Abstract
Purpose :
Studies have demonstrated sociodemographic disparities in amblyopia treatment outcomes, but factors underlying these disparities are incompletely characterized. This study evaluates demographic, clinical, and compliance-related factors associated with amblyopia resolution.
Methods :
This retrospective chart review evaluated children ≤8 years old diagnosed with unilateral refractive or strabismic amblyopia at our institution from 2012-2022. Demographic and clinical data were recorded from the medical record. Median household income was estimated using U.S. Census bureau data. The quality of neighborhood resources was measured by the Child Opportunity Index (COI). Treatment compliance was calculated by determining the percentage of visits at which parents reported at least 50% compliance with amblyopia treatment. Appointment delay was determined by calculating the difference between recommended and actual follow-up intervals. Amblyopia resolution was defined as <0.2 logMAR interocular visual acuity difference, or no consistent fixation preference in non-verbal patients. Patients with resolved and persistent amblyopia were compared using chi square and Mann-Whitney tests.
Results :
178 patients met inclusion criteria, and 140 (79%) had resolved amblyopia. Univariate analysis showed that patients with resolved amblyopia were younger at diagnosis (3.2±1.7 vs. 4.5±1.9 years, p=0.001), with higher median household incomes ($82,771±$28,925 vs. $72,009±$26,584, p=0.03), higher COI socioeconomic and overall scores (51.0±25.4 vs. 41.2±24.6, p=0.03; 51.0±25.4 vs. 41.2±24.6, p=0.03 respectively), higher rates of treatment compliance (81.4%±26.7% vs. 69.0%±30.9%, p=0.03), and more timely follow-up (follow-up appointments delayed by 222±467 days vs. 410±533 days, p=0.05). There were no differences in rates of amblyopia resolution by sex, race, ethnicity, amblyopia type, or initial amblyopic eye visual acuity or stereoacuity (p>0.05). In a multivariate analysis, younger age at diagnosis (p=0.0007) and shorter appointment delays (p=0.001) were significant independent predictors of amblyopia resolution.
Conclusions :
This analysis suggests that disparities in amblyopia resolution may be related to delays in amblyopia diagnosis and follow-up appointment times.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.