Original articleComparative Efficacy of Penalization Methods in Moderate to Mild Amblyopia
Section snippets
Patient Selection and Sample Size
Subjects included were selected from among children treated for amblyopia between January 2004 and December 2005 in Hospital Ramón y Cajal. The upper age limit for inclusion in the study was 10 years. The lower age limit was determined by the ability to cooperate with visual acuity testing using the logMAR crowded Glasgow acuity cards. For inclusion, interocular difference in visual acuity was at least two logMAR lines (0.2 logMAR units), and visual acuity in the amblyopic eye was at least 0.5
Results
The characteristics of children included in the study are summarized in Table 1. The outcome examination was completed by 32 children (91.4%) in the optical penalization group and by 31 children in the atropine group (88.5%). In the optical penalization group, three children were lost to follow-up. In the atropine group, two patients discontinued treatment because of intolerance, one was withdrawn because the amblyopic eye was treated mistakenly with atropine (subsequently treated with
Discussion
Pharmacologic penalization with atropine may be considered more effective than optical penalization by wearing a plus defocus lens in the treatment of moderate or mild amblyopia. Although using optical penalization is helpful in treating amblyopia, the effect of this treatment after six months (1.8 lines) is only slightly larger than half the effect of atropine penalization (3.4 lines). The stronger effect of atropine may be explained in part by the better compliance in comparison with optical
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Cited by (25)
Treatment compliance in amblyopia: A mini-review and description of a novel online platform for compliance tracking
2022, Survey of OphthalmologyCitation Excerpt :In the atropine alone group, 94% were found to have “excellent” compliance, 4% were considered good, 1% was considered fair, and 1% was considered poor.77 These high rates of subjectively reported compliance with atropine treatment are consistent with other studies.28,46,103 Multiple trials examining atropine treatment for childhood myopia also found subjective compliance rates of greater than 90%.14,116
The pursuit of stereopsis
2018, Journal of AAPOSCitation Excerpt :Recent research has focused on newer treatment modalities to address the issue of low compliance.15 Penalization of the sound eye to force fixation with the amblyopic eye has also been shown to be an alternative to patching.16,17 It can be done using optical penalization with glasses and pharmacological penalization using atropine.18
Compliance and patching and atropine amblyopia treatments
2015, Vision ResearchCitation Excerpt :Moreover, subjective compliance with atropine treatment is lower, on average, in older children (Scheiman et al., 2008) than in younger amblyopes (Pediatric-Eye-Disease-Investigator-Group, 2002, 2009) (Table 3). To estimate atropine compliance objectively, Tejedor et al. used dynamic retinoscopy to test the patient’s ability to accommodate; they reported 12.9% non-compliance (Tejedor & Ogallar, 2008). Because such an objective method did not track the whole process, it may have under- or over-estimated objective compliance.
Ophthalmological evaluation of normal child. Preventive measures. Signs for alarm
2009, Anales de Pediatria ContinuadaInterventions for improving adherence to amblyopia treatments in children
2023, Cochrane Database of Systematic Reviews