April 2011
Volume 52, Issue 14
ARVO Annual Meeting Abstract  |   April 2011
Optical Treatment of Strabismic and Combined Strabismic-Anisometropic Amblyopia
Author Affiliations & Notes
  • Susan A. Cotter
    Southern California College of Optometry, Fullerton, California
  • Jonathan M. Holmes
    Ophthalmology, Mayo Clinic, Rochester, Minnesota
  • Nicole Foster
    Jaeb Center for Health Research, Tampa, Florida
  • Michele Melia
    Jaeb Center for Health Research, Tampa, Florida
  • Pediatric Eye Disease Investigator Group
    Southern California College of Optometry, Fullerton, California
  • Footnotes
    Commercial Relationships  Susan A. Cotter, None; Jonathan M. Holmes, None; Nicole Foster, None; Michele Melia, None
  • Footnotes
    Support  NIH grants EY011751 & EY018810
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 6338. doi:
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      Susan A. Cotter, Jonathan M. Holmes, Nicole Foster, Michele Melia, Pediatric Eye Disease Investigator Group; Optical Treatment of Strabismic and Combined Strabismic-Anisometropic Amblyopia. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6338.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : To determine the visual acuity improvement in children with strabismic and combined strabismic-anisometropic (combined-mechanism) amblyopia treated with optical correction alone and to explore factors associated with improvement.

Methods: : In a prospective multi-center cohort study, 146 children 3 to <7 years old with previously untreated strabismic amblyopia (N=52) or combined-mechanism amblyopia (N=94) were provided with optical treatment in the form of spectacles. The spectacles were worn for the first time at the baseline visit, at which time visual acuity was measured using the Amblyopia Treatment Study HOTV visual acuity protocol; visual acuity was reassessed every 9 weeks thereafter until no further improvement in visual acuity was found. Ocular alignment was assessed at each visit. The main outcome measure was visual acuity 18 weeks after baseline.

Results: : Overall, amblyopic eye visual acuity improved a mean of 2.6 lines (95% CI: 2.3 to 3.0), with 75% of children improving ≥2 lines and 54% improving ≥3 lines. Resolution of amblyopia occurred in 32% (95% CI: 24% to 41%) of the children. The treatment effect was greater for strabismic amblyopia than for combined-mechanism amblyopia (3.2 versus 2.3 lines, adjusted P = 0.003). Visual acuity improved regardless of whether eye alignment improved.

Conclusions: : Optical treatment alone of strabismic and combined-mechanism amblyopia results in clinically meaningful improvement in amblyopic eye visual acuity for most 3 to < 7-year-old children, resolving in approximately one third without the need for additional treatment. Consideration should be given to prescribing refractive correction as the sole initial treatment for children with strabismic or combined-mechanism amblyopia.

Keywords: amblyopia • strabismus • clinical (human) or epidemiologic studies: outcomes/complications 

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