Compliance with Intermittent Occlusion Therapy Glasses for Amblyopia treatment in Children

Abstract

Purpose : Liquid crystal glasses utilize an intermittent occlusion technique (at 30-second opaque/transparent intervals) and avoid adhesive patches, potentially improving compliance. Several previous studies support the effectiveness of this new occlusion therapy device for amblyopia treatment. (Spierer et al, 2010; Wang et al, 2016) However, previous studies had no objective compliance measured for these glasses, which limits understanding of the dose-response for this treatment. This study reports the pilot data of a microsensor to monitor objective compliance with intermittent occlusion glasses.

Methods : Ten children (3-7 yr) with unilateral amblyopia associated with strabismus and anisometropia were enrolled. Amblyopia was defined as an interocular visual acuity difference of at least 0.2 logMAR. Prior to enrollment, they wore their optical correction glasses for 12 weeks. At enrollment, depending on the severity of amblyopia, they were prescribed 4 or 12 hours of Intermittent Occlusion Therapy Glasses (Amblyz™). An inexpensive, commercially available waterproof microsensor was attached to the temple arm to monitor compliance with glasses wear for 3 to 4 weeks. Compliance was defined as the percentage of hours of actual glasses wear compared to the hours prescribed. Daily compliance was calculated, and general compliance was the average of daily compliance. Compliance on weekdays and weekend was compared. The correlation of age and compliance was also calculated.

Results : Patients on average have visual acuity improved 0.11±0.13 logMAR (-0.1 to 0.3logMAR). Compliance varied among and within individuals. General compliance was averaged at 46.4% (ranged from 10% to 97%). Daily compliance declined with time for every patient, and mean daily compliance decreased by 2% everyday. Although there was no significant difference statistically, some individuals had lower daily compliance on weekends compared with that on weekdays. For this sample, there was no correlation between compliance with visual acuity improvement, nor with age. No parents reported that their child had social concerns related to the attached sensor.

Conclusions : Objective compliance with intermittent occlusion therapy glasses varies among individuals, but on average declines over time. Visual acuity improvement cannot be explained with compliance. These preliminary results are limited with small sample and short-term follow-up.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.