This article is more than 5 years old. Information may no longer be current.
Pathophysiology and age at onset may dictate development, treatment of amblyopia
Click Here to Manage Email Alerts
 John J. Sloper |
SAN ANTONIO — Amblyopia is a complex and enigmatic condition driven by neurologic changes in early life, a speaker said here.
"The strangest thing about this is the huge variability in the response to patching that we see in different children," John J. Sloper, FRCOphth, said during the Knapp Lecture at the American Association for Pediatric Ophthalmology and Strabismus meeting. "Different children respond in entirely different ways that we don't understand."
Evidence suggests that strabismic amblyopes have abnormalities of color and motion processing that stem from differences in magnocellular and parvocellular function, Dr. Sloper said.
Amblyopia is delineated by early and late sensitive periods. The early sensitive period, from birth to 8 weeks, is characterized by competition between eyes, cortical segregation, hypertrophy of lateral geniculate nucleus cells and no effect from reopening the eyes. Reverse suturing is effective during this period.
The late sensitive period, from 8 weeks to 18 months, is defined by cooperation between eyes, shrinkage of parvocellular cells and cortical changes. Reopening the eye allows recovery during this time.
A randomized trial of amblyopia treatment in children aged 7 to 17 years published by the Pediatric Eye Disease Investigator Group in Archives of Ophthalmology in 2005 showed that children responded to treatment after the sensitive periods, Dr. Sloper said.
Pediatric ophthalmologists may want to consider identifying imbalances between magnocellular and parvocellular pathways and selectively stimulating those pathways to treat amblyopia, he said.
- Disclosure: Dr. Sloper has no relevant financial disclosures.