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F. Matsumoto, A. Yamabe, H. Yamamoto, Y. Nakao, A. Wakayama, Y. Shimomura; Effect of a Combined Patching and Atropine Treatment in Patients With Anisometropic Amblyopia With Microtropia for the Prevention of Amblyopia Recurrence. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4710.
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We have previously reported that anisomertopic amblyopia with microtropia often recurs after a patching treatment. To prevent the recurrence, we investigated the effect of a combined patching and atropine occlusion treatment in patients with anisometropic amblyopia with microtropia.
Eight patients (mean age, 69±10 months) with anisometropic amblyopia with microtropia were included. The mean refractive errors for the amblyopic and fellow eyes were +5.69±1.11D and +2.15±1.5D (spherical), respectively. Patient’s pre-treatment visual acuity (VA) of the amblyopic eye ranged from 0.30-1.04 logMAR. The treatment protocol was as follows: (1) an initial patching time of eight hours or longer per day was set, (2) the patching time was reduced to 3-5 hours per day depending to the patient’s age when the VA ceiling of the amblyopic eye was reached, (3) if VA of the amblyopic eye remained stable, treatment of 1% atropine eye drops once per day was started on the fellow eye. During a follow-up period of 6-72 months, recurrence of amblyopia was determined based on the VA stability of the amblyopic eye.
Seven (87.5%) of the eight patients, had improved VA of 0 logMAR in the amblyopic eye after the patching treatment and were able to maintain their VA after the atropine occlusion treatment. The other patient (12.5%) had improved VA of 0.15 logMAR after the patching treatment and the VA was further improved after the atropine occlusion treatment. The overall treatment required 8-17 months; and the respective means were 5.14 months for the patching treatment of 8 hours or longer per day, 2 months for the patching treatment of 3-5 hours per day, and 3.14 months for the atropine occlusion treatment. None of the patients experienced amblyopia recurrence during the follow-up period.
Because atropine occlusion promotes binocular rivalry under binocular condition, an atropine occlusion treatment following patching can effectively prevent recurrence of amblyopia.
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