Interocular Axial Length Difference and Treatment Outcomes of Anisometropic Amblyopia.

Purpose: To evaluate the effect of interocular axial length (AL) difference on outcomes of treatment for anisometropic amblyopia in comparison with normal participants. Methods: In this historical cohort study, 83 patients with anisometropic amblyopia were divided into two age groups, 70 children (mean, 7.86 ± 1.56 and range, 5-15 years) and 13 adults (mean, 26.46 ± 10.87 and range, 16-45 years). The control group consisted of 43 non-amblyopic children and 17 non-amblyopic adults. Treatment outcomes after a period of one year were defined as successful or unsuccessful when posttreatment amblyopic corrected distance visual acuity (CDVA) was reported as ≤ 0.9 versus CDVA ≤ 0.8, respectively. AL was measured using a Lenstar LS900 (Haag-Streit AG, Switzerland). Results: Fifty-nine patients showed satisfactory treatment outcomes (55 children and 4 adults), while unsuccessful treatment outcomes were observed in 24 patients (15 children and 9 adults). The mean of amblyopia treatment duration was 1.24 ± 0.76 years. The mean of interocular AL difference in all patients, control, successful and unsuccessful treatment outcome groups were 0.49 ± 0.70mm (range, 0.00-3.89 mm), 0.12 ± 0.07 mm (range, 0.02-0.41), 0.33 ± 0.23 mm (range, 0.00-0.99 mm), and 1.81 ± 0.80 mm (range, 1.14-3.89 mm), respectively. In both age groups, the mean of interocular AL difference in patients with unsuccessful treatment outcomes was greater than those with successful treatment outcomes and that of the control group (P < 0.001). Conclusion: The results of this study suggest that the outcome of anisometropic amblyopia treatment may depend on the interocular AL difference.

Mediators of neovascularization and the hypoxic cornea.

The maintenance of corneal avascularity is essential to vision. The mechanisms by which the cornea becomes vascularized in response to inflammation or hypoxic stress are beginning to be elucidated. A detailed understanding of the molecular responses of the cornea to hypoxia is critical for prevention and development of novel treatments for neovascularization in a range of disease states. Here, we have examined the current literature on the major mediators of angiogenesis, which have previously been reported during hypoxia in the cornea in order to better understand the mechanisms by which corneal angiogenesis occurs in circumstances where the available oxygen is reduced. The normal cornea produces angiogenic factors that are regulated by the production of anti-angiogenic molecules. The various cell types of the cornea respond differentially to inflammatory and hypoxic stimuli. An understanding of the factors that may predispose patients to development of corneal blood vessels may provide an opportunity to develop novel prophylactic strategies. The difficulties with extrapolating data from other cell types and animal models to the cornea are also examined.