The authors present a systematic review with the aim of reporting how frequently and to what extent amblyopia recovers following the loss of vision in the fellow eye and identify any potential clinical predictors. Studies including adults with amblyopia and fellow eye vision loss where patient-level data was provided, with a minimum of two visual acuity measurements, were included. A total of 24 studies were identified for inclusion, involving 110 cases. The cause of the visual acuity loss in the fellow eye included optic neuropathy, age-related macular degeneration and uveal melanoma. Three studies contributed to the aim of reporting the prevalence and extent of recovery (42 cases). Improvement of visual acuity in the amblyopic eye was seen in similar incidences across these studies (81%), with a median improvement of 2.60logMAR and using the clinically meaning full cut off, 60% gained more than 2logMAR. Time taken to achieve the maximum amblyopic change was a median of 12 months. The potential predictive factors for greater improvement in visual acuity of the amblyopic eye, identified in a regression analysis, included younger age, poorer baseline amblyopic visual acuity and poorer fellow eye visual acuity. Recovery was noted regardless of type of amblyopia and type of pathology affecting the fellow eye. This review provides further evidence that neuroplastic capacity is available into adulthood, with the potential for clinically meaningful improvement of visual acuity in amblyopic eyes. The authors suggest that further experimentation to establish the mechanisms involved could result in therapeutic targets for amblyopia treatment in adults.
Visual acuity improvement in amblyopic eyes following fellow eye vision loss
Reviewed by Lauren Hepworth
Spontaneous recovery from amblyopia following fellow eye vision loss: A systematic review and narrative synthesis.
CONTRIBUTOR
Lauren R Hepworth
University of Liverpool; Honorary Stroke Specialist Clinical Orthoptist, Northern Care Alliance NHS Foundation Trust; St Helen’s and Knowsley NHS Foundation Trust, UK.
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