Skip to main content
Top
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 6/2007

01-06-2007 | Laboratory Investigation

Factors affecting the stability of visual function following cessation of occlusion therapy for amblyopia

Authors: Daniel J. Tacagni, Catherine E. Stewart, Merrick J. Moseley, Alistair R. Fielder

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 6/2007

Login to get access

Abstract

Aim

To identify factors that predict which children with amblyopia are at greatest risk of regression of visual acuity (VA) following the cessation of occlusion therapy.

Method

A retrospective analysis was performed of 182 children (mean age at cessation of treatment; 5.9±1.6 years) who had undergone occlusion therapy for unilateral amblyopia, and had been followed up at least once within 15 months of cessation. Statistical analysis was used to identify whether change in VA following treatment cessation had any association with various factors, including the child’s age, type of amblyopia, degree of anisometropia, initial severity of amblyopia, binocular vision status, length and dose of occlusion therapy, and VA response to treatment.

Results

At 1 year, follow-up from treatment cessation, children with “mixed” amblyopia (both anisometropia and strabismus) demonstrated significantly (p=0.03) greater deterioration in VA (0.11±0.11 log units) than children with only anisometropia (0.02±0.08 log units) or only strabismus (0.05±0.10 log units). However, none of the other factors investigated were found to be significant predictors.

Conclusion

This study supports previous research that it is possible to identify those children most at risk of deterioration in VA following cessation of occlusion therapy. The presence of mixed amblyopia was the only risk factor identified in this study. Management of amblyopia should take this into account, with a more intensive follow-up recommended for those with both anisometropia and strabismus (mixed) amblyopia.
Literature
1.
go back to reference Ching FC, Parks MM, Friendly DS (1986) Practical management of amblyopia. J Pediatr Ophthalmol Strabismus 23:12–16PubMed Ching FC, Parks MM, Friendly DS (1986) Practical management of amblyopia. J Pediatr Ophthalmol Strabismus 23:12–16PubMed
2.
go back to reference Hubel DH, Wiesel TN (1970) The period of susceptibility to the physiological effects of unilateral eye closure in kittens. J Physiol (London) 206:419–436 Hubel DH, Wiesel TN (1970) The period of susceptibility to the physiological effects of unilateral eye closure in kittens. J Physiol (London) 206:419–436
3.
go back to reference Leiba H, Shimshoni M, Oliver M, Gottesman N, Levartovsky S (2001) Long-term follow-up of occlusion therapy in amblyopia. Ophthalmology 108:1552–1555PubMedCrossRef Leiba H, Shimshoni M, Oliver M, Gottesman N, Levartovsky S (2001) Long-term follow-up of occlusion therapy in amblyopia. Ophthalmology 108:1552–1555PubMedCrossRef
4.
go back to reference Levartovsky S, Gottesman N, Shimshoni M, Oliver M (1992) Factors affecting long-term results of successfully treated amblyopia: age at beginning of treatment and age at cessation of monitoring. J Pediatr Ophthalmol Strabismus 29:219–223PubMed Levartovsky S, Gottesman N, Shimshoni M, Oliver M (1992) Factors affecting long-term results of successfully treated amblyopia: age at beginning of treatment and age at cessation of monitoring. J Pediatr Ophthalmol Strabismus 29:219–223PubMed
5.
go back to reference Levartovsky S, Oliver M, Gottesman N, Shimshoni M (1995) Factors affecting long-term results of successfully treated amblyopia: initial visual acuity and type of amblyopia. Br J Ophthalmol 79:225–228PubMed Levartovsky S, Oliver M, Gottesman N, Shimshoni M (1995) Factors affecting long-term results of successfully treated amblyopia: initial visual acuity and type of amblyopia. Br J Ophthalmol 79:225–228PubMed
6.
go back to reference Levartovsky S, Oliver M, Gottesman N, Shimshoni M (1998) Long-term effect of hypermetropic anisometropia on the visual acuity of treated amblyopic eyes. Br J Ophthalmol 82:55–58PubMedCrossRef Levartovsky S, Oliver M, Gottesman N, Shimshoni M (1998) Long-term effect of hypermetropic anisometropia on the visual acuity of treated amblyopic eyes. Br J Ophthalmol 82:55–58PubMedCrossRef
7.
go back to reference Malik SRK, Singh Virdi P, Goel BK (1975) Follow-up results of occlusion and pleoptic treatment. Acta Opthalmol (Copenh) 53:620–626CrossRef Malik SRK, Singh Virdi P, Goel BK (1975) Follow-up results of occlusion and pleoptic treatment. Acta Opthalmol (Copenh) 53:620–626CrossRef
8.
go back to reference Ohlsson J, Baumann M, Sjostrand J, Abrahamsson M (2002) Long-term visual outcome in amblyopia treatment. Br J Ophthalmol 86:1148–1151PubMedCrossRef Ohlsson J, Baumann M, Sjostrand J, Abrahamsson M (2002) Long-term visual outcome in amblyopia treatment. Br J Ophthalmol 86:1148–1151PubMedCrossRef
9.
go back to reference Oster J, Simon JW, Jenkins P (1990) When is it safe to stop patching? Br J Ophthalmol 74:709–711PubMed Oster J, Simon JW, Jenkins P (1990) When is it safe to stop patching? Br J Ophthalmol 74:709–711PubMed
10.
go back to reference Pediatric Eye Disease Investigator Group (2002) A randomised trial of atropine vs. patching for treatment of moderate amblyopia in children. Arch Ophthalmol 120:268–278 Pediatric Eye Disease Investigator Group (2002) A randomised trial of atropine vs. patching for treatment of moderate amblyopia in children. Arch Ophthalmol 120:268–278
11.
go back to reference Pediatric Eye Disease Investigator Group (2003) A randomized trial of patching regimens for treatment of moderate amblyopia in children. Arch Ophthalmol 121:603–611CrossRef Pediatric Eye Disease Investigator Group (2003) A randomized trial of patching regimens for treatment of moderate amblyopia in children. Arch Ophthalmol 121:603–611CrossRef
12.
go back to reference Pediatric Eye Disease Investigator Group (2003) A randomized trial of prescribed patching regimens for treatment of severe amblyopia in children. Ophthalmology 110:2075–2087CrossRef Pediatric Eye Disease Investigator Group (2003) A randomized trial of prescribed patching regimens for treatment of severe amblyopia in children. Ophthalmology 110:2075–2087CrossRef
13.
go back to reference Pediatric Eye Disease Investigator Group (2004) Risk of amblyopia recurrence after cessation of treatment. J AAPOS 8:420–428 Pediatric Eye Disease Investigator Group (2004) Risk of amblyopia recurrence after cessation of treatment. J AAPOS 8:420–428
14.
go back to reference Rahi JS, Logan S, Timms C, Russell-Eggitt I, Taylor D (2002) Risk, causes and outcomes of visual impairment after loss of vision in the non-amblyopic eye: a population-based study. Lancet 360:597–602PubMedCrossRef Rahi JS, Logan S, Timms C, Russell-Eggitt I, Taylor D (2002) Risk, causes and outcomes of visual impairment after loss of vision in the non-amblyopic eye: a population-based study. Lancet 360:597–602PubMedCrossRef
15.
go back to reference Reeves B (2002) Taxonomy and epidemiology of amblyopia. In: Moseley MJ, Fielder AR (eds) Amblyopia: a multidisciplinary approach. Butterworth-Heinemann, Oxford, pp 68–80 Reeves B (2002) Taxonomy and epidemiology of amblyopia. In: Moseley MJ, Fielder AR (eds) Amblyopia: a multidisciplinary approach. Butterworth-Heinemann, Oxford, pp 68–80
Metadata
Title
Factors affecting the stability of visual function following cessation of occlusion therapy for amblyopia
Authors
Daniel J. Tacagni
Catherine E. Stewart
Merrick J. Moseley
Alistair R. Fielder
Publication date
01-06-2007
Publisher
Springer-Verlag
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 6/2007
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-006-0395-2

Other articles of this Issue 6/2007

Graefe's Archive for Clinical and Experimental Ophthalmology 6/2007 Go to the issue

Announcements

Announcements