What are the guideline sources, guidelines and references for Amblyopia ?
Guideline sources The following summarized guidelines for the evaluation and management of amblyopia are prepared by our editorial team based on guidelines from the American Association for Pediatric Ophthalmology and Strabismus (AAPOS 2018) and the U.S. Preventive Services Task Force (USPSTF 2017). 1 2 3 3 3 4 5 Definition Amblyopia is a neurological disease characterized by cortical visual impairment, with loss or lack of development of central vision in one eye that is unrelated to primary ocular pathology. 3 Epidemiology Abnormal or inadequate stimulation of the visual system during its early developmental period results in amblyopia. Common etiologies include strabismus, refractive errors (anisometropia, and high hyperopia), and structural ocular abnormalities (ptosis, corneal opacity, vitreous hemorrhage, and congenital cataract). 3 Pathophysiology The prevalence of amblyopia in the United States is estimated to be less than 2000 cases per 100,000 individuals. 4 Disease course https://web.pathway.md/diseases/rec5LUyQBaHsEUOlH 1/3 6/23/23, 2:34 AM Amblyopia Pathway The resulting alterations in the development of visual pathways cause clinical manifestations of visual impairment and permanent vision loss of the affected eye. 3 Prognosis and risk of recurrence Amblyopia is not associated with an increase in mortality. 5 Guidelines 1. Screening and diagnosis Indications for screening: as per USPSTF 2017 guidelines, screen pediatric patients 3-5 years of age at least once for amblyopia or its risk factors. B 2. Classification and risk stratification Correction of refractive error: treat refractive error as the initial step in the care of children 0 to 17 years of age with amblyopia. B Patching: consider using patching as first-line therapy after refractive correction in children with moderate amblyopia - 20/40 to 20/80 - B with a prescribed dose of 2 hours of daily patching or weekend atropine. C Show 2 more Filters: consider using filters for the treatment of children with mild amblyopia who do not improve with eyeglasses alone. B Pharmacological treatment: consider using pharmacological treatment that produces cycloplegia of the nonamblyopic eye for the treatment of children who do not improve with eyeglasses alone. B 3. Follow-up and surveillance Follow-up assessment: schedule a follow-up examination 2-3 months after initiation of treatment in most patients, but timing will vary according to the intensity of the treatment and the age of the child. References 1. Wallace DK, Repka MX, Lee KA et al. Amblyopia Preferred Practice Pattern. Ophthalmology. 2018 Jan;125 1 P105 P142. Open 2. US Preventive Services Task Force, Grossman DC, Curry SJ et al. Vision Screening USPSTF in Children Aged 6 Months to 5 Years: US Preventive Services Task Force Recommendation Statement. JAMA. 2017 Sep 5;318 9 836 844. Open https://web.pathway.md/diseases/rec5LUyQBaHsEUOlH 2/3 6/23/23, 2:34 AM Amblyopia Pathway 3. Papageorgiou E, Asproudis I, Maconachie G et al. The treatment of amblyopia: current practice and emerging trends. Graefes Arch Clin Exp Ophthalmol. 2019 Jun;257 6 1061 1078. Open 4. Friedman DS, Repka MX, Katz J et al. Prevalence of amblyopia and strabismus in white and African American children aged 6 through 71 months the Baltimore Pediatric Eye Disease Study. Ophthalmology. 2009 Nov;116 11 2128 34.e1 2. Open 5. van de Graaf ES, van Kempen-du Saar H, Looman CW et al. Utility analysis of disability caused by amblyopia and/or strabismus in a population-based, historic cohort. Graefes Arch Clin Exp Ophthalmol. 2010 Dec;248 12 1803 7. Open https://web.pathway.md/diseases/rec5LUyQBaHsEUOlH 3/3