Decreased Visual Acuity of Dominant Eye Compared to Amblyopic Eye During Occlusion Therapy

Sang Hoon Park; Hae Ran Chang

doi:10.3341/jkos.2010.51.10.1374

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Park and Chang: Decreased Visual Acuity of Dominant Eye Compared to Amblyopic Eye During Occlusion Therapy

Original Article

J Korean Ophthalmol Soc 2010;51(10):1374-1379.

Published online: 7 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.10.1374

Decreased Visual Acuity of Dominant Eye Compared to Amblyopic Eye During Occlusion Therapy

Sang Hoon Park, MD, Hae Ran Chang, MD, PhD

Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

Address reprint requests to Hae Ran Chang, MD, PhD Department of Ophthalmology, Kangbuk Samsung Hospital #108 Pyung-dong, Jongro-gu, Seoul 110-746, Korea Tel: 82-2-2001-2250, Fax: 82-2-2001-2262, E-mail: HRCH0523@hanmail.net

Received 8 September 2009 Accepted 22 June 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 investigate the clinical features of patients with decreased visual acuity (VA) of the dominant eye as compared to that of the amblyopic eye during occlusion therapy.

Methods

The authors analyzed clinical features of 28 patients with VA reversed between the two eyes during occlusion therapy among 500 patients treated with occlusion therapy under the diagnosis of monocular amblyopia.

Results

Twenty-one patients with strabismic amblyopia (SA), five patients with anisometropic amblyopia (AA) and two patients with combined amblyopia (CA) were enrolled in the present study. Decreased VA of the dominant eye as compared to that of the amblyopic eye occurred 66.75 ± 83.63 weeks after the onset of occlusion therapy. Reversion of VA between both eyes occurred during amblyopia treatment in 17 patients and during maintenance therapy in 11 patients. The reversed VA was recovered in all patients. The mean duration (MD) of reversed VA was 15.00 ± 24.43 weeks, and the number of clinic visits (CV) was 4.68 ± 8.65. In five patients, the MD of reversed VA (59.80 ± 30.14 weeks, p = 0.016) and the number of CVs (18.40 ± 14.48, p < 0.001) were significantly longer than those of the other 23 patients (MD of reversed VA: 5.78 ± 4.04 weeks, number of CV: 1.70 ± 1.22); those five patients had low compliances and SAs.

Conclusions

Visual acuity was recovered in all patients with decreased VA of the dominant eye as compared to that of the amblyopic eye during occlusion therapy, rapid recovery was observed in most patients except in several patients with low compliance.

Keywords: Amblyopia, Compliance, Dominant eye, Occlusion therapy, Reversed visual acuity

References

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Table 1.

The mean duration from the beginning of occlusion to the onset of decreased visual acuity of the dominant eye

Causes of amblyopia	Number	Duration (wk)
Strabismic amblyopia	21	65.10 ± 67.66
Esotropia	18	67.56 ± 71.92
Exotropia	2	41.50 ± 48.79
Vertical strabismus	1	68.00
Anisometropic amblyopia	5	79.60 ± 154.87
Combined amblyopia	2	52.00 ± 5.66

Table 2.

Data of patients according to the onset of decreased visual acuity of dominant eye

	During treatment of amblyopia^* (17)^†	During maintenance therapy^‡ (11)
Method of treatment	Full-time occlusion (8)	Part-time occlusion (11)
Method of treatment	Part-time occlusion (9)	
Cause of amblyopia	Strabismic amblyopia (13)	Strabismic amblyopia (8)
	Anisometropic amblyopia (3)	Anisometropic amblyopia (2)
	Combined amblyopia (1)	Combined amblyopia (1)

^* From the beginning of occlusion to success of amblyopia treatment

^† Number of patients

^‡ From success of amblyopia treatment to cessation of occlusion.

Table 3.

The mean duration (wk) of decreased visual acuity of dominant eye according to causes of amblyopia

Causes of amblyopia	All patients	5 patients with low compliance	The other 23 patients^*
Causes of amblyopia	Duration^† (N)	Duration^† (N)	Duration^† (N)
Strabismic amblyopia	18.81 ± 27.31 (21)	28.60 ± 11.93 (5)	6.00 ± 4.15 (16)
Esotropia	20.39 ± 29.23 (18)	28.60 ± 11.93 (5)	5.23 ± 3.44 (13)
Exotropia	10.00 ± 8.49 (2)	0 (0)	10.00 ± 8.49 (2)
Vertical strabismus	8.00 (1)	0 (0)	8.00 (1)
Anisometropic amblyopia	3.20 ± 2.17 (5)	0 (0)	3.20 ± 2.17 (5)
Combined amblyopia	10.50 ± 2.12 (2)	0 (0)	10.50 ± 2.12 (2)

^* Exclusion of 5 patients with low compliance and esotropia

^† Wk.

Table 4.

The mean duration (wk) of decreased visual acuity of dominant eye according to the onset

Type of treatment	All patients	5 patients with low compliance	The other 23 patients^*
Type of treatment	Duration^† (N)	Duration^† (N)	Duration^† (N)
During treatment of amblyopia^‡	6.76 ± 4.37 (17)	15.00 (1)	6.25 ± 4.44 (16)
Full-time occlusion	4.63 ± 4.07 (8)	0 (0)	4.63 ± 4.07 (8)
Part-time occlusion	8.67 ± 4.42 (9)	15.00 (1)	7.88 ± 4.44 (8)
During maintenance therapy^§	28.82 ± 35.16 (11)	32.00 ± 10.61 (4)	4.71 ± 2.98 (7)

^* Exclusion of 5 patients with low compliance and esotropia

^† Wk

^‡ from beginning of occlusion to success of amblyopia treatment

^§ from success of amblyopia treatment to cessation of occlusion.

Table 5.

The mean duration (wk) of decreased visual acuity of dominant eye according to methods of treatment

Methods of treatment	All patients		5 patients with low compliance		The other 23 patients^*
Methods of treatment	Duration^† (N)	Number of clinic visit	Duration^† (N)	Number of clinic visit	Duration^† (N)	Number of clinic visit
DOT^‡	6.73 ± 3.82 (10)	2.18 ± 1.54	0 (0)	0	6.73 ± 3.82 (10)	2.18 ± 1.54
DOT & CRE^§	12.00 ± 0.0 (1)	1.00 ± 0.0	0 (0)	0	12.00 (1)	1.00 ± 0.0
CO^∏	5.10 ± 4.63 (10)	1.10 ± 0.32	0 (0)	0	5.10 ± 4.63 (10)	1.10 ± 0.32
OFE^#	16.00 ± 19.61 (4)	3.00 ± 1.63	29.50 ± 20.15 (2)	4.00 ± 1.41	2.50 ± 2.12 (2)	2.00 ± 1.41
OFE & CRE	80.00 ± 8.72 (3)	28.00 ± 8.64	80.00 ± 8.72 (3)	28.00 ± 8.64	0 (0)	0

^* Exclusion of 5 patients with low compliance and esotropia

^† Wk

^‡ decrease of occlusion time

^§ correction of Refractive error

^∏ cessation of occlusion

^# occlusion of fellow eye.

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