Randomized Trial of Treatment of Amblyopia in Children Aged 7 to 17 Years

Scheiman, Mitchell; Hertle, Richard W.; Beck, Roy W.; Edwards, Allison R.; Birch, Eileen E.; Cotter, Susan A.; Crouch, Earl R.; Cruz, Oscar A.; Davitt, Bradley V.; Donahue, Sean P.; Holmes, Jonathan M.; Lyon, Don; Repka, Michael X.; Sala, Nicholas A.; Silbert, David I.; Suh, Donny W.; Tamkins, Susanna M.

doi:10.1001/archopht.123.4.437

Cited by 384 publications

(135 citation statements)

References 31 publications

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“…The PEDIG study [15] reported acuity gains of about 0.27 log units in patients between 7 and 12 years and 0.18 log units in those between 13 and 17 years old. Prescribed occlusion was lower than in our study or the MOTAS study.…”

Section: Evaluation Of the Methods And Datamentioning

confidence: 98%

“…Before study entry, all patients had a full ophthalmic assessment including cycloplegic retinoscopy and fundoscopy, and a full orthoptic examination. Inclusion criteria were: age>7 years and amblyopia (strabismic, anisometropic or combined), and acuity difference between the eyes of at least 0.2 logMAR (logarithm of the minimum angle of resolution) for single and crowded optotypes after refractive adaptation [15,20,21]. While most patients received their glasses several months before entering the study, two received their first glasses 8 and 6.5 weeks respectively before baseline acuity was assessed, and in one patient there was a change of the astigmatic component of 0.75 D 7 weeks before.…”

Section: Patient Inclusionmentioning

confidence: 99%

“…In analogy to the PEDIG study [15], we calculated the "rate of responders" to treatment, i.e. the proportion of patients who gained at least 2 lines on an acuity chart: after 1 month of treatment there were 5/9 (55.55%) responders, after 4 months 6/9 (66.67%).…”

Section: Patientsmentioning

confidence: 99%

“…in textbooks 8 years [9] vs 12 years [10], and in the guidelines of ophthalmological societies 10 years (American Academy of Ophthalmology Preferred Practice Pattern [11]) vs 18 years (Guideline of the German Ophthalmological Societies DOG and BVA [12]). Recently, large prospective studies arrived at very different conclusions: a considerable potential of improvement after intensive treatment in patients between 7 and 10.3 years [13] and between 15 and 45 years of age [14], versus comparatively limited success rates in patients between 7 and 17 years (although those aged 7 to 12 improved more than those aged 13 to 17 years) [15,16].…”

Section: Introductionmentioning

confidence: 99%

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Electronic monitoring of occlusion treatment for amblyopia in patients aged 7 to 16 years

Fronius

Bachert

Lüchtenberg

2009

Graefes Arch Clin Exp Ophthalmol

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This study presents for the first time objective treatment and dose response data in amblyopic patients beyond the "classical" treatment age. Electronic monitoring of occlusion and considerable amounts of patching were shown to be feasible. The acuity results indicate that there is a potential for improvement, yet treatment seemed to be less efficient than shown by previous studies in younger patients. Continuation of this research may advance the discussion about age-dependent evidence-based amblyopia treatment, about preschool screening for amblyopia and about plasticity of the visual system.

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Section: Evaluation Of the Methods And Datamentioning

confidence: 98%

Section: Patient Inclusionmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Electronic monitoring of occlusion treatment for amblyopia in patients aged 7 to 16 years

Fronius

Bachert

Lüchtenberg

2009

Graefes Arch Clin Exp Ophthalmol

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“…reviews by Gilbert, 1998;Levi, 2005;Spolidoro et al, 2009). A large number of (sometimes quite controversial) psychophysical, neurophysiological and clinical studies suggested varying degrees of susceptibility to change beyond school entry age (Daw, 1998;Epelbaum et al, 1993;Scheiman et al, 2005;Wandell & Smirnakis, 2009).…”

Section: Introductionmentioning

confidence: 99%

Efficiency of electronically monitored amblyopia treatment between 5 and 16years of age: New insight into declining susceptibility of the visual system

et al. 2014

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The notion of a limited, early period of plasticity of the visual system has been challenged by more recent research demonstrating functional enhancement even into adulthood. In amblyopia ("lazy eye") it is still unclear to what extent the reduced effect of treatment after early childhood is due to declining plasticity or lower compliance with prescribed patching. The aim of this study was to determine the dose-response relationship and treatment efficiency from acuity gain and electronically recorded patching dose rates, and to infer from these parameters on a facet of age dependence of functional plasticity related to occlusion for amblyopia. The Occlusion Dose Monitor was used to record occlusion in 27 participants with previously untreated strabismic and/or anisometropic amblyopia aged between 5.4 and 15.8 (mean 9.2) years during 4months of conventional treatment. Group data showed improvement of acuity throughout the age span, but significantly more in patients younger than 7years despite comparable patching dosages. Treatment efficiency declined with age, with the most pronounced effects before the age of 7years. Thus, electronic recording allowed this first quantitative insight into occlusion treatment spanning the age range from within to beyond the conventional age for patching. Though demonstrating improvement in over 7year old patients, it confirmed the importance of early detection and treatment of amblyopia. Treatment efficiency is presented as a tool extending insight into age-dependent functional plasticity of the visual system, and providing a basis for comparisons of effects of patching vs. emerging alternative treatment approaches for amblyopia.

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Treatment of Amblyopia in Older Children

Hunter¹

2005

Arch Ophthalmol

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Randomized Trial of Treatment of Amblyopia in Children Aged 7 to 17 Years

Cited by 384 publications

References 31 publications

Electronic monitoring of occlusion treatment for amblyopia in patients aged 7 to 16 years

Electronic monitoring of occlusion treatment for amblyopia in patients aged 7 to 16 years

Efficiency of electronically monitored amblyopia treatment between 5 and 16years of age: New insight into declining susceptibility of the visual system

Treatment of Amblyopia in Older Children

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