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Kim, Park, and Yoo: The Effects of Occlusion Therapy in Patients With Anisometropic Amblyopia Aged 8 Years and Older
Original Article

J Korean Ophthalmol Soc 2010;51(1):70-75.

Published online: 7 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.1.70

The Effects of Occlusion Therapy in Patients With Anisometropic Amblyopia Aged 8 Years and Older

Seong Jae Kim, MD1, Yeon Jeong Park, MD1, Ji Myoung Yoo, MD1, 2

1Department of Ophthalmology, Gyeongsang National University, College of Medicine, Chinju, Korea

2Gyeongsang Institute of Health Science, Gyeongsang National University, Chinju, Korea

Address reprint requests to Ji Myong Yoo, MD Department of Ophthalmology Gyeong Sang National University, Colleage of Medicine #90 Chilam-dong, Jinju 660-987, Korea Tel: 82-55-750-8164, Fax: 82-55-758-4158, E-mail: yjm@gnu.ac.kr

Received 7 May 2009       Accepted 15 September 2009

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 compare the effects of full-time and part-time occlusion therapy in patients who had been diagnosed with anisometropic amblyopia after age eight and have begun treatment.

Methods

We included patients eight years old or older who had been diagnosed with anisometropic amblyopia. They were treated with full-time or part-time occlusion therapy and followed up for at least six months. Treatment was considered successful when visual acuity was increased by two lines or more.

Results

There were 26 total patients. There were 14 part-time and 12 full-time occlusion therapy patients in the respective groups. Visual acuity for the amblyopic eyes was significantly improved while the non-amblyopic eyes did not show any significant differences after the treatment. The changes in the visual acuity were significantly larger for the full-time treatment group compared to the part-time treatment group. The full-time occlusion group showed a significant difference in visual acuity of the amblyopic eyes after treatment. Lower visual acuity of an amblyopic eye at the first visit led to a greater improvement in visual acuity after the treatment.

Conclusions

With good compliance, occlusion therapy for anisometropic amblyopia can be successful even if it is initiated after eight years of age.

Keywords: Anisometropic amblyopia, Occlusion therapy

References

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Table 1.
Clinical characteristics of 12 amblyopic patients treated by full-time occlusion
Age /Sex Initial visual acuity (logMAR)
 Duration of treatment (months) Anisometropia (Diopter) Final visual acuity (logMAR)
OD OS OD OS
11/M 0 0.8 6 3.75 0 0.5
11/F 0 0.8 7 3.25 0.1 0.7
11/M 0.7 0 7 2 0.3 0.1
10/F 0 1 7 3 0 0.5
10/M 0 1 14 6 0 0.1
9/M 0.7 0 7.7 4.25 0.2 0
8/F 0.1 1 7.5 4 0.1 0.7
10/F 0 0.5 12.6 2.5 0 0.4
8/F 0.5 0.1 6.6 8 0.2 0.1
8/F 0.2 0 25.2 5.25 0.1 0
8/M 0 1 10 6.5 0 0.7
8/M 0.5 0.1 6.3 2 0.2 0.1
Table 2.
Clinical characteristics of 14 amblyopic patients treated by part-time occlusion
Age/Sex Initial visual acuity (logMAR)
 Duration of treatment (months) Anisometropia (Diopter) Final visual acuity (logMAR)
OD OS OD OS
13/F 0 0.8 7.1 5 0 0.4
11/M 0.1 0.2 6 1.5 0.1 0.1
10/M 0.1 0.3 6.1 3 0 0.2
8/M 0 0.5 9 2.5 0 0.2
10/M 0.1 0.7 21.1 3 0.1 0.5
8/F 0 0.2 14 2 0 0.2
8/F 0.7 0 13 4.75 0 0
8/F 0 0.2 6.1 3.5 0 0.1
8/M 0.1 0.2 6.6 2.75 0.1 0.1
8/M 0 0.3 9.6 2.75 0 0.2
8/M 0.3 0 6.6 4.5 0.2 0
9/M 0.3 0 8 −5 0.2 0
9/M 1 0 6.5 3.5 1 0
8/M 0.3 0 7 5.25 0.3 0
Table 3.
Clinical results of total, part-time and full-time occlusion patients
Total (n=26) Full-time (n=12) Part-time (n=14) p-value*
Mean age (years) 9.15±1.41 9.33±1.30 9.0±1.52 0.557
Initial VA in amblyopic eye (LogMAR) 0.565±0.30 0.73±0.26 0.43±0.26 0.008
Initial VA in sound eye (LogMAR) 0.03±0.05 0.03±0.05 0.03±0.05 0.846
Anisometropia (Diopter) 3.83±1.57 4.21±1.89 3.50±1.21 0.259
Final VA in amblyopic eye (LogMAR) 0.32±0.24 0.39±0.23 0.26±0.27 0.259
Final VA in sound eye (LogMAR) 0.03±0.05 0.04±0.05 0.02±0.04 0.283
Duration of follow-up (Months) 10.05±4.96 10.6±5.70 9.57±4.40 0.605

* p-value=Mann-Whitney U test between full-time and part-time occlusion patients.

Table 4.
Clinical findings according to the degree and type of anisometropia, initial visual acuity in the amblyopic eye and age in the total, full-time and part-time occlusion patients
Total (No. of success) Full-time (No. of success) Part-time (No. of success)
Anisometropia (diopters) <2 1 (1) 0 1 (1)
2≤ and <4 14 (7) 6 (4) 8 (3)
4≤ and <6 8 (4) 3 (2) 5 (2)
≥6 3 (3) 3 (3) 0
Anisometropia (type) Hyperopia 19 (13) 10 (7) 9 (6)
Myopia 7 (2) 2 (2) 5 (0)
Initial visual acuity 0.2≤ and <0.4 10 (4) 1 (1) 9 (3)
in amblyopic eye 0.4≤ and <0.6 4 (3) 3 (2) 1 (1)
(logMAR) ≥0.6 12 (8) 8 (6) 4 (2)
Age (years) 8 ∼ 9 16 (9) 6 (5) 10 (4)
≥10 10 (6) 6 (4) 4 (2)
Table 5.
Changes of visual acuity in amblyopic eye and success rate of occlusion treatment in the total, full-time and part-time occlusion patients
Changes of visual acuity in amblyopic eye (logMAR) p-value* Success rate of occlusion(%) p-value†
Total (n=26) 0.221±0.04 57.7
Full-time Occlusion (n=12) 0.342±0.223 0.014 75.0 0.02
Part-time Occlusion (n=14) 0.164±0.191 42.9

* p-value=Wilcoxon signed rank test

† p-value=Fisher's exact test.

Table 6.
Correlations between each factors of intial age, anisometropia, initial visual acuity of amblyopic eye and changes of visual acuity of the amblyopic eye
Anisometropia (p-value) Age (p-value) Initial V/A in amblyopic eye (p-value)
Changes of visual acuity in amblyopic eye (logMAR) Total −0.229 (0.260) −0.2555 (0.269) −0.619 (0.001)
Full-time −0.108 (0.739) −0.215 (−0.501) −0.675 (0.016)
Part-time 0.019 (0.948) −0.189 (0.517) −0.267 (0.356)
Success rate of occlusion(%) Total −0.520 (0.618) −0.168 (0.880) −0.448 (0.668)
Full-time −0.834 (0.459) −0.487 (0.864) −0.285 (0.836)
Part-time −0.584 (0.588) 0 (1) −0.401 (0.740)
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