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TitleNew pediatric risk factors for amblyopia: strabismic versus refractive
Author(s)Guimarães, Sandra
Vieira, Maria
Queirós, Tatiana Sofia Monteiro
Soares, Andreia
Costa, Patrício Soares
Silva, Eduardo
Birth Weight
Case-Control Studies
Child, Preschool
Medical History Taking
Refractive Errors
Retrospective Studies
Risk Factors
Surveys and Questionnaires
Vision Tests
Visual Acuity
Amblyogenic risk factors
Family history
Neonatal background
Issue date2018
PublisherSAGE Publications Ltd
JournalEuropean Journal of Ophthalmology
Abstract(s)Purpose: To assess the role of risk factors for amblyopia, such as family history and neonatal background, for the prediction of either strabismic amblyopia or refractive amblyopia.Methods: In this retrospective case-control model, the study population included all children born at the Hospital de Braga during 1997-2012 (3 to 18 years old) with ophthalmologic consultation in 2014. Data collection was performed from the clinical database and through telephone questionnaire surveys.Results: A total of 298 (50%) controls and 298 (50%) cases (120 [40.3%] strabismic amblyopia and 178 [59.7%] refractive amblyopia) were analyzed. A significantly lower birthweight was detected in patients with strabismic amblyopia (mean 2,961 g [95% confidence interval (CI) 2,827-3,096]) compared to controls (mean 3,198 g [95% CI 3,125-3,271]) (p = 0.002). Five-minute Apgar was significantly lower in patients with strabismic amblyopia (mean 9.57 [95% CI 9.37-9.77]) than in controls (mean 9.83 [95% CI 9.77-9.90]) (p = 0.004) or patients with refractive amblyopia (mean 9.79 [95% CI 9.69-9.89]) (p = 0.031). Family history of either amblyopia or strabismus was associated with amblyopia (chi(2) [2, n = 562] = 12.66; p = 0.002; Cramer V = 0.150; chi(2) [2, n = 561] = 11.0; p = 0.004; Cramer V = 0.140), but was significantly more associated with strabismic amblyopia (p = 0.0023 and p = 0.0032) than with refractive amblyopia (p = 0.48 and p = 0.015, respectively). Multinomial logistic regression model explained 50.8% of the variance in amblyopia development. Low 5-minute Apgar had a relevant odds ratio (OR) for either strabismic amblyopia (OR 3.44; p = 0.066) or refractive amblyopia (OR 3.30; p = 0.077).Conclusions: This division in amblyopia subtypes gives a new perspective of the risk factors for amblyopia, with family history and some obstetrician/neonatal outcomes appearing to be more relevant in strabismic amblyopia. Educating health care providers to recognize these risk factors can result in an early ophthalmologic referral.
AccessOpen access
Appears in Collections:ICVS - Artigos em Revistas Internacionais com Referee

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