Compliance in antiamblyopia occlusion therapy

Abstract

Antiamblyopia occlusion therapy relies on compliance. We retrospectively reviewed the charts of 496 amblyopic subjects. Measures of non-compliance included patient reporting and patient records of broken appointments. Out of 496 subjects, 92 (18%) failed to follow the occlusion regimen. Compliance with treatment was analyzed by age group, refractive error and type of strabismus. The failure rate was 82.6% for the unilateral high myopia group and 37.5% for the monofixation syndrome group. The risk for non-compliance appeared to be higher in the 1 to 2-year-old group (37%). The chi 2-test showed the differences to be highly significant (P less than 0.0001). Children having lower initial visual acuity were also significantly less complaint (P less than 0.007). Several factors such as age, parental understanding, initial visual acuity and improvement rate seem to be involved in compliance.

Association Between Occlusion Therapy and Optotype Visual Acuity in Children Using Data From the Infant Aphakia Treatment Study

“…We selected this dichotomization because the visual acuity assessment at twelve months of age may have affected subsequent patching and because it has previously been observed that patching is higher in the first year of life than thereafter (18). We limited the analysis to children with at least three assessments in the first period and five in the second because, although reported patching is consistent over time (Cronbach’s Alpha >0.75), relatively large intra-individual differences were reported.…”

Unilateral lens extraction for high anisometropic myopia in children and adolescents

“…[15][16][17] Poor compliance with amblyopia therapy in unilateral high myopia has been reported in previous studies. 4,5,18 Hussein and coworkers, 14 reporting on 104 children with anisometropic amblyopia, found that poor initial visual acuity, lack of compliance, and age older than 6 years are risks for treatment failure.…”

Light Transmission and Preference of Eye Patches for Occlusion Treatment

“…Also, patching is used in strabismus as a non- surgical treatment. [5], [6] Many studies have demonstrated that treatment compliance is the most important factor for predicting a successful outcome in amblyopia [10], [12]–[15]. In an attempt to improve compliance, optical and pharmacological penalization were introduced and used [16]–[18].…”

“…Many factors, such as patient’s age, initial visual acuity, refractive error and parental understanding, contribute to the compliance of eye patching. [10], [11] Nowadays, many brands of patches are available. However, there have been few investigations concerning the patch as a tool for occlusion therapy.…”