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F. Matsumoto, A. Wakayama, E. Arimura, H. Yamamoto, N. Obase, Y. Nakao, Y. Shimomura; Outcomes of a Combined Treatment Using Patching and Atropine Occlusion for Patients Exhibiting Anisometropic Amblyopia With Microtropia to Prevent Recurrence. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4344.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the outcomes of a combined treatment employing patching and atropine (AT) occlusion in patients exhibiting anisometropic amblyopia with microtropia to prevent recurrence.
Subjects were 11 patients (mean age, 57.5±10.2 months) with anisometropic amblyopia with microtropia. The mean refractive errors for the amblyopic and fellow eyes were +5.15±1.22 D and +2.28±1.36 D (spherical), respectively. Before treatment, the patients’ amblyopic eye had visual acuity (VA) ranging from 0.30-1.30 logMAR. The treatment protocol included: (1) An initial patching time for 8 hours or longer per day; (2) Depending on the patient’s age, the patching time was reduced to 3-5 hours per day when the amblyopic eye reached the VA ceiling; and (3) The fellow eye would receive treatment of 1% AT eye drops once per day if the amblyopic eye’s VA remained stable. Based on the VA stability of the amblyopic eye in a follow-up period of 6-72 months, the recurrence of amblyopia was determined.
In 10 (90.9%) of the 11 patients, VA of the amblyopic eye improved to 0 logMAR after the patching treatment and was maintained after the AT occlusion. VA of the remaining one patient (9.1%) had improved to 0.10 logMAR after the patching and further improved after the AT occlusion. Our subjects required an overall treatment period of 8-14 months. The mean durations for the 8-hour-or-longer patching, the 3-to-5-hour patching, and the AT occlusion were 5.89 months, 2.33 months, and 2.67 months, respectively. No patients experienced amblyopia recurrence during the follow-up period.
Our results showed that a combined treatment of patching and AT occlusion could be effective against amblyopia recurrence. We suspect that the AT occlusion might have promoted binocular rivalry under binocular condition.
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