The course of moderate amblyopia treated with patching in children: experience of the amblyopia treatment study

To * The writing committee listed in the Appendix served as author for the Pediatric Eye Disease Investigator Group. A listing of the investigators who participated in the study appears in the Appendix. assess the course of the response to patching treatment of moderate amblyopia and to assess facto...

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Veröffentlicht in:American journal of ophthalmology 2003-10, Vol.136 (4), p.620-629
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description To * The writing committee listed in the Appendix served as author for the Pediatric Eye Disease Investigator Group. A listing of the investigators who participated in the study appears in the Appendix. assess the course of the response to patching treatment of moderate amblyopia and to assess factors predictive of the response in children 3 years old to younger than 7 years old. Multicenter, randomized clinical trial comparing patching and atropine (one of the amblyopia treatment studies). A total of 209 children 3 years old to younger than 7 years of age with amblyopia in the range of 20/40 to 20/100 from the patching treatment arm of this trial were treated with patching of the sound eye from 6 hours per day up to all waking hours. Follow-up examinations were performed at 5 weeks, 16 weeks, and 6 months. The primary outcome measure was visual acuity in the amblyopic eye at 6 months. After 5 weeks of treatment, mean amblyopic eye acuity improved from baseline by 2.2 lines. For patients with baseline acuity of 20/80 or 20/100, a greater number of hours of prescribed patching was associated with greater improvement in the first 5 weeks ( P = .05). However, this relationship was not present when baseline acuity was 20/40 to 20/60 ( P = .57). At 6 months, visual acuity was improved from baseline by a mean of 3.1 lines, with the amount of improvement no longer related to the number of hours patching prescribed at baseline ( P = .93). Among the 157 patients improving at least 3 lines from baseline, 15% achieved their maximum improvement by 5 weeks and 52% by 16 weeks. None of the demographic or clinical factors assessed was predictive of the response to treatment. In the treatment of moderate amblyopia, a beneficial effect of patching is present throughout the age range of 3 years old to younger than 7 years old and the acuity range of 20/40 to 20/100. At 6 months, the amount of improvement appears to be similar when 6 hours of daily patching are initially prescribed vs a greater number of hours. However, when the baseline acuity is 20/80 to 20/100, a greater number of hours of prescribed patching may improve acuity faster.
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For patients with baseline acuity of 20/80 or 20/100, a greater number of hours of prescribed patching was associated with greater improvement in the first 5 weeks ( P = .05). However, this relationship was not present when baseline acuity was 20/40 to 20/60 ( P = .57). At 6 months, visual acuity was improved from baseline by a mean of 3.1 lines, with the amount of improvement no longer related to the number of hours patching prescribed at baseline ( P = .93). Among the 157 patients improving at least 3 lines from baseline, 15% achieved their maximum improvement by 5 weeks and 52% by 16 weeks. None of the demographic or clinical factors assessed was predictive of the response to treatment. In the treatment of moderate amblyopia, a beneficial effect of patching is present throughout the age range of 3 years old to younger than 7 years old and the acuity range of 20/40 to 20/100. 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Drug treatments</topic><topic>Product introduction</topic><topic>Sensory Deprivation</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Variables</topic><topic>Vision disorders</topic><topic>Visual Acuity - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pediatric Eye Disease Investigator Group</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><aucorp>Pediatric Eye Disease Investigator Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The course of moderate amblyopia treated with patching in children: experience of the amblyopia treatment study</atitle><jtitle>American journal of ophthalmology</jtitle><addtitle>Am J Ophthalmol</addtitle><date>2003-10-01</date><risdate>2003</risdate><volume>136</volume><issue>4</issue><spage>620</spage><epage>629</epage><pages>620-629</pages><issn>0002-9394</issn><eissn>1879-1891</eissn><coden>AJOPAA</coden><abstract>To * The writing committee listed in the Appendix served as author for the Pediatric Eye Disease Investigator Group. 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For patients with baseline acuity of 20/80 or 20/100, a greater number of hours of prescribed patching was associated with greater improvement in the first 5 weeks ( P = .05). However, this relationship was not present when baseline acuity was 20/40 to 20/60 ( P = .57). At 6 months, visual acuity was improved from baseline by a mean of 3.1 lines, with the amount of improvement no longer related to the number of hours patching prescribed at baseline ( P = .93). Among the 157 patients improving at least 3 lines from baseline, 15% achieved their maximum improvement by 5 weeks and 52% by 16 weeks. None of the demographic or clinical factors assessed was predictive of the response to treatment. In the treatment of moderate amblyopia, a beneficial effect of patching is present throughout the age range of 3 years old to younger than 7 years old and the acuity range of 20/40 to 20/100. 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subjects Age
Amblyopia - physiopathology
Amblyopia - therapy
Atropine - therapeutic use
Biological and medical sciences
Child
Child, Preschool
Compliance
Eye
Female
Follow-Up Studies
Humans
Male
Medical sciences
Mydriatics - therapeutic use
Ophthalmology
Patients
Pharmacology. Drug treatments
Product introduction
Sensory Deprivation
Time Factors
Treatment Outcome
Variables
Vision disorders
Visual Acuity - physiology
title The course of moderate amblyopia treated with patching in children: experience of the amblyopia treatment study
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