| Objective:To Explore the differences in the efficacy of visual perception learning for ametropic and anisometropic amblyopia,as well as the differences in the response to treatment by different ages,refractive categories,and basal visual acuity levels.Methods:According to the inclusion criteria,we included 160 children aged 3～12 years old who were diagnosed as ametropic and anisometropic amblyopia at the outpatient service of department of ophthalmology,Shandong Provincial Hospital.All children were asked medical history,undergone basic examination,and examined with mydriatic refraction.After recording the age,baseline best corrected visual acuity,and refractive error,everyone were provided with optical correction followed by the maximum plus to maximum visual acuity(MPMVA)and perceptual learning training guided by "SUNVISIONMED" system simultaneously.After which,the patients were supposed to test acuity improvement at the 3-month,6-month,and 12-month visit.Collecting all data,the patients were divided into younger age group(<7 years old)and older age group(≥ 7 years old)by age,divided into severe amblyopia group(>0.7 logMAR),moderate amblyopia group(0.3 to 0.7 logMAR),and mild amblyopia group(<0.3 logMAR)by baseline best corrected visual acuity,and divided into high hyperopia group(≥+5.00DS),moderate hyperopia group(≥+3.00DS,<+5.00DS),low hyperopia group(≥1.50DS,<+3.00DS),myopia group(<-0.50DS),and astigmatism group(Cytdnder≥ 2.00D).For each group,the vision improvement was calculated as average and standard deviation(SD).The associations of age,baseline best corrected visual acuity of amblyopic eye,and degree of anisometropia and ametropia with the degree of improvement in amblyopia were assessed using analysis of Pearson correlation.Results:The mean age of ametropic amblyopia was 5.2 ± 1.4 years and anisometropic amblyopia was 7.1±2.3 years,indicating that ametropic amblyopia was younger than anisometropic amblyopia(P<0.001).The average best corrected visual acuity of ametropic amblyopia was 0.426±0.245 logMRA and anisometropic amblyopia was 0.532 ± 0.365 logMRA,indicating that ametropic amblyopia had better basic vision(P=0.007).In both patients,the lower the age and the poorer baseline visual acuity in the amblyopic eyes(P<0.001,P=0.006).Ametropic amblyopia were mainly high hyperopia and high astigmatism(65.4%),and anisometropic amblyopia were mainly moderate and high hyperopia(68.2%).There was no significant correlation between refractive category in amblyopic eyes and baseline best corrected visual acuity(P=0.486,P=0.438),while in the hyperopia group,the larger the degree of refractive error was,the worse the baseline best-corrected visual acuity was(P<0.001,P=0.001).Follow-up showed that there was no statistical difference in the mean improvement of the best-corrected visual acuity of ametropic and anisometropic amblyopic eyes after treated for 3 months,6 months,and 12 months(P=0.947,P=0.582,P=0.051);the lower the baseline vision was,the greater the visual improvement was;during the visual development period,the younger the patients with ametropia were,the easier it was to improve their vision(P=0.047,3 months;P=0.012,6 months;P=0.021,12 months),while age was not significantly associated with the difficulty of visual improvement in anisometropic amblyopia(P=0.099,3 months;P=0.170,6 months;P=0.237,12 months);in ametropic amblyopia,the refractive category and the difficulty of visual improvement ultimately showed no significant association(P=0.823,3 months;P=0.479,6 months;P=0.629,12 months);in anisometropic amblyopia,refraction was not significantly associated with the difficulty to improve visual acuity(P=0.381,3 months;P=0.437,6 months;P=0.592,12 months).Conclusion:In combination with optical correction followed by the best corrected visual acuity,visual perceptual learning can effectively treat ametropic and anisometropic amblyopia,and a one-year follow-up showed no statistically significant difference in the improvement of visual acuity in the two types of amblyopic eyes. |
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