anisometropic amblyopia.
Methods::
Children diagnosed with strabismic and/or anisometropic amblyopia were recruited for electrophysiological assessment by VEPs. Monocular grating and optotype acuity were measured using sweep-VEPs and an Early Treatment Diabetic Retinopathy Study chart, respectively. During the same visit, transient PR-VEPs of each eye were recorded using stimuli subtending with a visual angle of 60', 15', and 7.5'. Parameters of amplitude (in μV) and latency (in ms) were determined from VEP recordings.
Results::
A group of 40 strabismic and/or anisometropic amblyopic children (22 females: 55%, mean age= 8.7 ± 2.2 years, median= 8 years) was examined. A control group of 19 healthy children (13 females: 68.4%, mean age= 8.2 ± 2.6 years, median= 8 years) was also included. The fellow eyes of all amblyopes had significantly worse optotype acuity (p=0.021) than the control group, regardless of whether they were strabismic (p=0.040) or anisometropic (p=0.048). Overall, grating acuity was significantly worse in the fellow eyes of amblyopes (p=0.016) than in healthy controls. Statistically prolonged latency for visual angles of 15' and 7.5' (p=0.018 and 0.002, respectively) was found in the strabismic group when compared with the control group. For the smaller visual stimulus (7.5'), statistically prolonged latency was found among all fellow eyes of amblyopic children (p<0.001).
Conclusions::
The fellow eyes of amblyopic children showed worse optotype and grating acuity, with subtle abnormalities in the PR-VEP detected as prolonged latencies for smaller size stimuli when compared with eyes of healthy children. These findings show the deleterious effects of amblyopia in several distinct visual functions, mainly those related to spatial vision.
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