Treatment of anisometropic amblyopia in children with refractive correction.

Abstract

OBJECTIVE:

To evaluate the effectiveness of refractive correction alone for the treatment of untreated anisometropic amblyopia in children 3 to <7 years old.

DESIGN:

Prospective, multicenter, noncomparative intervention.

PARTICIPANTS:

Eighty-four children 3 to <7 years old with untreated anisometropic amblyopia ranging from 20/40 to 20/250.

METHODS:

Optimal refractive correction was provided, and visual acuity (VA) was measured with the new spectacle correction at baseline and at 5-week intervals until VA stabilized or amblyopia resolved.

MAIN OUTCOME MEASURES:

Maximum improvement in best-corrected VA in the amblyopic eye and proportion of children whose amblyopia resolved (interocular difference of < or =1 line) with refractive correction alone.

RESULTS:

Amblyopia improved with optical correction by > or =2 lines in 77% of the patients and resolved in 27%. Improvement took up to 30 weeks for stabilization criteria to be met. After stabilization, additional improvement occurred with spectacles alone in 21 of 34 patients observed in a control group of a subsequent randomized trial, with amblyopia resolving in 6. Treatment outcome was not related to age, but was related to better baseline VA and lesser amounts of anisometropia.

CONCLUSION:

Refractive correction alone improves VA in many cases and results in resolution of amblyopia in at least one third of 3- to <7-year-old children with untreated anisometropic amblyopia. Although most cases of resolution occur with moderate (20/40-20/100) amblyopia, the average 3-line improvement in VA resulting from treatment with spectacles may lessen the burden of subsequent amblyopia therapy for those with denser levels of amblyopia.

• Authors: Susan A Cotter, Pediatric Eye Disease Investigator Group, Allison R Edwards, David K Wallace, Roy W Beck, Robert W Arnold, William F Astle, Carmen N Barnhardt, Eileen E Birch, Sean P Donahue, Donald F Everett, Joost Felius, Jonathan M Holmes, Raymond T Kraker, Michele Melia, Michael X Repka, Nicholas A Sala, David I Silbert, Katherine K Weise
• Journal: Ophthalmology (Ophthalmology) Vol. 113 Issue 6 Pg. 895-903 (Jun 2006) ISSN: 1549-4713 [Electronic] United States
• PMID: 16751032 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural)

Topics

• Amblyopia (physiopathology, therapy)
• Anisometropia (physiopathology, therapy)
• Child
• Child, Preschool
• Eyeglasses
• Female
• Follow-Up Studies
• Humans
• Male
• Prospective Studies
• Sensory Deprivation
• Time Factors
• Treatment Outcome
• Visual Acuity (physiology)