Against-the-rule (ATR) astigmatism as a predicting factor for the outcome of amblyopia treatment

Risk factors for treatment failure of anisometropic amblyopia

“…Another study concluded that against-the-rule astigmatism had an unfavorable impact on the outcome of amblyopia treatment. 12 Children with uncorrected astigmatism experience blurred vision at distance and near unlike myopic patients who can see clearly at their anterior focal point and hyperopic patients who can partially or completely focus an image through accommodation. 13 Another possible explanation is that cylindrical refraction can be more difficult to accurately determine in children, who are often uncooperative for examination, potentially reducing the effect of spectacle treatment.…”

Effect of astigmatism on refraction in children with high hyperopia

“…In their study, there was statistically significant less line gain of BCVA among patients with hyperopic ATR astigmatism compared with patients with hyperopic WTR astigmatism and myopic ATR patients compared with myopic WTR patients. A number of factors may have affected our results differently from the previous study (19). Of which, the enrolled patients all had unilateral amblyopia due to anisometropia without strabismus, whereas we did not gather systematic data.…”

“…However, the disparity of age may account for the dispute because the development of the older children was more or less completed. One finding determined that the outcome of amblyopia treatment seems to be less favorable in patients with either hyperopic or myopic ATR astigmatism (19). In their study, there was statistically significant less line gain of BCVA among patients with hyperopic ATR astigmatism compared with patients with hyperopic WTR astigmatism and myopic ATR patients compared with myopic WTR patients.…”

Anisometropic amblyopia: factors influencing the success or failure of its treatment

“…Somer et al 56 reported that the presence of againstthe-rule (ATR) anisometropic astigmatism (hypermetropic or myopic), rather than with-the-rule (WTR) astigmatism, is a factor that could contribute to the failure of treatment. In myopic and hypermetropic ATR astigmatism the vertical meridian is clear and the horizontal meridian is blurred, whereas in WTR astigmatism the vertical meridian is blurred and the horizontal meridian is clear.…”

“…In myopic and hypermetropic ATR astigmatism the vertical meridian is clear and the horizontal meridian is blurred, whereas in WTR astigmatism the vertical meridian is blurred and the horizontal meridian is clear. Somer et al 56 suggested that this blurring of the horizontal meridian might be why treatment results are poorer with ATR astigmatism. Although they found no difference between hypermetropic and myopic astigmatism, Kutschke 47 did find that anisometropic myopic astigmatism leads to a poorer outcome.…”