Zeitschrift für klinische und experimentelle Ophthalmologie
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Treatment of Anisometropic Amblyopia in Children with Automatic Frequency Conversion Laser

Zhisheng Li, Geng Li, Xueqiang Li, Na Xue, Lavonne Rayer Lee and Diana Danlai Fung

Objective: To evaluate the effectiveness of automatic frequency conversion laser (AFCLA) treatment in children with anisometropic amblyopia.

Methods: Prospective, noncomparative, interventional, noninvasive study was carried out in 102 anisometropic amblyopic children (4 to 13 years old) with the visual acuity ranging from 0.02 to 0.4 decimal in naked eyes. The area of the macula was irradiated by AFCLA through the conjunctiva from 200 cm distance for 240 sec with He-Ne laser light (wavelength 632.8 nm; automatic frequency conversion 10-35 Hz; average radiant power 0.98-3.5 mW; beam spot size at target 0.8 cm²). AFCLA treatment was performed for initial 10-40 days, following up with 10-40 days consolidation therapy at 3,6,12 and 24 months, respectively. No occlusion was applied, and no additional medication was administered. Best-corrected visual acuity and refractive error in both amblyopic eyes (AE) and dominated eyes (DE) were measured.

Results: The amblyopes' visual acuity improved by 3 or more lines in 66.7% after the treatment of initial 10 to 40 days; in 94.2%, 99%, 100%, 100% after 10-40 days consolidation therapy at 3,6,12 and 24 months, respectively. The percentage of anisometropia (calculated difference in spherical equivalent <0.5 diopter (D) difference) decreased in 14.7%, 32.4%, 51.0% and 67.6% after 10-40 days consolidation therapy at 3, 6, 12 and 24 months, respectively. Treatment outcome was not related to age (P=0.86), prior treatment history of atropine (P=0.19) and visual training (P=0.62) but was related to better baseline visual acuity (P=0.01), less amounts of anisometropia (P=0.02) and prior treatment history of patching (P=0.03).

Conclusion: AFCLA improves visual acuity of children with anisometropic amblyopia. Following up 24 months, even anisometropic amblyopes with severe low vision are recoverable.