J Korean Ophthalmol Soc.  2010 Oct;51(10):1374-1379.

Decreased Visual Acuity of Dominant Eye Compared to Amblyopic Eye During Occlusion Therapy

• Park SH
• Chang HR

Abstract

PURPOSE
To investigate the clinical features of patients with decreased visual acuity (VA) of the dominant eye as compared to that of the amblyopic eye during occlusion therapy.
METHODS
The authors analyzed clinical features of 28 patients with VA reversed between the two eyes during occlusion therapy among 500 patients treated with occlusion therapy under the diagnosis of monocular amblyopia.
RESULTS
Twenty-one patients with strabismic amblyopia (SA), five patients with anisometropic amblyopia (AA) and two patients with combined amblyopia (CA) were enrolled in the present study. Decreased VA of the dominant eye as compared to that of the amblyopic eye occurred 66.75 +/- 83.63 weeks after the onset of occlusion therapy. Reversion of VA between both eyes occurred during amblyopia treatment in 17 patients and during maintenance therapy in 11 patients. The reversed VA was recovered in all patients. The mean duration (MD) of reversed VA was 15.00 +/- 24.43 weeks, and the number of clinic visits (CV) was 4.68 +/- 8.65. In five patients, the MD of reversed VA (59.80 +/- 30.14 weeks, p = 0.016) and the number of CVs (18.40 +/- 14.48, p < 0.001) were significantly longer than those of the other 23 patients (MD of reversed VA: 5.78 +/- 4.04 weeks, number of CV: 1.70 +/- 1.22); those five patients had low compliances and SAs.
CONCLUSIONS
Visual acuity was recovered in all patients with decreased VA of the dominant eye as compared to that of the amblyopic eye during occlusion therapy, rapid recovery was observed in most patients except in several patients with low compliance.

Keyword

Amblyopia; Compliance; Dominant eye; Occlusion therapy; Reversed visual acuity

MeSH Terms

Amblyopia
Ambulatory Care
Compliance
Eye
Humans
Phenothiazines
Visual Acuity
Phenothiazines

Reference

References

1. von Noorden GK. Binocular vision and ocular motility. 6th ed.St. Louis: Mosby;2002. p. 246–97.

2. Simons K. Amblyopia characterization, treatment, and prophylaxis. Surv Ophthalmol. 2005; 50:123–66.

3. Kim YH, Choi MY. The prospective comparison of the efficacy of intermittent atropine penalization and part-time occlusion therapy. J Korean Ophthalmol Soc. 2008; 49:958–66.

4. Pediatric Eye Disease Investigator Group. A randomized trial of atropine vs. patching for treatment of moderate amblyopia in children. Arch Ophthalmol. 2002; 120:268–78.

5. Scott WE, Kutschke PJ, Keech RV, et al. Amblyopia treatment outcomes. J AAPOS. 2005; 9:107–11.

6. Korean Association for Pediatric Ophthalmology and Strabismus. Current concepts in strabismus. 2nd ed.Naewae Haksool;2008. p. 403–7.

7. Yeom HY, Han SH, Lee JB. Effects of solitary part-time occlusion for the treatment of monocular amblyopia patients. J Korean Ophthalmol Soc. 2004; 45:1134–40.

8. Scott WE, Stratton VB, Fabre J. Full time occlusion therapy for amblyopia. Am Orthopt J. 1980; 30:125–30.

9. Freeman RS, Isenberg SJ. The use of part-time occlusion for early onset unilateral exotropia. J Pediatr Ophthalmol Strabismus. 1989; 26:94–6.

10. Parks MM, Friendly DS. Treatment of eccentric fixation in children under four years of age. Am J Ophthalmol. 1966; 61:395–9.

11. Mein J, Harcourt B. Diagnosis and management of ocualr motility disorders. 1st ed.London: Blackwell Scientific Publication;1986. p. 189.

12. Kaye SB, Chen SI, Price G, et al. Combined optical and atropine penalization for the treatment of strabismic and anisometropic amblyopia. J AAPOS. 2002; 6:289–93.

13. Choi CY, Chang HR. Factors affecting compliance in amblyopia occlusion therapy. J Korean Ophthalmol Soc. 2000; 41:2633–7.