Abstract
Purpose :
To evaluate the impact of clinical and sociodemographic factors on visual outcomes in pediatric patients treated for anisometropic, strabismic, combined anisometropic-strabismic or bilateral ametropic forms of amblyopia.
Methods :
Retrospective cohort study undertaken at a single academic center. Subjects consisted of children <16 years of age who received ≥1 year of treatment and were ≥6 years at their final exam. Patients with deprivation forms of amblyopia and intraocular pathology were excluded. Primary outcome was the attainment of BCVA ≥20/40 in both eyes. The influence of clinical and sociodemographic factors on the relationship between early age at treatment and visual outcomes were investigated using stratified analysis and multi-variable regression models. Student-test, chi-square test, one-way analysis of variance test and log-binomial regression was used for data analysis.
Results :
Clinical findings of 550 pediatric patients (286 males/264 females) who presented at a mean age of 5.0±2.2 years (range=0.6-11.9 years) and whose final visits were conducted at 9.5±2.3 years (range=6.0-17.8 years) were included in the analysis. Age at initial diagnosis (p=0.372) and final visit (p=0.295) were similar across both groups. Late age (≥7 years) at treatment initiation, African-American race, poor compliance with treatment, presence of high refractive error (>4.50D of hypermetropia or >6.50 D of myopia) status at initial visit were associated with unsuccessful outcomes (BCVA <20/40 in at least 1 eye) at final visit, whereas gender, type of amblyopia, Medicaid insurance status, living in 2-parent household, presence of mother as caregiver at initial visit, and prematurity status were not associated with unsuccessful outcomes. After adjusting for gender, racial background and refractive error status, the prevalence of unsuccessful outcome was 2.04 times higher in patients who were older (≥7y) at presentation compared to those treated at younger (<7 years) age (Prevalence ratio: 2.04, 95% CI: 1.42, 2.94).
Conclusions :
Early age at treatment is associated with better visual outcomes in amblyopic children. African-American children attain worse outcomes compared to their White and Hispanic counterparts and should be monitored more closely during their treatment.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.