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Ocular alignment may contribute to myopic shift in hyperopic eyes with amblyopia
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Ocular alignment correlated with a change in spherical equivalent refractive error in hyperopic eyes with amblyopia, a study found.
“Among children treated for anisometropic, strabismic, or combined mechanism amblyopia, there is a decrease in amblyopic eye spherical equivalent refractive error to less hyperopia after controlling for baseline refractive error,” the study authors said. “This negative shift toward emmetropia is associated with ocular alignment, which supports the suggestion that better motor and sensory fusion promote emmetropization.”
The prospective cohort study included 105 patients younger than 7 years who had previously participated in a randomized trial comparing atropine with patching for moderate amblyopia. Median patient age was 5.2 years.
After wearing refractive correction for at least 4 weeks, patients were randomized to daily patching (from 6 hours to full time) or one drop of atropine 1% once daily for 6 months. Primary outcomes were evaluated 6 months after randomization. Treatment was at investigator discretion between 6 months and 2 years after randomization. Cycloplegic refraction was measured at baseline and age 10 years.
Results at 10 years showed diminished spherical equivalent refractive error from hyperopia to less hyperopia; the decrease was –0.65 D in the amblyopic eye and –0.39 D in the fellow eye.
A greater decrease in refractive error in the amblyopic eye showed a significant correlation with improved ocular alignment (P = .004); the greatest decrease in refractive error was seen in orthotropic patients.
Data showed no association between ocular alignment category and change in fellow-eye refractive error, the authors said.
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Am J Ophthalmol. 2012;154(2):297-302.
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