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J. Ho, M. Luu, Y. Pang; Efficacy of Treatment Options for Anisometropic Amblyopia. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4346.
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It is unclear whether the addition of vision therapy to amblyopia treatment contributes to the acuity improvement of the amblyopic eye. The purpose of this study is to compare the treatment outcomes of different treatment modalities on anisometropic amblyopia, including optical correction (OC), patching (PC), and patching plus vision therapy (PVT).
Charts of 725 amblyopic patients were reviewed. Only patients without previous amblyopia treatment and spectacle correction were eligible. Treatment was considered completed when the acuity in the amblyopic eye was stable on 3 consecutive visits. Forty subjects met the study’s criteria, with 6, 11, and 23 subjects in the treatment groups of OC, PC, and PVT, respectively. Data collected included the subjects’ age, gender, race, baseline visual acuity (BVA), anisometropia, and final VA (FVA) at the end of amblyopia treatment. VA improvement (VAI) of the amblyopic eye was calculated. Analysis of covariance (ACOVA) was performed to compare the treatment outcomes among groups of OC, PC, and PVT while controlling age, gender, race, and the degree of anisometropia.
The mean (±SD) age of subjects was 8.21±3.32 years old. The mean BVA (±SD) in the amblyopic eye was 0.67±0.30 logMAR, with 0.48±0.10, 0.64±0.35, 0.73±0.30 logMAR in the OC, PC, and PVT groups, respectively, with no statistical difference in BVA among 3 groups. The mean FVA in the amblyopic eye was 0.31±0.25 logMAR, with 0.17±0.10, 0.34±0.35, 0.33±0.22 logMAR in each of the groups, respectively. The mean VAI was 0.36±0.19 logMAR among all groups, with an average of 0.31±0.13, 0.30±0.15, and 0.40±0.22 logMAR in the each of the groups, respectively. Each treatment group significantly improved acuity in the amblyopic eye (OC: P=0.002, PC: P<0.001, PVT: P<0.001). However, there were no statistical difference in the either FVA or VAI among three treatment group while controlling age, gender, race, and the degree of anisometropia.
Although each treatment effectively improved VA in the amblyopic eye, no statistical difference was identified among the treatment groups. Further study is needed to test whether vision therapy impacts other vision functions, such as accommodation, in amblyopic patients.
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