Abnormal Radial Deformation Hyperacuity in Children with Strabismic Amblyopia

作者:Subramanian Vidhya*; Morale Sarah E; Wang Yi Zhong; Birch Eileen E
来源:Investigative Ophthalmology & Visual Science, 2012, 53(7): 3303-3308.
DOI:10.1167/iovs.11-8774

摘要

PURPOSE. In infants and toddlers, letter acuity is not a useful option, and grating acuity may underestimate the depth of strabismic amblyopia. Here, as a first step to establish the effectiveness of the paradigm as a clinical test, we assessed if radial deformation hyperacuity, known to be severely disrupted in adults with strabismic amblyopia, could be a potential test to detect and monitor strabismic amblyopia in young children. METHODS. Fifty-one strabismic children and 130 normal controls ages 3 to 17 years participated. Radial deformation hyperacuity with three different radial frequency (RF) patterns (1 degrees radius 8 RF, 0.5 degrees radius 8 RF, and 1 degrees radius 16 RF), optotype acuity, and grating acuity were measured. For strabismic children, hyperacuity and grating acuity were identified as normal/amblyopic based on age-matched norms. The normal/abnormal classification was compared with amblyopia diagnosis by gold standard early treatment diabetic retinopathy study (ETDRS) optotype visual acuity. RESULTS. The 0.5 degrees radius 8 RF pattern had 83% sensitivity and 71% positive predictive value (PPV) for strabismic amblyopia. In comparison, the 1 degrees radius 8 RF and 1 degrees radius 16 RF patterns had poorer sensitivity (27%-12%) and PPV (57%-50%) for amblyopia, similar to grating acuity (sensitivity = 38%, PPV = 31%). Amblyopic deficits using the 0.5 degrees radius 8 RF pattern were directly proportional to optotype visual acuity deficits. CONCLUSIONS. The demonstrated feasibility of radial deformation stimuli for forced-choice preferential looking testing and the sensitivity and specificity of the small radius radial deformation hyperacuity stimulus for amblyopia support the potential to utilize this test to detect and monitor amblyopia in infants and preschool children. (Invest Ophthalmol Vis Sci. 2012;53:3303-3308) DOI:10.1167/iovs.11-8774

  • 出版日期2012-6