"Combined occlusion and atropine therapy" versus "Augmented part-time patching" in children with refractory/residual amblyopia: A pilot study

Abstract

Purpose:To compare the efficacy of combined occlusion and atropine therapy (COAT) and augmented part-time patching for the treatment of unilateral refractory/residual amblyopia.Methodology:This retrospective study evaluated children between 4 and 11 years with refractory/residual amblyopia who were treated with either additional atropine (COAT group) or increased hours of patching (augmented group). Data were collected on improvement in best-corrected visual acuity (BCVA; logarithm of the minimum angle of resolution [logMAR] units) at each follow-up visit.Results:There were 19 children in the COAT group and 17 children in the augmented group. The baseline BCVA of the amblyopic eye was 0.79 ± 0.36 logMAR in the COAT group and 0.72 ± 0.26 logMAR in augmented group. Children were statistically significantly younger in the COAT group (6.4 ± 2.2 years) compared to the augmented group (8.6 ± 3.3 years, P = 0.02). The mean duration of follow-up was statistically significantly longer in the augmented group (20.2 COAT group; 13.9 months augmented group) (P = 0.03). Compliance was similar in both groups. LogMAR BCVA (adjusted for difference in age and baseline BCVA) was statistically significantly better in the COAT group (0.56 ± 0.04) compared to the augmented group (0.80 ± 0.04) at 3 months (P = 0.000); 6 months (COAT group, 0.50 ± 0.04 vs. augmented group, 0.74 ± 0.04; P = 0.04) and at 1 year (COAT group, 0.42 ± 0.04 vs. augmented group, 0.67 ± 0.04, P = 0.000). There was statistically significantly greater improvement in logMAR BCVA at 6 months in COAT group (0.26 ± 0.15) compared to the augmented group (0.02 ± 0.14), (P = 0.0002). Age, gender, pretreatment BCVA, duration of follow-up, or compliance to patching did not affect improvement in BCVA.Conclusions:COAT may result in greater improvement in BCVA than augmented part-time patching in children with unilateral residual/refractory amblyopia.

Treatment Outcome of Occlusion for Unilateral Amblyopia in Saudi Children 6-12 Years Old

“…[ 21 ] and Sachdeva et al . [ 22 ] With the increasing age of the children, the success rate declined in a study in Nepal. [ 23 ] With better access to health care for girls in Saudi Arabia and a selection of only 6–12-year-old children, we did not find an association between age and sex with the success of occlusion therapy.…”

Amblyopia and Current Treatment Approaches

“…26,27 Son zamanlarda yapılan bir çalışmada kombine uygulanan kapama ve atropin tedavisi ile kısmi zamanlı kapama tedavileri 4-11 yaş arası 19 çocukta karşılaştırılmış ve kombine kapama ve atropin tedavisi uygulanan çocuklarda kısmi zamanlı kapama uygulanan çocuklara göre görme keskinliğinde büyük bir artış gözlenmiştir. 28 Atropinin daha kolay tolere edildiğini ve daha ekonomik bir tedavi olduğunu savunan görüşler de vardır. En önemli sorun atropine bağlı gelişen ışık hassasiyeti ve ciltte kızarıklık yan etkileridir.…”

Effectiveness of syntonic phototherapy in amblyopia in terms of improved visual acuity and contrast sensitivity

“…visual acuity assessment, neutral density filter test, contrast sensitivity testing, crowding phenomenon testing, fundoscopy, refraction, stereoacuity testing, central and eccentric fixation testing and tests for sensory abnormalities. 9 The earlier the treatment the better is the prognosis. 10 There are basically two ways to treat amblyopia, one is treating underlying aetiology while other is stimulating amblyopic eye.…”