Advances in anisometropic amblyopia management: A narrative literature review

Abstract

Amblyopia attributed to strabismus, anisometropia or the combined effect of both causes results in reduced visual acuity for patients. Objective. Consequently, the objective of this review was to assess the effectiveness of various forms of management among patients with anisometropic amblyopia aged three to 17 years. Method. For the study’s design, a narrative literature review was chosen. The articles analysed were generated from two electronic databases: Ovid Medline and PubMed Central. Only studies published between January 2000 to date were included. Results. The final nine studies included in this review comprised research published by the Pediatric Eye Investigator Group and other related studies. For the thematic focus of these studies, researchers emphasized comparative effectiveness of various approaches to amblyopia management for children of different ages. Refractive correction was reported to be an effective approach to managing amblyopia among children of at least three and under seven years of age. For children aged between three and 17 years, amblyopia could be managed through atropine penalization and patching. However, the risk of amblyopia’s recurrence or reduced stereoacuity was noted after treatment. To reduce such a recurrence, researchers emphasized the need to taper treatment before ceasing the respective protocols. The majority of the reviewed studies comprised randomised control trials, and study subjects were diagnosed with different types of amblyopia – including strabismic and anisometropic amblyopia or amblyopia attributed to the combined effect of strabismus and anisometropia. Conclusion. Despite the risk of recurrence, non-responsiveness to treatment and poor stereoacuity, anisometropic amblyopia can be effectively managed through refractive correction, patching and atropine penalization. Future studies need to assess the effectiveness of emerging treatments, including modified iPad treatment, liquid-crystal-display eyeglasses and acupuncture. Keywords: Amblyopia, Anisometropia, Anisometropic Amblyopia