Recurrence of Amblyopia after Occlusion Therapy

Bhola, Rahul; Keech, Ronald V.; Kutschke, Pamela J.; Pfeifer, Wanda; Scott, William E.

doi:10.1016/j.ophtha.2006.04.034

Cited by 103 publications

(80 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Conventional amblyopia treatment emphasizes patching or penalization of the fellow-fixing (non-amblyopic) eye to force the use of the amblyopic eye [4][5][6]. While effective at improving visual acuity [6,7], current treatment is often associated with residual monocular [8] and binocular [9] deficits, and a high rate of recurrence [10]. It has been argued that the monocular treatment approach may not be maximally effective, as it does not directly address suppression [11,12].…”

Section: Introductionmentioning

confidence: 99%

Transcranial Direct Current Stimulation Enhances Recovery of Stereopsis in Adults With Amblyopia

et al. 2013

View full text Add to dashboard Cite

Amblyopia is a neurodevelopmental disorder of vision caused by abnormal visual experience during early childhood that is often considered to be untreatable in adulthood. Recently, it has been shown that a novel dichoptic videogamebased treatment for amblyopia can improve visual function in adult patients, at least in part, by reducing inhibition of inputs from the amblyopic eye to the visual cortex. Non-invasive anodal transcranial direct current stimulation has been shown to reduce the activity of inhibitory cortical interneurons when applied to the primary motor or visual cortex. In this doubleblind, sham-controlled cross-over study we tested the hypothesis that anodal transcranial direct current stimulation of the visual cortex would enhance the therapeutic effects of dichoptic videogame-based treatment. A homogeneous group of 16 young adults (mean age 22.1±1.1 years) with amblyopia were studied to compare the effect of dichoptic treatment alone and dichoptic treatment combined with visual cortex direct current stimulation on measures of binocular (stereopsis) and monocular (visual acuity) visual function. The combined treatment led to greater improvements in stereoacuity than dichoptic treatment alone, indicating that direct current stimulation of the visual cortex boosts the efficacy of dichoptic videogamebased treatment. This intervention warrants further evaluation as a novel therapeutic approach for adults with amblyopia.

show abstract

Section: Introductionmentioning

confidence: 99%

Transcranial Direct Current Stimulation Enhances Recovery of Stereopsis in Adults With Amblyopia

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Typically, patients with mild to moderate amblyopia are prescribed complete occlusion for 2-6 waking hours per day, over several months to more than a year (Pediatric Eye Disease Investigator Group 2003a,b; Repka et al 2003;Stewart et al 2004Stewart et al , 2006. Patients with moderate to severe amblyopia are often prescribed 6-10 h or more than a day (Pediatric Eye Disease Investigator Group 2003a,b), and some clinicians recommend more aggressive full-time occlusion for severe amblyopia (Dorey et al 2001;Bhola et al 2006;Stankovic & Milenkovic 2007). As reported in a recent large-scale clinical study of children (3-8 years of age), the dose-response rate for occlusion is approximately 0.1 log unit (1 chart line) per 120 h of occlusion, and the treatment efficacy is 3-4 logMAR lines (Stewart et al 2004).…”

Section: Introductionmentioning

confidence: 99%

Improving the performance of the amblyopic visual system

Levi

2008

Phil. Trans. R. Soc. B

129

116

View full text Add to dashboard Cite

Experience-dependent plasticity is closely linked with the development of sensory function; however, there is also growing evidence for plasticity in the adult visual system. This review re-examines the notion of a sensitive period for the treatment of amblyopia in the light of recent experimental and clinical evidence for neural plasticity. One recently proposed method for improving the effectiveness and efficiency of treatment that has received considerable attention is 'perceptual learning'. Specifically, both children and adults with amblyopia can improve their perceptual performance through extensive practice on a challenging visual task. The results suggest that perceptual learning may be effective in improving a range of visual performance and, importantly, the improvements may transfer to visual acuity. Recent studies have sought to explore the limits and time course of perceptual learning as an adjunct to occlusion and to investigate the neural mechanisms underlying the visual improvement. These findings, along with the results of new clinical trials, suggest that it might be time to reconsider our notions about neural plasticity in amblyopia.

show abstract

“…Recurrence in amblyopia was noted in 7% to 27%, with a low reported recurrence in children who underwent treatment after the age of 7 years 49 . Age of the child at the cessation of treatment does appear to be a factor, with recurrence inversely correlated with patient age 46 .…”

Section: Recurrence Of Amblyopia Following Therapymentioning

confidence: 95%

“…Some recent studies have sought to identify factors which may influence whether recurrence is likely to occur [46][47][48][49] . These include; age of termination of treatment; VA at the time of cessation of treatment; and which type of amblyopia is present.…”

Section: Recurrence Of Amblyopia Following Therapymentioning

confidence: 99%