Efficacy of occlusion for strabismic amblyopia: can an optimal duration be identified?
نویسنده
چکیده
BACKGROUND/AIMS The study of occlusion efficacy in amblyopia has been hampered by the use of non-logMAR acuity tests and a failure to assess threshold acuity for both eyes. These issues are addressed in the current study which compares the effect of spectacles alone and spectacles in combination with occlusion, with the use of the logMAR crowded test. METHODS Changes in uniocular and interocular acuity differences were compared for two age matched groups of previously untreated children with strabismic amblyopia: one compliant with spectacles only (n = 17, mean 6.2 (SD 2.5) years) and the other with spectacles and occlusion (n = 69, mean 5.1 (1) years) over a 1 year period. Changes in logMAR acuity were also analysed for a larger occluded group (n = 119) in response to successive 200 hour blocks of occlusion up to > or =1000 hours, in an attempt to isolate an optimal occlusion regime. RESULTS Visual acuity improved for more of the amblyopic eyes of the occluded (74%) than the spectacles only group (59%), and only one child from the latter group deteriorated. Mean visual acuity improved for both eyes of both treatment groups, but the change was significantly larger for the strabismic eyes of the occluded group overall and within the first 6 month period (p <0. 05). Occlusion was only effective for the first 400 hours worn. Subsequent visual improvement was bilateral and symmetrical. CONCLUSION Occlusion is more effective in the treatment of strabismic amblyopia than spectacles alone, and the effect is optimal within the first 6 months of wear. In terms of occlusion duration, maximal improvement occurs in response to 400 hours of occlusion wear or less, and to full time occlusion. Visual maturation continues, but is retarded for amblyopic eyes.
منابع مشابه
Pattern Visual Evoked Potential as a Predictor of Occlusion Therapy for Amblyopia
PURPOSE This study was conducted to investigate the role of the pattern visual evoked potential (pVEP) as a predictor of occlusion therapy for patients with strabismic, anisometropic, and isometropic amblyopia. The secondary aim was to compare the characteristics of pVEP between strabismic and anisometropic amblyopia. METHODS This retrospective comparative case series included 120 patients wh...
متن کاملChildhood amblyopia: current management and new trends.
INTRODUCTION OR BACKGROUND With a prevalence of 2-5%, amblyopia is the most common vision deficit in children in the UK and the second most common cause of functional low vision in children in low-income countries. SOURCES OF DATA Pubmed, Cochrane library and clinical trial registries (clinicaltrials.gov, ISRCTN, UKCRN portfolio database). AREAS OF AGREEMENT Screening and treatment at the a...
متن کاملEYcacy of occlusion for strabismic amblyopia: can an optimal duration be identified?
Background/aims—The study of occlusion eYcacy in amblyopia has been hampered by the use of non-logMAR acuity tests and a failure to assess threshold acuity for both eyes. These issues are addressed in the current study which compares the eVect of spectacles alone and spectacles in combination with occlusion, with the use of the logMAR crowded test. Methods—Changes in uniocular and interocular a...
متن کاملStrabismic Amblyopia: When to Treat the Amblyopia, When to Operate
Introduction: Strabismic amblyopia is frequently encountered by pediatric ophthalmologists and orthoptists. An understanding of its onset and of the timing of treatment may lead to better long-term treatment results. Methods: A review was conducted of past and recent literature pertaining to strabismic amblyopia. Articles relevant to further understanding the onset, course, and management of st...
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ورودعنوان ژورنال:
- The British journal of ophthalmology
دوره 84 6 شماره
صفحات -
تاریخ انتشار 2000