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Authors
Jonathan M. Holmes, B.M., B.Ch., Michele Melia, Sc.M., Yasmin S. Bradfield, M.D., Oscar A. Cruz, M.D., Brian Forbes, M.D., Ph.D.

Factors Associated with Recurrence of Amblyopia on Cessation of Patching

publication date
2007 Mar 23
Category
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Abstract/Introduction

Purpose

In a prospective observational study, we previously reported that weaning (tapering or gradually reducing) treatment in children treated with 6 to 8 hours of daily patching for amblyopia resulted in a 4-fold reduction in odds of recurrence. We now report the association of additional factors with recurrence or regression of amblyopia in 30 this same cohort.

 

Design

Prospective, nonrandomized, observational study.

 

Participants

69 children aged less than 8 years, with successfully treated anisometropic or strabismic amblyopia (improved at least 3 logarithm of the minimum angle of resolution (logMAR) lines).

 

Methods

Patients were enrolled at the time they stopped patching for amblyopia. Patients were classified according to whether patching was stopped abruptly or weaned prior to cessation. They were followed off treatment for 52 weeks to assess recurrence of amblyopia.

 

Main outcome measure

Recurrence of amblyopia defined as a 2 or more logMAR level reduction of visual acuity from enrollment (cessation of patching), confirmed by a second examination. Recurrence was also considered to have occurred if treatment was restarted with a 2 or more logMAR level reduction of visual acuity even if it was not confirmed by a second examination.


Conclusion/Results

Results

The risk of recurrence was higher with better visual acuity at the time of cessation of treatment (adjusted risk ratio (RR)=0.68 per line of worse visual acuity (VA), 95% confidence interval (CI)=0.51, 0.90), a greater number of lines improved during the previous treatment (adjusted RR=1.5 per line increase, 95% CI=1.1, 2.0), and a prior history of recurrence (adjusted RR=2.7, 95% CI=1.5, 4.9). Orthotropia or excellent stereoacuity at the time of patching cessation did not appear to have a protective effect on the risk of recurrence.

 

Conclusions

The higher risk of recurrence in the most successfully treated children with amblyopia and absence of protection from orthotropia and excellent randot dot stereoacuity suggests that careful and prolonged follow-up is needed for all children who have been previously treated for amblyopia.


Testimonials


Vision therapy is well worth the response, time and effort. Our Son had a hard time focusing and writing neatly. After vision therapy Seth could complete a task in half the time if previously took. His abilities to focus improved greatly and so did his handwriting.

Also, he was better at listening. As a parent, we wanted learning to be fun for our Son, and vision therapy made this possible.


Amanda T.

Vision Therapy is well worth the expense, time and effort. Our son had a hard time focusing handwriting neatly. After vision therapy Seth could complete a task in half the time it previously took his abilities to focus and improved greatly and so did his handwriting.

Also, he was better at listening. As a parent you wanted learning to be fun for our son and vision therapy made this possible.


Alexa H.

Vision Therapy has given or son the tools he needs to be able to scan and read the written word more effectively and efficiently.

He love working with John and these working sessions give him the motivation to gladly work on his homework assignments.

It amazed us to see the difference in the tracking of his eyes and along a line of it's from the beginning to the end of the treatment.

Dr. McBryar , Kristen and John  are all marvelous and we would recommend them to anyone I only wish that we would have found them sooner!


Charlotte M.

Prior to coming to the institute for vision development my son complained of daily headaches. Therapy has eliminated his headaches completely. I love knowing my son is able to learn pain-free for the rest of his life because of the work that has been done over just a few weeks in this office. He he absolutely loved coming that didn't even feel like going to a doctor or therapy. We are grateful for the relief he was able to find by coming here.

Thank you!


Olivia C.

Seems much less frustrated with life

Reads non-stop and fast

Spelling abilities have been hugely improved

Seems much more confident

Thank You!!!


Kelly O.

When we first came to the practice, my son did not have huge issues, but lots of small ones- trouble with reading, sports (hitting the baseball consistently), coordination, etc- that were not easily detectable,but when put together presented issues. The staff here were all very professional and loving towards him. While I was concerned in the reading, my son was concerned with the athletic side. Seeing improvement night off the bat gave him confidence that i have nor seen in him and made him want to not only Come to therapy, but also made him want to work hard. He has surpassed his grade level and above in reading and hit his first home run this year! Thank you!!!


Alice M.
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