Impact of patching and atropine treatment on the child and family in the amblyopia treatment study.
OBJECTIVE
To assess the psychosocial impact on the child and family of patching and atropine as treatments for moderate amblyopia in children younger than 7 years.


METHODS
In a randomized, controlled clinical trial, 419 children younger than 7 years with amblyopic eye visual acuity in the range of 20/40 to 20/100 were assigned to receive treatment with either patching or atropine at 47 clinical sites. After 5 weeks of treatment, a parental quality-of-life questionnaire was completed for 364 (87%) of the 419 patients. Main Outcome Measure Overall and subscale scores on the Amblyopia Treatment Index.


RESULTS
High internal validity and reliability were demonstrated for the Amblyopia Treatment Index questionnaire. The overall Amblyopia Treatment Index scores and the 3 subscale scores were consistently higher (worse) in the patching group compared with the atropine-treated group (overall mean, 2.52 vs 2.02, P<.001; adverse effects of treatment: mean, 2.35 vs 2.11, P =.002; difficulty with compliance: mean, 2.46 vs 1.99, P<.001; and social stigma: mean, 3.09 vs 1.84, P<.001, respectively).


CONCLUSIONS
Although the Amblyopia Treatment Index questionnaire results indicated that both atropine and patching treatments were well tolerated by the child and family, atropine received more favorable scores overall and on all 3 questionnaire subscales.
Holmes
Jonathan M
JM
Beck
Roy W
RW
Kraker
Raymond T
RT
Cole
Stephen R
SR
Repka
Michael X
MX
Birch
Eileen E
EE
Felius
Joost
J
Christiansen
Stephen P
SP
Coats
David K
DK
Kulp
Marjean T
MT
D000328:Adult; D000550:Amblyopia / Q000628:therapy*; D001285:Atropine / Q000627:therapeutic use*; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009184:Mydriatics / Q000627:therapeutic use; D010349:Patient Compliance; D002666:Psychology, Child; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D012683:Sensory Deprivation; D011795:Surveys and Questionnaires
D009184:Mydriatics; D001285:Atropine