Abstract
Purpose :
Amblyopia is the most common visual disease in childhood. An extended period of optical treatment (EOT) prior to patching for amblyopia is included in clinical guidelines in several countries. However, EOT has not been directly compared to a treatment group without EOT in an RCT.
Methods :
A prospective RCT, stratified 334 children for type and severity of amblyopia, was performed comparing EOT (18 weeks glasses wear prior to patching; n=170) to an early patching (EP) group (3 weeks glasses wear prior to patching; n=164). Glasses wear and patching were electronically monitored in half the cohort. The primary outcome was success (≤0.200 interocular difference in logMAR visual acuity) after 12 weeks of patching.
Results :
The EP group had a higher level of success (66.7%) compared to the EOT group (53.9%, P=0.022). Similar outcomes were also observed after 18 weeks and 24 weeks of patching, using other definitions of success, and with imputation of missing values. Prescribed and electronically monitored hours of patching were not significantly different between the two groups. Younger children with less severe amblyopia had a higher likelihood of successfully responding to EOT only.
Conclusions :
EOT is not an effective treatment strategy for amblyopia as a whole, providing a lower success rate compared to treatment without EOT and offering no advantage in terms of visual outcomes or the amount of patching required. However, younger children, with less severe amblyopia are more likely to successfully respond to EOT. Hence a personalised approach to the use of EOT is recommended.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.