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ABSTRACT: Objective
To determine visual acuity improvement in children with strabismic and combined strabismic-anisometropic (combined-mechanism) amblyopia treated with optical correction alone and to explore factors associated with improvement.Design
Prospective, multicenter, cohort study.Participants
We included 146 children 3 to <7 years old with previously untreated strabismic amblyopia (n = 52) or combined-mechanism amblyopia (n = 94).Methods
Optical treatment was provided as spectacles (prescription based on a cycloplegic refraction) that were worn for the first time at the baseline visit. Visual acuity with spectacles was measured using the Amblyopia Treatment Study HOTV visual acuity protocol at baseline and every 9 weeks thereafter until no further improvement in visual acuity. Ocular alignment was assessed at each visit.Main outcome measures
Visual acuity 18 weeks after baseline.Results
Overall, amblyopic eye visual acuity improved a mean of 2.6 lines (95% confidence interval [CI], 2.3-3.0), with 75% of children improving ? 2 lines and 54% improving ? 3 lines. Resolution of amblyopia occurred in 32% (95% CI, 24%-41%) of the children. The treatment effect was greater for strabismic amblyopia than for combined-mechanism amblyopia (3.2 vs 2.3 lines; adjusted P = 0.003). Visual acuity improved regardless of whether eye alignment improved.Conclusions
Optical treatment alone of strabismic and combined-mechanism amblyopia results in clinically meaningful improvement in amblyopic eye visual acuity for most 3- to <7-year-old children, resolving in at least one quarter without the need for additional treatment. Consideration should be given to prescribing refractive correction as the sole initial treatment for children with strabismic or combined-mechanism amblyopia before initiating other therapies.Financial disclosure(s)
The authors have no proprietary or commercial interest in any of the materials discussed in this article.
SUBMITTER: Writing Committee for the Pediatric Eye Disease Investigator Group
PROVIDER: S-EPMC3250558 | biostudies-literature | 2012 Jan
REPOSITORIES: biostudies-literature
Cotter Susan A SA Foster Nicole C NC Holmes Jonathan M JM Melia B Michele BM Wallace David K DK Repka Michael X MX Tamkins Susanna M SM Kraker Raymond T RT Beck Roy W RW Hoover Darren L DL Crouch Eric R ER Miller Aaron M AM Morse Christie L CL Suh Donny W DW
Ophthalmology 20110929 1
<h4>Objective</h4>To determine visual acuity improvement in children with strabismic and combined strabismic-anisometropic (combined-mechanism) amblyopia treated with optical correction alone and to explore factors associated with improvement.<h4>Design</h4>Prospective, multicenter, cohort study.<h4>Participants</h4>We included 146 children 3 to <7 years old with previously untreated strabismic amblyopia (n = 52) or combined-mechanism amblyopia (n = 94).<h4>Methods</h4>Optical treatment was prov ...[more]