June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
A Modified Amblyopia Treatment Index in Beijing, China: Lessons Learned
Author Affiliations & Notes
  • Jennifer Ann Galvin
    Yale, New Haven, Connecticut, United States
  • Juan Bu
    Peking University 3rd Hospital, Beijing, China
  • Wendy F. Li
    Yale, New Haven, Connecticut, United States
  • Footnotes
    Commercial Relationships   Jennifer Galvin, None; Juan Bu, None; Wendy Li, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2416. doi:
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      Jennifer Ann Galvin, Juan Bu, Wendy F. Li; A Modified Amblyopia Treatment Index in Beijing, China: Lessons Learned. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2416.

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

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Purpose : Successful amblyopia treatment in children depends upon treatment adherence. Previous studies have characterized adherence using the amblyopia treatment index (ATI) questionnaire. However, there is limited literature on amblyopia treatment adherence in the Chinese population. The purpose of this study was to assess barriers to adherence and treatment outcomes in Chinese amblyopic children with a modified Chinese ATI.

Methods : A cohort study was conducted at Peking University 3rd Hospital from June to August 2016. Included were patients with a diagnosis of amblyopia (interocular visual acuity difference greater than logMAR 0.2) and completion of patching therapy. Clinical ophthalmic data was collected from medical records. Parents reported adherence to prescribed patching regimens and then completed the modified ATI. Chi-square analysis was used to analyze association between sociodemographic data, adherence, and treatment success.

Results : 30 patients (14 male, 16 female) with mean age at diagnosis of 4.6 +/- 2.4 years participated. Twenty-four patients (80%) had refractive amblyopia, two (6.7%) strabismic, and four (13.3%) combined. Mean treatment duration was 15.1 +/- 11.9 months. At the end of treatment, 11 (36.7%) had residual amblyopia. Age greater than 6 years at diagnosis (p=0.037), belief that patching had adverse effects (p=0.007), and concerns about social stigma (p=0.007) were associated with adherence difficulties. Worse baseline vision (p = 0.006) and adherence difficulty (p = 0.013) were associated with residual amblyopia. Of note, treatment adherence was not affected by parental education or distance from treating hospital.

Conclusions : Regardless of parental education or distance to tertiary hospital, Chinese parents are dedicated to treating amblyopia. However, Chinese parents, like parents in previous studies of other cultures, have challenges with treatment adherence due to psychosocial factors and social stigma of patching treatment. Our patients had higher levels of refractive amblyopia compared to previous studies. In this way, correcting refractive error treated the majority of our patients’ amblyopia, contributing to a lower rate of residual amblyopia.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.


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