Impact of Patching and Atropine Treatment on the Child and Family in the Amblyopia Treatment Study

Holmes, Jonathan M.; Beck, Roy W.; Kraker, Raymond T.; Cole, Stephen R.; Repka, Michael X.; Birch, Eileen E.; Felius, Joost; Christiansen, Stephen P.; Coats, David K.; Kulp, Marjean Taylor

doi:10.1001/archopht.121.11.1625

Cited by 138 publications

(37 citation statements)

References 8 publications

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“…While in patients with mild to moderate amblyopia all treatment protocols produced comparatively similar outcome. This is similar to observations of PEDIG in younger children 7-10…”

Section: Discussionsupporting

confidence: 91%

Part-time occlusion therapy for amblyopia in older children

Singh¹,

Sachdev²,

Brar³

et al. 2008

Indian J Ophthalmol

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Aim:To compare the efficacy of part-time versus full-time occlusion for treatment of amblyopia in children aged 7-12 years.Materials and Methods:Prospective interventional case series. One hundred children between 7-12 years of age with anisometropic (57), strabismic (25) and mixed (18) unilateral amblyopia were randomized (simple randomization) into four groups (25 each) to receive two hours, four hours, six hours or full-time occlusion therapy. Children were regularly followed up at six-weekly intervals for a minimum of three visits.Statistical Analysis:Intragroup visual improvement was analyzed using paired t-test while intergroup comparisons were done using ANOVA and unpaired t-test.Results:All four groups showed significant visual improvement after 18 weeks of occlusion therapy (P<0.001). Seventy-three (73%) of the total 100 eyes responded to amblyopia therapy with 11 eyes (44%), 17 eyes (68%), 22 eyes (88%) and 23 eyes (92%) being amblyopia responders in the four groups respectively, with the least number of responders in the two hours group. In mild to moderate amblyopia (vision 20/30 to 20/80), there was no significant difference in visual outcome among the four groups (P=0.083). However, in severe amblyopia (vision 20/100 or worse), six hours (P=0.048) and full-time occlusion (P=0.027) treatment were significantly more effective than two hours occlusion.Conclusion:All grades of part-time occlusion are comparable to full-time occlusion in effectiveness of treatment for mild to moderate amblyopia in children between 7-12 years of age unlike in severe amblyopia, where six hours and full-time occlusion were more effective than two hours occlusion therapy.

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“…While in patients with mild to moderate amblyopia all treatment protocols produced comparatively similar outcome. This is similar to observations of PEDIG in younger children 7-10…”

Section: Discussionsupporting

confidence: 91%

Part-time occlusion therapy for amblyopia in older children

Singh¹,

Sachdev²,

Brar³

et al. 2008

Indian J Ophthalmol

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“…2, 3, 16, 17 In this study, we hypothesized that 4-hours of IO-Therapy (50% of wear time) would not be inferior to 2-hours of traditional continuous adhesive patch occlusion treatment, in improving visual acuity in 3- to 7-year-old children with moderate, unilateral amblyopia . We tested our hypothesis with a randomized, controlled, non-inferiority clinical trial using methods based upon the gold-standard PEDIG Amblyopia Treatment Study (ATS) protocols for moderate amblyopia.…”

Section: Introductionmentioning

confidence: 98%

A pilot randomized clinical trial of intermittent occlusion therapy liquid crystal glasses versus traditional patching for treatment of moderate unilateral amblyopia

Wang

Neely

Galli

et al. 2016

Journal of American Association for Pediatric Ophthalmology and

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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.

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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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Impact of Patching and Atropine Treatment on the Child and Family in the Amblyopia Treatment Study

Cited by 138 publications

References 8 publications

Part-time occlusion therapy for amblyopia in older children

Part-time occlusion therapy for amblyopia in older children

A pilot randomized clinical trial of intermittent occlusion therapy liquid crystal glasses versus traditional patching for treatment of moderate unilateral amblyopia

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

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