Clinical profile of anisometropic amblyopic patients may predict therapy response

WAIKOLOA, Hawaii — The clinical profile of pediatric patients with anisometropic amblyopia may be helpful in predicting patients’ responses to therapy, according to a presentation here.

Mohamed A. Hussein, MD, conducted a retrospective review of 104 patients ages 3 to 8 years with anisometropic amblyopia. He found that the risk for amblyopia treatment failure was associated with the patient’s age at treatment initiation, visual acuity of 20/200 or worse and the presence of concurrent strabismus.

According to the study, the difference in vision between each patient’s eyes was at least 3 logMAR acuity lines. All children had a visual acuity of at least 20/50 in the amblyopic eye, and 73% of children had visual acuities worse than 20/70 in the affected eye.

All patients were treated with spectacles, patches or atropine drops and followed for about 26 months, Dr. Hussein said.

In the study, treatment failure was determined by a patient’s inability to gain at least 3 logMAR lines of acuity or achieve vision better than 20/40 in the affected eye. Many patients who were considered failures had existing factors influencing their outcomes.

Dr. Hussein said late treatment (at or after age 6) significantly influenced the outcome (P = 0.020). Initial visual acuity in the amblyopic eye of 20/200 or worse (P = 0.038), and concurrent strabismus (P = 0.036) also significantly influenced outcomes.

Dr. Hussein presented the results of the study during the American Association for Pediatric Ophthalmology and Strabismus annual meeting.