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M.B. Awan, F.A. Proudlock, I. Choudhuri, D. Grosvenor, N. Sarvananthan, I. Gottlob; Outcome of amblyopia treatment . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4998.
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Purpose: The management of amblyopia remains controversial. We assessed the visual outcome of treatment of amblyopia in a hospital setting. Methods: Clinical notes of one hundred children (female 39, male 61) seen between 1996 and 2002 were reviewed. The information collated included the age at presentation, type of amblyopia, duration of treatment before discharge, number of examinations, number of orthoptists, prescribed patching and visual acuity. Results: Ages of amblyopic children ranged between 1 and 9 years (mean 4.4yrs), 32 were strabismic, 36 anisometropic, 26 mixed, 4 ametropic, 1 microtropic and 1 had stimulus deprivation. Mean duration of treatment was 30 months, number of examinations was 12.7, the number of different orthoptist seen was 4.8, the total number of hours prescribed was 1927. The mean improvement in Snellen visual acuity (±SD) during patching was 1.25 lines (± 2.0 lines), 1.4 lines (± 1.27 lines), and 2.2 lines (± 3.1 lines) for stabismics, anisometropes and mixed amblyopes, respectively. For all patients 53.1% improved to visual acuity of 20/30 or better and 74.5% to visual acuity of 20/40 or better. Visual acuity at start and prescribed hours of patching were very strong predictors of increase in visual acuity (p<0.001). The number of different orthoptists involved in treatment was a weak predictor of visual outcome. We found that age at presentation, recorded compliance, no of clinic visits and total duration of treatment were all poor predictors of visual outcome. Conclusions: The mean improvement in visual acuity was poor in all groups. Main predictors for good visual outcome were initial visual acuity and total hours of prescribed patching, whereas age at presentation did not predict visual outcome. This highlights the need for improvement of amblyopia therapy in UK clinics.
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