Orbit (Amsterdam, Netherlands) · 2026
Congenital nasolacrimal duct obstruction and amblyogenic risk factors: a systematic review of the evidence and controversies.
Систематический обзорСтатьяНазвание и аннотация: Перевод в очереди
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Khademi Behzad, Moallem Mehdi
Аннотация
PURPOSE: Congenital nasolacrimal duct obstruction (CNLDO) represents the predominant etiology of infantile epiphora. It frequently resolves spontaneously; but persists in approximately 5-6% of cases. The possible correlation between CNLDO and risk factors for amblyopia, including anisometropia, refractive errors, and strabismus, remains a subject of debate, which consequently affects the timing and selection of therapeutic interventions.
METHODS: This systematic review adhered to the PRISMA2020 guidelines. Comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar (1998-2024) was conducted to identify studies on coexistence of CNLDO and amblyopia risk factors. Eligible studies include original research articles and case series that reported on refractive errors, the amblyopia prevalence, or biometric parameters associated with CNLDO. Review articles, editorial pieces and papers not published in English were excluded from the analysis. A total of 24 studies met the inclusion criteria and were subjected to a qualitative synthesis.
RESULTS: Findings across various studies exhibited significant heterogeneity. The reported CNLDO prevalence varied considerably, ranging from 2.6% to 33%, with anisometropia and hyperopia as the most common conditions. Although several investigations suggested a higher incidence of ARF and amblyopia in cases of unilateral or persistent CNLDO, other studies found no significant differences compared to the general population or age-matched controls. These discrepancies primarily arise from inconsistencies in ARF definitions (according to AAPOS 2003, 2013, 2021 guidelines), differences in patient age groups and the lack of adequately matched control groups. The proposed mechanisms underlying these findings include disrupted emmetropization resulting from chronic epiphora, orbital structural anomalies and eye-rubbing - induced astigmatism.
CONCLUSION: Evidence regarding the correlation between CNLDO and amblyopia remains inconclusive. Standardised ARF definitions, age-matched controls and biometric analyses are crucial for future studies to clarify this issue and improve treatment strategies.
METHODS: This systematic review adhered to the PRISMA2020 guidelines. Comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar (1998-2024) was conducted to identify studies on coexistence of CNLDO and amblyopia risk factors. Eligible studies include original research articles and case series that reported on refractive errors, the amblyopia prevalence, or biometric parameters associated with CNLDO. Review articles, editorial pieces and papers not published in English were excluded from the analysis. A total of 24 studies met the inclusion criteria and were subjected to a qualitative synthesis.
RESULTS: Findings across various studies exhibited significant heterogeneity. The reported CNLDO prevalence varied considerably, ranging from 2.6% to 33%, with anisometropia and hyperopia as the most common conditions. Although several investigations suggested a higher incidence of ARF and amblyopia in cases of unilateral or persistent CNLDO, other studies found no significant differences compared to the general population or age-matched controls. These discrepancies primarily arise from inconsistencies in ARF definitions (according to AAPOS 2003, 2013, 2021 guidelines), differences in patient age groups and the lack of adequately matched control groups. The proposed mechanisms underlying these findings include disrupted emmetropization resulting from chronic epiphora, orbital structural anomalies and eye-rubbing - induced astigmatism.
CONCLUSION: Evidence regarding the correlation between CNLDO and amblyopia remains inconclusive. Standardised ARF definitions, age-matched controls and biometric analyses are crucial for future studies to clarify this issue and improve treatment strategies.