Comparison of Results of 2-Hour, 6-Hour and Full-Time Patching Regimens in Treatment of Monocular Amblyopia

Jin Hwan Ahn; Mi Hyun Lee; Jun Mo Park; Hee Young Choi

doi:10.3341/jkos.2009.50.11.1724

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Ahn, Lee, Park, and Choi: Comparison of Results of 2-Hour, 6-Hour and Full-Time Patching Regimens in Treatment of Monocular Amblyopia

Original Article

J Korean Ophthalmol Soc 2009;50(11):1724-1729.

Published online: 31 August 2009

DOI: https://doi.org/10.3341/jkos.2009.50.11.1724

Comparison of Results of 2-Hour, 6-Hour and Full-Time Patching Regimens in Treatment of Monocular Amblyopia

Jin Hwan Ahn, MD, Mi Hyun Lee, MD, Jun Mo Park, MD, Hee Young Choi, MD, PhD

Department of Ophthalmology, School of Medicine, Pusan National University, Busan, Korea

Address reprint requests to Hee Young Choi, MD, PhD, Department of Ophthalmology, School of Medicine, Pusan National University #1-10 Ami-dong 1-ga, Seo-gu, Busan 602-739, Korea Tel: 82-51-240-7324, Fax: 82-51-242-7341, E-mail: hychoi@pusan.ac.kr

Received 6 August 2009 Accepted 21 July 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 compare effects of a 2-hour, 6-hour, and full-time patching regimens in monocular amblyopia patients under 10 years of age.

Methods

This study recruited monocular amblyopia patients under 10 years of age. The patients were divided into a 2-hour patching group (group A, n=34), a 6-hour patching group (group B, n=33), and a full time patching group (group C, n=28) according to the patching time. A prospective analysis was then performed. The ages at the start of treatment, differences of corrected visual acuity between the 2 eyes and severity of the 3 groups were compared and analyzed. On the final evaluation, ‘success’ was defined when the difference of corrected visual acuity between the 2 eyes converted into logMAR was less than 0.1.

Results

The ages at the start of treatment in group A, B, C were 5.61, 5.48 and 5.71 years, respectively. The best corrected visual acuity of an amblyopic eye converted into logMAR changed to 0.13 after treatment in group A, to 0.16 in group B and to 0.19 in group C. Although visual acuity after the treatment was increased significantly compared to the beginning of treatment in all 3 groups, the final visual acuity showed no statistically significant difference among the 3 groups. Because the occlusion therapy success rates were 70.6%, 69.7% and 64.3% for groups A, B and C, respectively, there was no statistically significant difference.

Conclusions

In the 2-hour, 6-hour, and full-time patching regimens, all patients showed a significant improvement in visual acuity although their success rates were not significantly different. Therefore, the part-time patching therapy favored by patients and parents is effective for the first treatment of amblyopia.

Keywords: Amblyopia, Patching treatment

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Figure1.

Visual acuity measurements in the amblyopic eye in each group at baseline and final follow up. The point estimates and 95% confidence intervals are shown. The difference between treatment groups in mean logMAR acuity and the 95% confidence intervals were adjusted for baseline visual acuity.

Table 1.

Comparison of baseline characteristics of 2-hour vs 6-hour-vs full-time daily patching

	2hr (n=34)(No, (%))	6hr (n=33)(No, (%))	Full time (n=28)(No, (%))
Age (Mean ± SD, years)	5.6±1.63	5.48±1.92	5.96±1.75
<5	9 (26)	12 (36)	6 (21)
5 to <7	16 (47)	13 (39)	12 (43)
7 to <10	9 (27)	8 (26)	10 (36)
Gender
Male	15 (44)	15 (45)	12 (43)
Female	19 (56)	18 (55)	16 (57)
Initial visual acuity (LogMAR)
Amblyopic eye	0.44±0.34	0.45±0.43	0.50±0.33
Sound eye	0.15±0.20	0.14±0.17	0.10±0.12
Depth of amblyopia
Severe (≤0.2)	10 (29)	12 (36)	14 (50)
Moderate (0.3-0.5)	15 (44)	9 (28)	9 (32)
Mild (≥0.5)	9 (27)	12 (36)	5 (18)
Cause of amblyopia
Strabismus	14 (41)	9 (28)	15 (54)
Anisometorpia	7 (21)	10 (30)	6 (22)
Mixed	13 (38)	14 (42)	7 (24)
Duration of treatment
(Mean± SD, Month)	21.0±15.5	22.2±14.2	24.7±20.4

Table 2.

Visual acuity improvements stratified by baseline characteristics in 2-hour, 6-hour and full-time patching

	2hr (n=34)	6hr (n=33)	Full time (n=28)
Age (years)
<5	0.45±0.38	0.36±0.28	0.53±0.47
5 to <7	0.25±0.19	0.23±0.18	0.28±0.26
7 to <10	0.20±0.25	0.23±0.34	0.21±0.18
Gender
Male	0.22±0.18	0.27±0.27	0.28±0.31
Female	0.37±0.33	0.29±0.26	0.33±0.31
Depth of amblyopia
Severe	0.58±0.29	0.55±0.22	0.46±0.35
Moderate	0.29±0.13	0.22±0.13	0.24±0.10
Mild	0.02±0.15	0.05±0.05	0.03±0.15
Cause of amblyopia
Strabismus	0.25±0.26	0.22±0.28	0.14±0.12
Anisometorpia	0.35±0.17	0.33±0.18	0.32±0.30
Mixed	0.27±0.37	0.29±0.30	0.44±0.40

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