OCT 28, 2013
Pediatric Ophth/Strabismus
This prospective, nonrandomized study found that both the split- and continuous-hours part-time patching regimens significantly improved BCVA in children with anisometropic amblyopia.
The traditional and most widely used method of amblyopia treatment is occlusion of the sound eye. However, patching continuously for the recommended three to six hours is likely to interfere with the daily activities of learning, playing outdoors, and recreation, and may have emotional impact.
A common practice is to split the patching into two or more sessions amounting to the same duration of patching hours. However, this method had never been compared previously with the conventional continuous-hours part-time patching.
Subjects were 68 children between 4 and 11 years of age. Patching regimen was assigned according to patient preference, with “continuous-hours part-time patching” defined as “the continuous uninterrupted patching of the sound eye for the designated number of the hours of patching,” and “split-hours part-time patching” defined as “the patching of the sound eye in two sessions totaling to the designated number of the hours of patching.”
Both groups showed similar and comparable improvement in BCVA at three and six months. However, the authors note that the rate of improvement in BCVA was greater and appeared to peak faster in the continuous-hours patching group. This difference was statistically insignificant (P = 0.06), but this could be a result of the small sample size. They write that this also may be due to the slower effect of split-hours patching in overcoming the inhibitory effect of amblyogenic stimuli from the sound eye.
They note that patients were allocated according to choice, which resulted in an asymmetric number of patients in the groups (44 in the continuous group and 24 in the split group) and could have induced bias and led to weaker statistical analysis. They have planned a randomized controlled clinical trial to address this limitation.