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M. T. Kulp, D. K. Wallace, E. Lazar, M. Melia, PEDIG; Stereoacuity in Children With Anisometropic Amblyopia. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4357.
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To determine factors associated with stereoacuity at 30 cm in subjects with anisometropic amblyopia and no heterotropia, and to describe stereoacuity in subjects who had resolution of amblyopia (visual acuity of 20/25 or better and with less than one line of interocular difference) after amblyopia treatment.
We combined individual stereoacuity data for subjects enrolled in 7 studies conducted by the Pediatric Eye Disease Investigator Group. Eligible children were aged 3 to <18 years with anisometropic amblyopia, no heterotropia, and baseline visual acuity 20/100 or better. Multivariate regression models were used to identify factors associated with baseline stereoacuity and with improvement in stereoacuity after treatment with patching or Bangerter filters.
We enrolled 633 subjects. Better baseline stereoacuity was associated with better baseline amblyopic eye acuity (p<0.001), less anisometropia (p<0.001), and anisometropia due to astigmatism (p<0.001). Mean baseline stereoacuity was 0.11 log arc seconds better for every additional line of better logMAR amblyopic eye acuity and 0.05 log arc seconds better for each vector diopter decrease in anisometropia. Stereoacuity improvement in response to amblyopia treatment was associated with worse baseline stereoacuity (p<0.001), better baseline amblyopic eye acuity (p<0.001), and greater improvement in amblyopic eye acuity from baseline to outcome (p<0.001). Stereoacuity improved 0.68 log arc seconds for every additional log arc second of worse baseline stereoacuity, 0.13 log arc seconds for each logMAR line of better baseline amblyopic eye acuity, and 0.13 log arc seconds for every additional line of logMAR improvement in amblyopic eye acuity from baseline to outcome. Among 238 children who were treated with patching or Bangerter filters and who had stereoacuity measured after amblyopia treatment, 46 children had amblyopic eye acuity 20/25 or better and within one line of the fellow eye visual acuity. Of these, 22 (48%) had stereoacuity of 100 seconds of arc or worse.
Amblyopic children are more likely to show improvement in stereoacuity with treatment when they have worse baseline stereoacuity, better baseline amblyopic eye acuity, and greater improvement of amblyopic eye acuity. Many amblyopic children have poor stereoacuity despite resolution of this visual acuity deficit.
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