OCT 13, 2014
This long-term study found that most children treated for moderate amblyopia before age 7 have good visual acuity at 15 years of age, although mild residual amblyopia is common. The outcome was similar regardless of initial treatment with atropine or patching.
This prospective study reports the visual acuity results at 15 years of age among 147 patients who were younger than 7 years when enrolled in a multicenter treatment trial for moderate amblyopia.
They randomized 419 children with amblyopia and visual acuity of 20/40 to 20/100 to patching (minimum of six hours/day) or atropine sulfate eye drops 1% (one drop daily) for six months. Treatment after six months was at the discretion of the investigator. They enrolled a randomly selected subgroup of 188 children into the long-term follow-up study.
At 15 years of age, the mean visual acuity in the amblyopic eye was approximately 20/25; 59.9% of amblyopic eyes had visual acuity of 20/25 or better and 33.3% had 20/20 or better.
Mean interocular acuity difference was 2.1 lines; 48.3% had an intraocular difference of two or more lines and 71.4% of one or more lines.
Treatment (other than spectacles) was prescribed for nine participants (6.1%) aged 10 to 15 years. Mean intraocular acuity difference was similar at examinations at 10 and 15 years of age in these patients.
Visual acuity of amblyopic and fellow eyes at 15 years of age was similar between the atropine and patching treatment groups. However, patients who were younger than 5 at the start of the initial trial had better visual acuity than those aged 5 to 6 years. .
The authors say that younger age at initiation of treatment might be advantageous if plasticity decreases with age or if a shorter duration of amblyogenic insult reduces the severity of the effect on the visual sensory system.