Changes in accommodation disorders in children with anisometropic amblyopia and hypermetropia
https://doi.org/10.29413/ABS.2024-9.1.13
Abstract
Background. Accommodation disorders in children with hypermetropia is one of the main factors in emmetropization disorders and maintenance of image defocusing. The most severe changes in accommodation are observed in children with anisometropia and hyperopia.
The aim of the work. To evaluate the changes in the accommodative function of the eye in children with hyperopia, amblyopia, who underwent refractive laser surgery (RLS), as well as in children with spectacle and contact lens correction in combination with pleoptic treatment.
Methods and materials. Group 1 consisted of 30 children after RLS; group 2 consisted of 29 children who had spectacle correction; group 3 consisted of 26 children who had soft contact lens correction; all children received pleoptic treatment. Clinical examination included the analysis of objective reserves of relative accommodation (RRA) and objective accommodative response (OAR) with an open field autorefractometer, and the results of accommodation measurement.
Results. In 1.5 years, statistically significant changes were observed in the coefficient of accommodation response (CAR) of the amblyopic eye between the groups 1 and 2 – 0.12 ± 0.02 and 0.00 ± 0.1 relative units, respectively (p = 0.01). Similar statistically significant changes were obtained in OAR and objective RRA of the amblyopic eye. OAR in the group 1 was –2.1 ± 0.67 dpt, in the group 2 – –1.38 ± 0.19 dpt (p = 0.01). At the end of the observation, the OAR in the group 1 was –2.1 ± 0.67 dpt, the objective RRA – –2.1 ± 0.67 dpt; in the group 2 the OAR was –1.38 ± 0.19 dpt (p = 0.01), the objective RRA – –1.38 ± 0.19 dpt (p = 0.01). There were no statistically significant changes in these parameters of the amblyopic eye between the groups 1 and 3.
Conclusion. There was an improvement of accommodation disorders in children with anisometropia, hyperopia and amblyopia after refractive laser surgery and in children with contact lens correction. Due to a decrease in the refractive indices of the amblyopic eye, the values of CAR, OAR and objective RRA after refractive laser surgery tended to be closer to the normal values.
About the Authors
I. L. Kulikova
Cheboksary Branch of the S. Fyodorov Eye Microsurgery Federal State Institution;
Postgraduate Doctors’ Training Institute
Russian Federation
Russian Federation
Irina L. Kulikova – Dr. Sc. (Med.), Ophthalmic Surgeon, Deputy Director for Treatment, Traktorostroiteley ave. 10, Cheboksary 428028;
Professor at the Ophthalmology Course, Mikhaila Sespelya str. 27, Cheboksary 428018
K. A. Aleksandrova
Cheboksary Branch of the S. Fyodorov Eye Microsurgery Federal State Institution
Russian Federation
Russian Federation
Ksenia A. Aleksandrova – Ophthalmic Surgeon at the Unit of Ambulatory Surgery and Conservative Treatment,
Traktorostroiteley ave. 10, Cheboksary 428028
References
1. International Agency for the Prevention of Blindness. WHO Facts. Blindness and visual impairment: Global facts. 2013. URL: http://www.iapb.org/vision-2020/global-facts [date of access: 01.09.2022].
2. Hashemi H, Fotouhi A, Yekta A, Pakzad R, Ostadimoghaddam H, Khabazkhoob M. Global and regional estimates of prevalence of refractive errors: Systematic review and metaanalysis. J Curr Ophthalmol. 2017; 30(1): 3-22. doi: 10.1016/j.joco.2017.08.009
3. Maychuk NV, Mushkova IA, Malyshev IS, Obraztsova MR. Discussing questions of laser refractive surgery in hyperopia: Literature review and clinical experience. Ophthalmology in Russia. 2022; 19(2): 350-358. (In Russ.). doi: 10.18008/1816-5095-2022-2-350-358
4. Bolinovska S. Hyperopia in preschool and school children. Med Pregl. 2007; 60(3-4): 115-21. doi: 10.2298/mpns0704115b
5. Horwood AM, Riddell PM. Hypo-accommodation responses in hypermetropic infants and children. BrJ Ophthalmol. 2011; 95(2): 231-237. doi: 10.1136/bjo.2009.177378
6. Kushnarevich NYu. An aggressive approach to hyperopia management: A method of maximum use of adaptive reserves intrinsic for the algorithms of natural refractive development. Russian Ophthalmological Journal. 2017; 10(2): 78-85. (In Russ.). doi: 10.21516/2072-0076-2017-10-2-78-85
7. Ntodie M, Saunders KJ, Little JA. Correction of low-moderate hyperopia improves accommodative function for some hyperopic children during sustained near work. Invest Ophthalmol Vis Sci. 2021; 62(4): 6. doi: 10.1167/iovs.62.4.6
8. Toor S, Horwood A, Riddell P. The effect of asymmetrical accommodation on anisometropic amblyopia treatment outcomes. J AAPOS. 2019; 23(4): 203.e1-203.e5. doi: 10.1016/j.jaapos.2019.05.010
9. Markova EYu, Perfilyeva EA. Contact lenses in pediatric ophthalmological practice. Ophthalmology in Russia. 2020; 17(1): 32-41. (In Russ.). doi: 10.18008/1816-5095-2020-1-32-41
10. Balalin SV, Trufanova LP. Ophthalmogypertensive syndrome of over-extension accommodation as a factor of risk of progression of myopia. National Journal Glaucoma. 2019; 18(2): 29-37. (In Russ.). doi: 10.25700/NJG.2019.02.04
11. Solodkova EG, Kuznetsova OS, Fokin VP, Balalin SV, Sivolobov VA. Analysis of accomodation status in patients with hypermetropy. Modern Technologies in Ophthalmology. 2019; 5: 227-230. (In Russ.). doi: 10.25276/2312-4911-2019-5-227-230.22
12. Katargina LA. Accommodation: A guide for doctors. Moscow: Aprel; 2012. (In Russ.).
13. Avetisov ES, Mats KA. Method of training the ciliary muscle with weakened accommodation. Proceedings of a scientific conference on the prevention, pathogenesis and treatment of the ophthalmological diseases in children. Moscow: Meditsina; 1971: 60-63. (In Russ.).
14. Tarutta EP, Filinova OB, Tarasova NA. The new methods for objective accomodometry. Russian Pediatric Ophthalmology. 2012; 1: 45-48. (In Russ.).
15. Tarutta EP, Tarasova NA. Accommodative tone in myopia, measured by various methods, and its possible prognostic value. Vestnik oftalmologii. 2012; 2: 34-37. (In Russ.).
Review
For citations:
Kulikova I.L., Aleksandrova K.A. Changes in accommodation disorders in children with anisometropic amblyopia and hypermetropia. Acta Biomedica Scientifica. 2024;9(1):129-135. (In Russ.) https://doi.org/10.29413/ABS.2024-9.1.13
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