Visual Outcomes of Amblyopia Therapy
Melissa Anne M. Santos, MD, Marissa N. Valbuena, MD, MHPEd, and Andrea Kristina F. Monzon-Pajarillo, MD
Objectives
To determine the visual outcome of amblyopia treatment and describe the relationship between age of onset and consult, compliance as measured by a patch diary, amblyopia subtype, and severity with the final visual outcome.
Methods
Thirty-two consecutive, newly-diagnosed cases of amblyopia, aged 3-8 years on initial consult, with no history of prior amblyopia treatment, were included. Patching was done based on current AAO recommendations and patients were followed up monthly for 6 months. Treatment success was defined as best corrected visual acuity (BCVA) better than 20/30 (0.17LogMAR), or a 3-line improvement from baseline, or stable isoacuity for at least 3 months. Treatment failure was defined as no improvement of BCVA after 3 months of occlusion therapy or a regression of 2 lines. Descriptive and correlation statistics were performed comparing age of onset and consult, amblyopia subtype, severity, and compliance with the main outcome measure of BCVA at 6 months.
Results
Sixteen (50%) attained treatment success. Patients seen earlier (age 2-5 years) had higher rates of success (75%) than those seen later (age 6-8 years) (35%). A moderately strong negative correlation (r=-0.48, p=0.01) existed between severity of amblyopia and final BCVA at 6 months. overall compliance to patching was 88±18%, with good compliance in the success group (92%) compared to fair compliance in the failure group (84%) and a moderate correlation between compliance and BCVA (r=0.37, p=0.05).
Conclusion
Treatment success was related to severity, compliance, and younger age of treatment. In the presence of good compliance, severity was a strong prognostic variable.
Keywords:Amblyopia, Patching, Compliance, Sensory Deprivation, Anisometropia, Occlusion therapy