Compliance With Occlusion Therapy for Childhood Amblyopia

Wallace, Michael P.; Stewart, Catherine E.; Moseley, Merrick J.; Stephens, David A.; Fielder, Alistair R.

doi:10.1167/iovs.13-11861

Cited by 109 publications

(72 citation statements)

References 32 publications

(42 reference statements)

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“…Occlusion therapy is important because there are reports that approximately 70% of patients do not regain good visual acuity by only wearing eyeglasses [6]. However, occlusion therapy has side effects, such as occlusion amblyopia, skin rashes, and mental distress [7], and compliance is extremely poor [8, 9]. In recent years, due to the development of image technology, a variety of amblyopia treatment devices that present the visual target to only the amblyopic eye under open binoculars have been developed [10–13].…”

Section: Introductionmentioning

confidence: 99%

Comparison between Amblyopia Treatment with Glasses Only and Combination of Glasses and Open-Type Binocular “Occlu-Pad” Device

Iwata

Handa

Ishikawa

et al. 2018

BioMed Research International

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We evaluated amblyopia treatment, comparing training with glasses only and training with glasses and the Occlu-pad, a binocular open-type amblyopia training device. Forty-six children (4.8 ± 1.1 years) diagnosed with anisometropic amblyopia, all wearing complete correction glasses, were treated either with glasses only, or with glasses in combination with the Occlu-pad (training time: 2 days a week, 30 minutes per day). We compared visual acuity scores at 3 and 6 months after treatment had started, and examined the compliance rate for the Occlu-pad training. Three months as well as 6 months after amblyopia treatment started, the “Occlu-pad treatment group” showed significantly improved visual acuity, compared to the “Glasses treatment group” (at both 3 and 6 months: p < 0.0001). The compliance rate for using the Occlu-pad was 88.4 ± 18.7% after 3 months and 69.6 ± 19.5%, after 6 months. There was no significant correlation between the training time using the Occlu-pad and improvement in visual acuity (3 months: p = 0.97; 6 months: p = 0.55). The compliance rate for months 4 to 6 was significantly lower than that for months 1 to 3 (p = 0.003). Amblyopia treatment using the Occlu-pad device in combination with glasses led to a better effect than treatment with glasses alone.

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Section: Introductionmentioning

confidence: 99%

Comparison between Amblyopia Treatment with Glasses Only and Combination of Glasses and Open-Type Binocular “Occlu-Pad” Device

Iwata

Handa

Ishikawa

et al. 2018

BioMed Research International

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“…10 A further drawback shared by both patching and penalisation is that they are 'dissociative' and do nothing to encourage the amblyopic and the normal eye to work in harmony together. Furthermore, compliance with patching is often poor with up to 50% of patients not complying with the prescribed dosage, 11 suggesting that the treatment is not popular with children. There is clearly a need for something better.…”

Section: Introductionmentioning

confidence: 99%

Randomised controlled trial of video clips and interactive games to improve vision in children with amblyopia using the I-BiT system

et al. 2016

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BackgroundTraditional treatment of amblyopia involves either wearing a patch or atropine penalisation of the better eye. A new treatment is being developed on the basis of virtual reality technology allowing either DVD footage or computer games which present a common background to both eyes and the foreground, containing the imagery of interest, only to the amblyopic eye.MethodsA randomised control trial was performed on patients with amblyopia aged 4–8 years with three arms. All three arms had dichoptic stimulation using shutter glass technology. One arm had DVD footage shown to the amblyopic eye and common background to both, the second used a modified shooter game, Nux, with sprite and targets presented to the amblyopic eye (and background to both) while the third arm had both background and foreground presented to both eyes (non-interactive binocular treatment (non-I-BiT) games).ResultsSeventy-five patients were randomised; 67 were residual amblyopes and 70 had an associated strabismus. The visual acuity improved in all three arms by approximately 0.07 logMAR in the amblyopic eye at 6 weeks. There was no difference between I-BiT DVD and non-I-BiT games compared with I-BiT games (stated primary outcome) in terms of gain in vision.ConclusionsThere was a modest vision improvement in all three arms. Treatment was well tolerated and safe. There was no difference between the three treatments in terms of primary stated outcomes but treatment duration was short and the high proportion of previously treated amblyopia and strabismic amblyopia disadvantaged dichoptic stimulation treatment.Trial registration numberNCT01702727, results.

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“…Ayrıca nörovizyon yönteminde iyi gören gözden ödün vermeden ambliyopik göz uyarılabilmektedir (interaktif binoküler tedavi). Kapama yöntemlerine uyumun %50 civarında düşük olması (50), bu hastalarda kullanılabilceğini gündeme getirmiştir. Kişiye özel bir bilgisayar programı yapılır.…”

Section: Nörovizyon Tedavisi (Dikoptik Tedavi)unclassified

“…Refraktif ambliyopi ve şaşılık ambliyopisi olan 178 olgu üzerinde yapılan bir çalışmada, konjontivaya 1 cm mesafeden, 30 sn süre ile makulaya lazer ışını (780 nm, 292 Hz, 7,5 mW; spot büyüklüğü 3 mm) uygulaması ile görme keskinliğinde artış saptanmıştır (50).…”

Section: Yeni Tedavi Yöntemleriunclassified

Ambliyopide Son Durum

Yaşar

2017

Osmangazi̇ Journal of Medicine

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Özet: Ambliyopi, organik bir göz patolojisi olmamasına rağmen görme keskinliğinde tek veya çift taraflı azalma olmasıdır. Çocuklar ve genç erişkinlerde tek taraflı görme azlığının en sık sebepi ambliyopi olup genel toplumda görülme sıklığı %1-5 arasında değişmektedir. Ambliyopide kritik yaş ilk 4 yaş olmakla birlikte 6-7 yaşta saptanan olgularda tedavi ile başarı şansı yüksektir. Zamanında saptanıp uygun tedavisi yapıldığında ambliyopiye bağlı görme kaybı geri dönüşümlüdür ve bu kitik süre geçtiğinde ise görme kaybı yaşam boyu sürekli hale gelmektedir. Ambliyopinin en sık sebepleri anizometropi, şaşılık ya da ikisinin birlikteliği olup ayrıca deprivasyona bağlı olarak da ambliyopi oluşabilmektedir. Tedavi yöntemlerinden refraktif düzeltme, kapama tedavisi ve penelizayon en sık kullanılan yöntemler olup ayrıca son zamanlarda nörovizyon tedavisi, medikal tedavi, refraktif cerrahi, akapunktur, makülaya düşük doz lazer ve mavi-kırmızı ışıkla uyarı gibi yöntemler de denenmiştir. Ambliyopi tedavisinde başarıyı etkileyen en önemli faktörler olgunun yaşı ve tedavi başlangıcındaki görme keskinliğidir. Olgunun yaşı ne kadar küçük ise daha kısa sürede daha iyi sonuçlara ulaşılmaktadır. Tanı esnasında görme keskinliği ne kadar düşükse tedaviyle alınan yanıt da azalmaktadır. Abstract: Amblyopia is the reduction of visual acuity in one or both eyes, without the presence of an organic ocular pathology. Amblyopia is the most common reason for a unilateral vision loss in young adults and children. The prevelance in the population varies between %1-5. While the first 4 years of life are the most crucial years, with the right treatment vision can be increased up until 6-7 years of age. Vision loss caused by amblyopia is reversible with the adequate treatment in the right time frame, if it is detected later on in life or left untreated, it can be permanent. Most common causes of amblyopia are; anisometropia, strabismus or simultaneous presence of both. Deprivation can also cause amblyopia. Primary treatment options are; correction of refractive errors, occlusion therapy and penalization. In recent years neurovision therapies, medical treatment, refractive surgeries, acupuncture and macular stimulation with low dose laser or blue-red light therapies have been tried. The most important factor affecting the outcome of the treatment is the patients age and the best corrected visual acuity (BCVA) at diagnosis. Better results are achieved in younger age groups. Patients with lower BCVAs at time of diagnosis usually have a poorer outcome.

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Compliance With Occlusion Therapy for Childhood Amblyopia

Abstract: This study shows that compliance with patching treatment averages less than 50% and is influenced by several factors. A greater understanding of these influences should improve treatment outcome. (ClinicalTrials.gov number, NCT00274664).

Cited by 109 publications

References 32 publications

Comparison between Amblyopia Treatment with Glasses Only and Combination of Glasses and Open-Type Binocular “Occlu-Pad” Device

Comparison between Amblyopia Treatment with Glasses Only and Combination of Glasses and Open-Type Binocular “Occlu-Pad” Device

Randomised controlled trial of video clips and interactive games to improve vision in children with amblyopia using the I-BiT system

Ambliyopide Son Durum

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