Amblyopia: is treatment possible?

New Orleans-Although amblyopia has been recognized for a long time, patching has been the primary treatment and the cause is unknown., according to Creig Hoyt, MD of San Francisco during the William F. Hoyt Lecture at the annual meeting of the American Academy of Ophthalmology.

One of the most important issues he addressed was the possibility of developing an effective treatment for the disorder.

"If we assume that the primary problem in amblyopia is in the visual cortex, which is still controversial, and that synaptic plasticity is the issue at stake in the disease, can we expect to devise a pharmacologic therapy for amblyopia? There is fairly good evidence that NMDA receptors, neurotropic vectors, nitric acid, and inhibition are all important in neural changes that occur in experimental monocular deprivation. At least there are some target areas. But NMDA is not to be involved in the development of plasticity of the visual cortex in a complex of more than 75 proteins that can be grouped into five different classes," he said. In addition, there are 200 carbons that are expressed uniquely in the kitten visual cortex.

Extensive study is still required to determine whether one or more of these classes are involved in synaptic plasticity in amblyopia.

"If we assume that the visual cortex is the origin of ambylopia, the number of targets that we have for developing pharmacologic therapy is numerous. We are just beginning to identify some of the problems, but the picture is far from clear," he said.