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Published on: September 27, 2024
Effect of 4-Month Intermittent Atropine Penalization in Amblyopic Children for Whom Patch Therapy Had Failed
Insights
Four-month intermittent atropine penalization improved vision in children with amblyopia who failed patching. Younger age and lower initial visual acuity predicted success in this amblyopia treatment.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus
Background:
- Amblyopia, or
Purpose of the Study:
- To assess the efficacy of 4-month intermittent atropine penalization in children with amblyopia previously unresponsive to patching.
- To identify factors predicting successful outcomes in this patient group.
Main Methods:
- Retrospective analysis of 41 children with amblyopia treated with 1% atropine drops twice weekly in the sound eye for 4 months.
- Treatment success defined as a two-line improvement in best-corrected visual acuity (BCVA) in the amblyopic eye.
- Comparison of demographic and treatment-related factors between successful and failed treatment groups.
Main Results:
- Nearly half (48.8%) of the children achieved treatment success.
- Younger age and poorer pretreatment BCVA in the amblyopic eye were significantly associated with successful outcomes.
- The mean age of participants was 5.59 years, with a mean BCVA of 0.40 logMAR at the start of atropine treatment.
Conclusions:
- Four-month intermittent atropine penalization is an effective treatment for improving BCVA in children with amblyopia who have not responded to patching.
- This treatment approach shows particular promise for younger children and those with initially lower visual acuity in the amblyopic eye.
Purpose:
To evaluate the effect of 4-month intermittent atropine penalization in children with amblyopia for whom patch therapy had failed and to analyze the factors associated with treatment success.
Methods:
This retrospective observational study included participants who visited the hospital between January 1, 2011, and December 31, 2015. Forty-one children with amblyopia for whom patch therapy had failed were included and their medical records were analyzed retrospectively. They were treated with 1% atropine eye drops in the sound eye twice per week for 4 months. Treatment success was defined as a best corrected visual acuity (BCVA) improvement of two lines in the amblyopic eye. Age, cause of amblyopia, pretreatment BCVA at the start of atropine penalization in the amblyopic eye, age at the start of eyeglass prescription, age at the start of patch therapy, duration, compliance with and total amount of patch therapy, type of refraction, type of strabismus, and cause of failure of patch therapy were analyzed and compared between two groups: the failure and success groups.
Results:
Twenty of 41 patients (48.8%) showed treatment success. The mean age was 5.59 ± 1.52 years and the mean BCVA of the amblyopic eye was 0.40 ± 0.20 logarithm of the minimum angle of resolution (logMAR). Younger age and poor pretreatment BCVA at the start of atropine penalization in the amblyopic eye were the factors associated with treatment success.
Conclusions:
Intermittent atropine penalization for 4 months can improve BCVA in children with amblyopia for whom patch therapy has failed. Atropine penalization can be especially effective in younger children and those with poor BCVA at the start of atropine penalization in the amblyopic eye. [J Pediatr Ophthalmol Strabismus. 2017;54(6):375-380.].
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