Journal List > J Korean Ophthalmol Soc > v.51(11) > 1008689

TOOLS
Lee and Chang: Long-Term Visual Outcome Following Cessation of Occlusion Therapy in Unilateral Amblyopia
Original Article

J Korean Ophthalmol Soc 2010;51(11):1499-1503.

Published online: 7 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.11.1499

Long-Term Visual Outcome Following Cessation of Occlusion Therapy in Unilateral Amblyopia

Jun Yong Lee, MD, Hae Ran Chang, MD

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

Address reprint requests to Hae Ran Chang, MD Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine #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 31 May 2010       Accepted 7 September 2010

Copyright © 2010 Korean Ophthalmological Society

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 evaluate a long-term visual outcome following cessation of occlusion therapy in unilateral amblyopia.

Methods

A total of 70 patients who successfully finished occlusion therapy (including maintenance therapy) for unilateral amblyopia and were followed up for at least 1 year after cessation of occlusion were retrospectively reviewed. Even after the success of occlusion therapy, maintenance therapy or regular examinations were performed until the visual development of the normal fellow eye (NE) was completed. The recurrence of amblyopia was defined as a 2 or more logarithm of the minimum angle of resolution (LogMAR) levels of visual acuity (VA) reduction of the amblyopic eye (AE), as compared to the NE, at the last evaluation.

Results

Amblyopia was associated with strabismus in 19 patients, anisometropia in 33 patients, and both in 39 patients. The mean age at the cessation of occlusion and at the last evaluation was 7.7 ± 1.9 years and 11.4 ± 2.9 years, respectively. The mean VA of the AE was 0.01 ± 0.03 and mean stereopsis was 101.7 ± 87.5 seconds of arc at the cessation of occlusion, and both improved at the last evaluation. However, the improvement of mean VA of the AE was not statistically significant (p = 0.21). The mean duration of maintenance therapy was 25.6 ± 21.0 months, and was 3 times longer than the duration required to achieve success in the treatment of amblyopia. At the last evaluation, the recurrence of amblyopia was not found, while 3 patients (4.3%) lost 1 LogMAR level of VA in the AE, as compared to the NE.

Conclusions

Visual outcome following successful cessation of occlusion therapy for unilateral amblyopia was favorable without recurrence of amblyopia.

Keywords: Amblyopia, Occlusion therapy, Recurrence

References

1. Tacagni DJ, Stewart CE, Moseley MJ, Fielder AR. Factors affecting the stability of visual function following cessation of occlusion therapy for amblyopia. Graefes Arch Clin Exp Ophthalmol. 2007; 245:811–6.
crossref
2. Holmes JM, Beck RW, Kraker RT, et al. Riks of amblyopia recurrence after cessation of treatment. J AAPOS. 2004; 8:420–8.
3. Bhola R, Keech RV, Kutschke P, et al. Reccurence of amblyopia after occlusion therapy. Ophthalmology. 2006; 113:2097–100.
4. Ohlsson J, Baumann M, Sjostrand J, Abrahamsson M. Long term visual outcome in amblyopia treatment. Br J Ophthalmol. 2002; 86:1148–51.
crossref
5. Oster JG, Simon JW, Jenkins P. When is it safe to stop patching? Br J Ophthalmol. 1990; 74:709–11.
crossref
6. Scott WE, Dickey CF. Stability of visual acuity in amblyopic patients after visual maturity. Graefes Arch Clin Exp Ophthalmol. 1988; 226:154–7.
crossref
7. Holmes JM, Melia M, Bradfield YS, et al. Factors aassociated with recurrence of amblyopia on cessation of patching. Ophthalmology. 2007; 114:1427–32.
8. Ching FC, Parks MM, Friendly DS. Practical management of amblyopia. J Pediatr Ophthalmol Strabismus. 1986; 23:12–6.
crossref
9. Malik SR, Virdi PS, Goel BK. Follow-up results of occlusion and pleoptic treatment. Acta Ophthalmol (Copenh). 1975; 53:620–6.
crossref
10. Levartovsky S, Oliver M, Gottesman N, Shimshoni M. Factors affecting long term results of successfully treated amblyopia: innitial visual acuity and type of amblyopia. Br J Ophthalmol. 1995; 79:225–8.
11. Woo KJ, Choi MY. The clinical features with recurrence of amblyopia after cessation of amblyopia treatment. J Korean Ophthalmol Soc. 2009; 50:1705–11.
12. Von Noorden GK. Binocular Vision and Ocular Motility. 6th ed.St. Louis: C.V. Mosby;2002. p. 548.
13. Leiba H, Shimshoni M, Oliver M, et al. Long-term follow-up of occlusion therapy in amblyopia. Ophthalmology. 2001; 108:1552–5.
crossref

Figure 1.
Changes in visual acuity after initiation of occlusion.
jkos-51-1499f1.tif
Figure 2.
The improvement of mean visual acuity from cessation of occlusion to the last follow-up.
jkos-51-1499f2.tif
Table 1.
Comparison of visual acuity between the amblyopic eye and the normal eye
Visual acuity of amblyopic eye (LogMAR) Visual acuity of normal eye (LogMAR)
Initiation of occlusion 0.47 ± 0.32 0.13 ± 0.25
Success of treatment 0.12 ± 0.14 0.09 ± 0.12
Cessation of occlusion 0.01 ± 0.03 0.008 ± 0.03
Last follow-up 0.005 ± 0.02 0.00 ± 0.00
Table 2.
Clinical characteristics of three patients with one-line interocular difference in visual acuity at the last follow-up
Patient Cause of amblyopia Age at IO*(yrs) Initial VA†(LogMAR) Duration of maintenance (mon) Age at CO‡(yrs) VA* at CO‡(LogMAR) Stereopsis at CO‡(Seconds of arc) Age at the last follow-up (yrs)
Total 4.8 ± 1.8 0.47 25.6 ± 21 7.7 ± 1.9 0.01 101.7 ± 87.5 11.4 ± 2.9
A Mixed 5.6 0.3 12 7.3 0.00 40 12.9
B Anisometropic 3.7 1.0 37 7.5 0.00 100 12.3
C Strabismic 2.0 1.7 91 10.2 0.05 200 12.2

* Initiation of occlusion

† Visual acuity

‡ Cessation of occlusion.

TOOLS
Similar articles