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Bethlehem Dessalegn Mekonnen, Xiaoxuan Cai, Jennifer Galvin; Characterizing parental adherence with amblyopia therapy at Menilik II Referral Hospital in Addis Ababa: A 14 Week Study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1545.
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© ARVO (1962-2015); The Authors (2016-present)
Success in treating amblyopia is critically dependent on treatment adherence. There are limited studies performed in the East African region to assess barriers to adherence with amblyopia treatment and outcomes of treatment. Our study aims to identify factors associated with higher compliance in amblyopia treatment.
A hospital-based retrospective and prospective observational study was performed at the pediatric ophthalmology clinic of Menilik II Referral Hospital in Addis Ababa from March to June 2015. Included were Ethiopian children, between ages 4 and 8, with a clinical diagnosis of amblyopia defined as an interocular acuity difference of at least 0.2 logMAR. Patients with deprivation amblyopia, neurologic or traumatic eye disease or previous intraocular surgery were excluded. We collected demographic and clinical data from charts. Parents were asked to estimate the number of hours they were able to administer patching in the past week and fill out a brief questionnaire addressing adherence, social stigma and adverse effects associated with patching. Questions addressing parent’s basic knowledge of amblyopia and its treatment were also included in the questionnaire.
Forty-seven patients (22 male, 25 female) of mean age 6.36 +/- 1.28 years participated. 38 (80.8 %) of patients were residents of the capital, Addis Ababa and 74 % spoke Amharic, the national language. Amblyopia was associated with strabismus (n=31), anisometropia (n=6) and combined (n=10). Mean duration of treatment was 19 +/- 17 months. Mean non-adherence defined as patching for less than half the prescribed hours per week was 40%. Adherence was associated with gender, severity of amblyopia and parental educational level. Male gender (p= 0.0013), worse initial visual acuity (p=0.0016), and lower parental education level (p< 0.001) were correlated with lower adherence. Only 23.4% (n=11) of patients achieved residual amblyopia of 0.19 logMAR units or less. The main factor affecting the outcome of amblyopia treatment in this study is treatment adherence.
Comparison with the literature suggests that the results of patching treatment in our study may be falling significantly short of possible success. Initially worse visual acuity and lower parental education level are two factors which influenced amblyopia treatment adherence in this setting.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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