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Published on: September 27, 2024
New pediatric risk factors for amblyopia: strabismic versus refractive
Sandra Guimaraes1,2, Maria Vieira3, Tatiana Queirós1
11 Department of Ophthalmology, Hospital de Braga, Braga - Portugal.
Insights
Family history and neonatal factors like birthweight and Apgar scores are key predictors for amblyopia development. Strabismic amblyopia is more strongly associated with these risk factors than refractive amblyopia.
Area of Science:
- Ophthalmology
- Pediatrics
- Genetics
Background:
- Amblyopia, or
Purpose of the Study:
- To investigate the predictive value of family history and neonatal factors for strabismic versus refractive amblyopia.
- To differentiate risk factors between amblyopia subtypes.
Main Methods:
- Retrospective case-control study of children born between 1997-2012.
- Data collected from clinical databases and telephone surveys.
- Analysis included 298 cases and 298 controls.
Main Results:
- Lower birthweight and 5-minute Apgar scores were significantly associated with strabismic amblyopia.
- Family history of amblyopia or strabismus was more strongly linked to strabismic amblyopia.
- Multinomial logistic regression identified low 5-minute Apgar as a significant predictor for both amblyopia types.
Conclusions:
- Family history and specific obstetric/neonatal outcomes are crucial for predicting strabismic amblyopia.
- Recognizing these risk factors can guide early ophthalmologic referrals for timely intervention.
Purpose:
To assess the role of risk factors for amblyopia, such as family history and neonatal background, for the prediction of either strabismic amblyopia or refractive amblyopia.
Methods:
In this retrospective case-control model, the study population included all children born at the Hospital de Braga during 1997-2012 (3 to 18 years old) with ophthalmologic consultation in 2014. Data collection was performed from the clinical database and through telephone questionnaire surveys.
Results:
A total of 298 (50%) controls and 298 (50%) cases (120 [40.3%] strabismic amblyopia and 178 [59.7%] refractive amblyopia) were analyzed. A significantly lower birthweight was detected in patients with strabismic amblyopia (mean 2,961 g [95% confidence interval (CI) 2,827-3,096]) compared to controls (mean 3,198 g [95% CI 3,125-3,271]) (p = 0.002). Five-minute Apgar was significantly lower in patients with strabismic amblyopia (mean 9.57 [95% CI 9.37-9.77]) than in controls (mean 9.83 [95% CI 9.77-9.90]) (p = 0.004) or patients with refractive amblyopia (mean 9.79 [95% CI 9.69-9.89]) (p = 0.031). Family history of either amblyopia or strabismus was associated with amblyopia (χ2 [2, n = 562] = 12.66; p = 0.002; Cramer V = 0.150; χ2 [2, n = 561] = 11.0; p = 0.004; Cramer V = 0.140), but was significantly more associated with strabismic amblyopia (p = 0.0023 and p = 0.0032) than with refractive amblyopia (p = 0.48 and p = 0.015, respectively). Multinomial logistic regression model explained 50.8% of the variance in amblyopia development. Low 5-minute Apgar had a relevant odds ratio (OR) for either strabismic amblyopia (OR 3.44; p = 0.066) or refractive amblyopia (OR 3.30; p = 0.077).
Conclusions:
This division in amblyopia subtypes gives a new perspective of the risk factors for amblyopia, with family history and some obstetrician/neonatal outcomes appearing to be more relevant in strabismic amblyopia. Educating health care providers to recognize these risk factors can result in an early ophthalmologic referral.
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