Ergebnisse später Therapie von exzentrischer Fixation bei verschiedenen Amblyopieformen

Gusek-Schneider, Gabriele-Charlotte

doi:10.1055/s-0029-1245743

Cited by 1 publication

(1 citation statement)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Central fixation was reached by all patients in median after 3 months. Similar to our results, the mean time to reach central fixation according to the doctoral thesis of Hillesheim (cited in [39]) was 4 months (with 75% of patients reaching it after 3 months) and according to the study by Gusek-Schneider [47], it was 4.5 months. In Gusek-Schneider`s study, there was no significant correlation between age and time to achieving foveolar fixation, which is in accordance with our data.…”

Section: Fixationsupporting

confidence: 90%

Electronically monitored occlusion therapy in amblyopia with eccentric fixation

Mehmed

Fronius

Pohl

et al. 2021

Graefes Arch Clin Exp Ophthalmol

View full text Add to dashboard Cite

Purpose Amblyopia with eccentric fixation, especially when not diagnosed early, is a therapeutic challenge, as visual outcome is known to be poorer than in amblyopia with central fixation. Consequently, treatment after late diagnosis is often denied. Electronic monitoring of occlusion provides us the chance to gain first focussed insight into age-dependent dose response and treatment efficiency, as well as the shift of fixation in this rare group of paediatric patients. Methods In our prospective pilot study, we examined amblyopes with eccentric fixation during 12 months of occlusion treatment. We evaluated their visual acuity, recorded patching duration using a TheraMon®-microsensor, and determined their fixation with a direct ophthalmoscope. Dose-response relationship and treatment efficiency were calculated. Results The study included 12 participants with strabismic and combined amblyopia aged 2.9–12.4 years (mean 6.5). Median prescription of occlusion was 7.7 h/day (range 6.6–9.9) and median daily received occlusion was 5.2 h/day (range 0.7–9.7). At study end, median acuity gain was 0.6 log units (range 0–1.6) and residual interocular visual acuity difference (IOVAD) 0.3 log units (range 0–1.8). There was neither significant acuity gain nor reduction in IOVAD after the 6th month of treatment. Children younger than 4 years showed best response with lowest residual IOVAD at study end. Efficiency calculation showed an acuity gain of approximately one line from 100 h of patching in the first 2 months and half a line after 6 months. There was a significant decline of treatment efficiency with age (p = 0.01). Foveolar fixation was achieved after median 3 months (range 1–6). Three patients (> 6 years) did not gain central fixation. Conclusion Eccentric fixation is a challenge to therapy success. Based on electronic monitoring, our study quantified for the first time the reduction of treatment efficiency with increasing age in amblyopes with eccentric fixation. Despite some improvement in patients up to 8 years, older patients showed significantly lower treatment efficiency. In younger patients with good adherence, despite poor initial acuity, central fixation and low residual IOVAD could be attained after median 3 months. Hence, the necessity of early diagnosis and intensive occlusion should be emphasized.

show abstract

Section: Fixationsupporting

confidence: 90%