Improvements in occlusion therapy needed to increase adherence, study says

Br J of Ophthalmol. 2010;94:1007-1011.

Occlusion treatments with long mean duration times resulted in variable, unsatisfactory and expensive visual outcomes, contributing to noncompliance in pediatric amblyopia patients, a study found.

The retrospective study included 322 children with amblyopia who had been treated previously with occlusion therapy. Mixed amblyopes underwent the longest mean duration of patching (2,815 hours over 23 months), followed by strabismic amblyopes (1,984 hours) and anisometropic amblyopes (1,238 hours), according to the study.

"The times of occlusion we found were very long compared with optimal patching times found in recent studies, which showed that much shorter periods of occlusion and the total amount of hours patched can achieve optimal improvements," the study authors said.

Overall, 319 patients received glasses and five patients received atropine treatment. More than 75% of anisometropic and strabismic patients attained a visual acuity of 6/12, compared to only 64% of mixed amblyopes, according to the study.

"As long treatment is likely to inflate costs, increase the psychological burden for patients and decrease compliance, a priority should be placed on increasing amblyopia research into ... determining optimal patching regimens [and] providing realistic guidelines for ophthalmologists and orthoptists for determining the point at which therapy should be stopped," the study authors said.