The Clinical Features With Recurrence of Amblyopia After Cessation of Amblyopic Treatment

Kyeong Jin Woo; Mi Young Choi

doi:10.3341/jkos.2009.50.11.1705

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Woo and Choi: The Clinical Features With Recurrence of Amblyopia After Cessation of Amblyopic Treatment

Original Article

J Korean Ophthalmol Soc 2009;50(11):1705-1711.

Published online: 31 August 2009

DOI: https://doi.org/10.3341/jkos.2009.50.11.1705

The Clinical Features With Recurrence of Amblyopia After Cessation of Amblyopic Treatment

Kyeong Jin Woo, MD, Mi Young Choi, MD

Department of Ophthalmology, Chungbuk National University College of Medicine, Chungbuk National University Medical Research Institute, Cheongju, Korea

Address reprint requests to Mi Young Choi, MD, Department of Ophthalmology, College of Medicine, Chungbuk National University Hospital #410 Gaesin-dong, Heungdeok-gu, Cheongju 361-763, Korea Tel: 82-43-269-6335, Fax: 82-43-264-5263, E-mail: mychoi@chungbuk.ac.kr

Received 16 February 2009 Accepted 4 August 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To identify the clinical features with recurrence of amblyopia after cessation of amblyopic treatment.

Methods

Amblyopic children followed up at least 1 year after successful treatment were evaluated. A recurrence of amblyopia was defined as a reduction of more than 2 levels in visual acuity (VA) of the amblyopic eye after cessation of treatment. The age and VA of the amblyopic eye at the start and during follow-up, type of amblyopia, type and duration of treatment, weaning and stereopsis on cessation of treatment were analyzed.

Results

Amblyopia recurred in 5 out of 82 patients with successful treatment, and the period of recurrence varied from 7 to 31 months after cessation of treatment. Two out of 5 recurred patients had only patching therapy and the other 3 patients had atropine penalization after patching therapy. The weaning was performed in the 5 recurred patients at cessation of treatment. There was no remarkable clinical factor associated with recurrence of amblyopia.

Conclusions

The recurrence rate was 6% after cessation of amblyopic treatment and there was no factor associated with recurrence of amblyopia. Therefore, regular follow-up may be required after successful treatment for amblyopia.

Keywords: Amblyopia, Atropine, Patching, Penalization, Recurrence

References

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Figure 1.

Kaplan-Meier curve showing cumulative probability of recurrence of amblyopia. Three patients who had stopped atropine penalization developed recurrence at 7.0, 13.3, 13.8 months and two who had stopped patching at 12.3, 30.1 months.

Table 1.

Clinical characteristics of patients with recurrence of amblyopia from previous viewpoint as risk factor of recurrence

Group	Case	Cause of amblyopia	Weaning of treatment	Age (years) at start / at end	VA (LogMAR) of amblyopic eye at start / at end
Atropine	No. 1	Anisometropia	Yes	6.1 / 6.6	0.7 / 0.0
stopped	No. 2	Strabismus	Yes	6.6 / 7.1	0.5 / 0.05
	No. 3	Anisometropia	Yes	7.8 / 8.5	0.3 / 0.05
Patching	No. 1	Anisometropia	Yes	4.6 / 6.8	0.4 / 0.05
stopped	No. 2	Strabismus	Yes	4.4 / 4.7	0.5 / 0.05

Table 2.

Demographic characteristics

	Atropine stopped N=33, n (%)	Patching stopped N=49, n (%)	p-value
Gender			0.466^*
Male	17 (52)	20 (41)
Female	16 (48)	29 (59)
Age (years)	6.2±1.8	5.3±1.9	0.061^†
< 3	0 (0)	2 (4)
3 ≤ < 5	10 (30)	19 (39)
5 ≤ < 7	14 (42)	21 (43)	0.066^*
7 ≤ < 9	7 (21)	6 (12)
9 ≤ < 11	2 (7)	1 (2)

^*Chi-square test

^†t-test.

Table 3.

Cause of amblyopia

	Atropine stopped N=33, n (%)	Patching stopped N=49, n (%)
Strabismus	16 (48)	21 (43)
Esotropia	8 (50)	1 (5)
Exotropia	8 (50)	20 (95)
Anisometropia	17 (52)	25 (51)
Myopia	2 (12)	2 (8)
Hyperopia	10 (65)	12 (48)
Astigmatism	5 (23)	11 (44)
Combined	0 (0)	3 (6)

Table 4.

Inter-eye difference at treatment of amblyopia and cessation of treatment

Intereye difference (LogMAR levels)	Atropine stopped N=33	Patching stopped N=49	p-value
At treatment of amblyopia			0.430^*
2∼3	15	20
4∼5	9	20
6∼7	4	5
8∼9	5	4
At cessation of treatment			0.536^*
0	17	32
1	16	15
2	0	2

^*t-test.

Table 5.

Duration of treatment

(months)	Atropine stopped N=33, n (%)	Patching stopped N=49, n (%)	p-value
3 ≤ < 6	11 (33)	9 (18)
6 ≤ < 9	11 (33)	9 (18)
9 ≤ < 12	4 (12)	4 (8)	0.536^*
12 ≤ < 15	2 (6)	4 (8)
15 ≤ < 18	2 (6)	4 (8)
18 ≤	3 (10)	19 (40)
Mean± SD	8.2±5.3	17.6±13.6	<0.01^*

^*t-test.

Table 6.

Stereopsis at cessation of treatment

(Sec of arc)^*	Atropine stopped N=29, n (%)	Patching stopped N=35, n (%)	p-value
40∼80	5 (17)	14 (40)
100∼200	11 (38)	8 (23)	0.066^†
400∼800	12 (41)	8 (23)
No stereopsis	1 (4)	5 (14)

^*Titmus stereo Tests, Stereo Optical Cl. Inc., Chicago, IL

^†Chi-square test.

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