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Amblyopia treatment and quality of life: the child's perspective on atropine versus patching
Deborah A Steel1,2, Charlotte J Codina1, Gemma E Arblaster1
1Orthoptics, Bradford Royal Infirmary , Bradford.
Insights
Children with amblyopia reported no significant difference in quality of life between patching and atropine treatments. Both treatments are well-tolerated and suitable as first-line options for amblyopia management.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Quality of Life Research
Background:
- Amblyopia, or "lazy eye," affects visual development in children.
- Current treatments include patching and atropine eye drops.
- Assessing treatment impact from a child's perspective is crucial for adherence and well-being.
Purpose of the Study:
- To compare the impact of patching versus atropine on Health-Related Quality of Life (HRQoL) in children aged 5-7 years with amblyopia.
- To evaluate children's subjective experiences with these two common amblyopia treatments.
Main Methods:
- Forty-six children starting patching or atropine for uniocular amblyopia were enrolled.
- Children completed the Child Amblyopia Treatment Quality-of-Life Questionnaire (CAT-QoL) and the Pediatric Quality of Life Inventory (PedsQL™) after four weeks.
- HRQoL scores were compared between the patching and atropine groups.
Main Results:
- No statistically significant differences in CAT-QoL scores were observed between the patching (median=6.3) and atropine (median=5.6) groups.
- Similarly, no significant differences were found in PedsQL™ total scores between the patching (median=80) and atropine (median=83.33) groups after treatment.
- These findings indicate comparable quality of life outcomes for both treatment modalities.
Conclusions:
- Patching and atropine treatments for amblyopia do not significantly impact children's quality of life.
- Both treatments are well-tolerated by children and can be confidently offered as first-line therapies.
- Clinicians can continue to utilize both patching and atropine based on individual patient needs and preferences.
Abstract:
Background: The impact on children of patching versus atropine treatment for amblyopia was assessed using children's perspective Health-Related Quality of Life (HRQoL) scores in 5 to 7-year olds. Methods: Forty-six children on the threshold of commencing either patching or atropine treatment for amblyopia were recruited. Treatment was prescribed for uniocular amblyopia of visual acuity (VA) 0.2 logMAR or worse. After four weeks of their chosen treatment, each child completed the Child Amblyopia Treatment Quality-of-Life Questionnaire (CAT-QoL). The Pediatric Quality of Life Inventory (PedsQL™), Young Child (5-7) Self-Report version, was completed before and after four weeks of treatment. Quality of life scores were compared between the two treatment groups. Results: Sixty-one percent (n = 28) of participants were male and 56.5% (n = 26) were white British. The CAT-QoL has a range of 0-16, with 16 being the worst quality of life. No significant difference was found between the patching group (n = 30, mean age 69.7 months) and the atropine group (n = 16, mean age 69.3 months) for CAT-QoL quality of life scores (Patch median = 6.3, Atropine median = 5.6, U = 199, p = .341, 95% CI of the median difference of -2.3 to 0.9). The Young Child (5-7) Self-Report version of the PedsQL™ has a 'total score' range of 0-100, with 0 being the worst quality of life. There was also no significant difference in PedsQL™ quality of life total scores (Patch median = 80, Atropine median = 83.33, U = 239.5, p = .991, 95% CI of the median difference -13.33 to 10) after four weeks of treatment. Conclusion: Amblyopic children reported that patching and atropine treatments did not have a significant impact on their quality of life. Patching and atropine should continue to be offered as first-line treatments for amblyopia, as children appear to tolerate both well and do not favor one over the other.