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Graefe's Archive for Clinical and Experimental Ophthalmology

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01-10-2009 | Neuro-ophthalmology

Electronic monitoring of occlusion treatment for amblyopia in patients aged 7 to 16 years

Authors: Maria Fronius, Iris Bachert, Marc Lüchtenberg

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 10/2009

Abstract

Background

Age limits for the prescription of amblyopia treatment have been debated and challenged recently, due to results of studies from ophthalmology and the neurosciences. Lack of knowledge about compliance with prescribed treatment is still a major factor for the uncertainty about the amount of plasticity in the visual system of older children and adolescents. The development of devices for the electronic recording of patching (Occlusion Dose Monitor, ODM) has allowed the collection of objective data about daily occlusion.

Methods

In a prospective study, occlusion dose rates were recorded continuously during 4 months by means of the ODM developed in the Netherlands [1] in nine amblyopic patients between 7 and 16 years of age who were prescribed between 5 and 7 hours of daily patching. Visual acuity was assessed every 3 to 6 weeks.

Results

The electronic monitoring showed objective occlusion between 2 and 6.25 hours/day (mean 4.61 h/d) during the first month and 0 to 6.5 hours/day (mean 3.47 h/d) during the following 3 months of treatment. The total acuity gain in the amblyopic eye amounted to between –0.1 and 0.4 log units (mean 0.19) for crowded optotypes. Differences to initial acuities were statistically significant. The calculated average dose-response relationship (cumulated hours occlusion*0.1/acuity gain) for 4 months of occlusion was 234 hours of occlusion per 0.1 log unit of acuity gain.

Conclusions

This study presents for the first time objective treatment and dose response data in amblyopic patients beyond the “classical” treatment age. Electronic monitoring of occlusion and considerable amounts of patching were shown to be feasible. The acuity results indicate that there is a potential for improvement, yet treatment seemed to be less efficient than shown by previous studies in younger patients. Continuation of this research may advance the discussion about age-dependent evidence-based amblyopia treatment, about preschool screening for amblyopia and about plasticity of the visual system.

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Title: Electronic monitoring of occlusion treatment for amblyopia in patients aged 7 to 16 years
Authors: Maria Fronius
Iris Bachert
Marc Lüchtenberg
Publication date: 01-10-2009
Publisher: Springer-Verlag
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 10/2009
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-009-1090-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Electronic monitoring of occlusion treatment for amblyopia in patients aged 7 to 16 years

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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