Study finds persistent amblyopia increases risk of cardiometabolic disorders

(Image Credit: AdobeStock/ArtemisDiana)

First author Siegfried Karl Wagner, MD, FRCOphth, and colleagues, who conducted a study to identify the association between unilateral childhood amblyopia and cardiometabolic disorders in adulthood, reported greater cardiometabolic dysfunction in adults who had childhood amblyopia.¹ Wagner is from the Institute of Ophthalmology, University College London, and the NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology London, both in London.

Their prospective cohort study included 126,399 participants in the United Kingdom Biobank who underwent an ocular examination, of whom 67,321 underwent retinal imaging. The investigators wanted to determine if there was an association between amblyopia and components of the metabolic syndrome and individual cardiometabolic diseases. Childhood amblyopia, classified as resolved or persisting into adulthood, cardiometabolic disease and mortality were defined using ophthalmic assessment, self-reported hospital admissions, and death records, they explained.

Retinal photography and optical coherence tomography images were reviewed for morphologic features of the optic nerve and the retinal vasculature and sublayers.

Analysis findings

The investigators reported that participants with persistent amblyopia (n = 2,647) were more likely to be obese, hypertensive, and diabetic compared with participants who did not have amblyopia (controls, n = 18,481 controls). The presence of persistent amblyopia also was associated with an increased risk of myocardial infarction and death.

Evaluation of the amblyopic eyes on retinal images showed that the eyes had significantly increased venular caliber increased tortuosity but lower fractal dimension and a thinner ganglion cell-inner plexiform layer. The amblyopic eyes with a persisting visual deficit had lower optic nerve disc height and width compared to the control eyes.

Evaluation of the unaffected fellow eyes of participants with amblyopia also had significantly lower retinal fractal dimension and a thinner ganglion cell-inner plexiform layer.

They pointed out that differences in the retinal features in the amblyopic eye and the unaffected non-amblyopic eye suggested a generalized versus local processes.

In commenting on their findings, Wagner and colleagues said, “Adults who had amblyopia in childhood have increased risk of cardiovascular disease and metabolic dysfunction. Optic nerve morphology should be investigated further as a prognostic factor for treatment response in children undergoing treatment for amblyopia. As a leading cause of childhood visual impairment, amblyopia may also represent a relatively common and accessible neurodevelopmental model for research into the early life factors of health and disease.”

The authors advised that while “further longitudinal research is needed to understand the basis of the observed associations, healthcare professionals should be cognizant of greater cardiometabolic dysfunction in adults who had childhood amblyopia. Differences in retinal features in both the amblyopic eye and the unaffected non-amblyopic eye suggest a generalized disease process versus local disease processes.”

Reference

1. Wagner SK, Bountziouka V, Hysi P, Rahi JS, on behalf of the UK Biobank Eye & Vision Consortium. Associations between unilateral amblyopia in childhood and cardiometabolic disorders in adult life: a cross-sectional and longitudinal analysis of the UK Biobank. eClinicalMedicine 2024;70:102493