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Heike M. Elflein, Alexander Karl-Georg Schuster, Susanne Pitz, Jochen Hardt, Stefan Nickels, Thomas Münzel, Philipp S Wild, Manfred E Beutel, Maria Blettner, Karl J Lackner, Norbert Pfeiffer, Josef M. Unterrainer; Amblyopia and its influences on planning skills. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2365.
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Amblyopia is a main cause for reduced, mainly monocular vision and also leads to disturbed binocular functions. Amblyopia is characterized by a healthy eye with reduced development of visual acuity during childhood and reduced stereoscopic vision. Amblyopia can have effects on higher neural functions like reduced position acuity and impaired spatial processing. Therefore, we assessed whether there is a difference in visuo-spatial planning skills between persons with and without amblyopia, as measured by the established Tower of London test (ToL).
The Gutenberg Health study (GHS) is a large population-based interdisciplinary cohort study. Amblyopia was defined as visual acuity of ≤ 0.63 (worse eye) together with an amblyogenic factor (anisometropia >= 1D, astigmatism >= 1D, history of strabism). To avoid misclassification bias caused by age-related medical conditions like cataract, we restricted our analysis to the youngest subgroup (aged 35 – 44 years at baseline examination) with a prevalence of amblyopia of 5.6 % [95% confidence interval 4.9–6.5%]. Visuo-spacial planning skills were measured by a touch-screen version of the Tower of London test (ToL). The ToL consisted of 24 tasks where three beads of different colors placed on pegs in a start position have to be moved bead by bead to reach a target position. Performance was measured by the number of correctly solved tasks in three subgroups: i, participants with amblyopia (n=78), ii, participants with visual acuity ≤ 0.63 (worse eye) not caused by amblyopia (n=65) and iii, participants with visual acuity > 0.63 (worse eye) (n=1426). We additionally performed linear regression models to investigate the association between amblyopia and ToL score with adjustment for age, sex, and socio-economic status.
Overall ToL performance in non-amblyopic persons was 15.3 (±3.33 standard deviation (SD)), while it was 14.56 (±3.76 SD) in amblyopic and 15.14 (±3.65 SD) in persons with visual acuity ≤ 0.63 of the worse eye without amblyopia. In linear regression models amblyopic status was associated with a lower ToL performance (-1.21 - 1.41, p=0.083 - 0.2), but not statistically significant.
Ambylopic persons have a lower ToL score compared to persons with normal visual acuity. Even persons with reduced visual acuity who are non-amblyopic have higher ToL scores than amblyopic persons. However, this difference was not statistically significant (with p<0.05).
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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