Oculometric parameters of hyperopia in children with esotropic amblyopia.

Citation information: Debert I, de Alencar LM, Polati M, Souza MB & Alves MR. Oculometric parameters of hyperopia in children with esotropic amblyopia. Ophthalmic Physiol Opt 2011, 31, 389–397. doi: 10.1111/j.1475-1313.2011.00850.x Abstract Purpose:  To study the oculometric parameters of hyperopia in children with esotropic amblyopia, comparing amblyopic eyes with fellow eyes. Methods:  Thirty-seven patients (5–8 years old) with bilateral hyperopia and esotropic amblyopia underwent a comprehensive ophthalmic examination, including cycloplegic refraction, keratometry and A-scan ultrasonography. Anterior chamber depth, lens thickness, vitreous chamber depth and total axial length were recorded. The refractive power of the crystalline lens was calculated using Bennett’s equations. Paired Student’s t-tests were used to compare ocular biometric measurements between amblyopic eyes and their fellow eyes. The associations of biometric parameters with refractive errors were assessed using Pearson correlation coefficients and linear regression. Multivariable models including axial length, corneal power and lens power were also constructed. Results:  Amblyopic eyes were found to have significantly more hyperopic refraction, less corneal power, greater lens power, shorter vitreous chamber depth and shorter axial length, despite similar anterior chamber depth and lens thickness. The strongest correlation with refractive error was observed for the axial length/corneal radius ratio (r36 = −0.92, p < 0.001 for amblyopic and r36 = −0.87, p < 0.001 for fellow eyes). Axial length accounted for 39.2% (R2) of the refractive error variance in amblyopic eyes and 35.5% in fellow eyes. Adding corneal power to the model increased R2 to 85.7% and 79.6%, respectively. A statistically significant correlation was found between axial length and corneal power, indicating decreasing corneal power with increasing axial length, and they were similar for amblyopic eyes (r36 = −0.53, p < 0.001) and fellow eyes (r36 = −0.57, p < 0.001). A statistically significant correlation was also found between axial length and lens power, indicating decreasing lens power with increasing axial length (r36 = −0.72, p < 0.001 for amblyopic eyes and r36 = −0.69, p < 0.001 for fellow eyes). Conclusions:  We observed that the correlation among the major oculometric parameters and their individual contribution to hyperopia in esotropic children were similar in amblyopic and non-amblyopic eyes. This finding suggests that the counterbalancing effect of greater corneal and lens power associated with shorter axial length is similar in both eyes of patients with esotropic amblyopia.