May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
The Pediatric Vision Screener: Improvement of Binocularity Scores After Successful Treatment of Anisometropic Amblyopia
Author Affiliations & Notes
  • D. G. Hunter
    Ophthalmology, Childrens Hospital Boston, Boston, Massachusetts
  • S. E. Loudon
    Ophthalmology, Childrens Hospital Boston, Boston, Massachusetts
  • C. A. Rook
    Ophthalmology, Childrens Hospital Boston, Boston, Massachusetts
  • D. S. Nassif
    Ophthalmology, Childrens Hospital Boston, Boston, Massachusetts
  • N. V. Piskun
    Ophthalmology, Childrens Hospital Boston, Boston, Massachusetts
  • Footnotes
    Commercial Relationships  D.G. Hunter, Johns Hopkins University, P; S.E. Loudon, None; C.A. Rook, None; D.S. Nassif, None; N.V. Piskun, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 2829. doi:
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      D. G. Hunter, S. E. Loudon, C. A. Rook, D. S. Nassif, N. V. Piskun; The Pediatric Vision Screener: Improvement of Binocularity Scores After Successful Treatment of Anisometropic Amblyopia. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2829.

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Abstract

Purpose: : The Pediatric Vision Screener (PVS) is a polarized binocular retinal birefringence scanner that detects binocular foveal fixation, generating a binocularity score (BIN; 0-100%). We have previously shown that a PVS BIN threshold of 60% detects strabismus with high accuracy in a 2.5 second series of 5 scans performed from a 40 cm distance. This study was undertaken to determine whether BIN changes after treatment of amblyopia and strabismus.

Methods: : From June 2003 till December 2007, 202 children were scanned with the PVS at Children’s Hospital Boston. All children received a gold-standard orthoptic examination and were classified as amblyopic, at risk for amblyopia, or control. From May till December 2007 repeat testing was performed during follow-up appointments.

Results: : Twenty-two children received two sequential PVS measurements. Mean age was 5.0 years. Eight children had anisometropic amblyopia, 1 had treated anisometropic amblyopia, and 13 had strabismic or mixed amblyopia. Mean BIN at first measurement was 14% for the anisometropic amblyopes and 13% for the strabismic or mixed amblyopes. In the 4 patients with anisometropic amblyopia who were successfully treated for amblyopia, BIN improved to 100%. In the patient with treated anisometropic amblyopia, BIN remained 100%. In the 5 patients with constant strabismus who were successfully treated for amblyopia, BIN did not improve, except in one patient with intermittent strabismus who recovered stereopsis and improved to BIN 67%. BIN did not improve overall in the 12 patients who did not improve after amblyopia therapy.

Conclusions: : Improvement in the BIN score is an indicator of successful amblyopia therapy in anisometropic amblyopes. The results are consistent with the hypothesis that patients with anisometropic amblyopia have a previously unrecognized microstrabismus. Furthermore, this microstrabismus appears to improve with successful amblyopia therapy. Strabismic amblyopes show no such change with treatment.

Keywords: amblyopia • screening for ambylopia and strabismus • strabismus 
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