Twenty regular smokers ( > 15 cigarettes/day), were tested on a letter cancellation task, over four successive days. On one of the test days subjects were smoking deprived for > 12 h, while on the other days they were not nicotine deprived (smoking was allowed until 1 h before testing). The first letter cancellation test was given prior to smoking. Then one cigarette was smoked and a second letter cancellation test given. Performance was significantly impaired by nicotine deprivation, when assessed both by response time (p < 0.05) and target detection (p < 0.001). Cigarette smoking led to significant improvements in both speed and accuracy with the deprived smokers. However, this improved performance basically reflected a return to near baseline values. The performance of the non-deprived subjects remained largely unchanged. There was no evidence of performance differences between high, mid and low frequency letter targets. Each showed an accuracy reduction of about 5% during smoking deprivation, and returned to baseline following nicotine reinstatement. Thus, while sustained attention was significantly influenced by nicotine status, there was no evidence of altered attentional selectivity.
INTRODUCTION
This pilot study was designed to compare the effectiveness of intermittent occlusion therapy (IO-Therapy) using liquid crystal glasses versus continuous occlusion therapy using traditional adhesive patches for treating amblyopia.
DESIGN
A randomized controlled trial. Children 3–8 years of age with previously untreated, moderate, unilateral amblyopia (visual acuity of 20/40 to 20/100 in the amblyopic eye) were enrolled. Amblyopia was associated with strabismus, anisometropia, or both. All subjects had worn optimal refractive correction (if needed) for at least 12 weeks without improvement. Subjects were randomized into two treatment groups: a 4-hour IO-Therapy Group with liquid crystal glasses (Amblyz™), set at 30-second opaque/transparent intervals (occluded 50% of wear time) or a 2-hour continuous Patching Group (occluded 100% of wear time). For each patient, visual acuity was measured with the ATS-HOTV method before and after 12 weeks of treatment.
RESULTS
At the conclusion of the first 12 week-treatment interval, data from 34 patients were available for analysis. Amblyopic eye visual acuity improvement from baseline was 0.15±0.12 (95% CI=0.09 to 0.15) logMAR in the IO-Therapy Group (N=19) and 0.15±0.11 (95% CI=0.1 to 0.15) logMAR in the Patching Group (N=15). Improvements in both groups were significant. The difference between groups was not statistically significant (P=0.73). No adverse effects were reported.
CONCLUSION
In this pilot study, IO-Therapy with Amblyz liquid crystal glasses is not inferior to adhesive patching and is a promising alternative treatment for children 3–8 years of age with moderate amblyopia. A larger randomized clinical trial is needed to confirm results in future.
Data from 203 consecutive primary pediatric IOL implantations showed the heterogeneous nature of the variables involved in predictions of refractive outcomes in this population. The complexities of this issue support the need for specific methods of measurement and an IOL calculation formula for the pediatric population.
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