Recurrence of amblyopia after occlusion therapy.
OBJECTIVE
To determine the stability of visual acuity (VA) after a standardized occlusion regimen in children with strabismic and/or anisometropic amblyopia.


METHODS
Retrospective, population-based, consecutive observational case series.


METHODS
Four hundred forty-nine patients younger than 10 years who underwent an occlusion trial for amblyopia and were observed until there was a recurrence of amblyopia or for a maximum of 1 year after decrease or cessation of occlusion therapy.


METHODS
We performed a retrospective chart review of all patients treated by occlusion therapy for strabismic and/or anisometropic amblyopia at our institution over a 34-year period. Of the 1621 patients identified in our database, 449 met the eligibility criteria and were included in this study. Patients having at least a 2 logarithm of the minimum angle of resolution (logMAR)-level improvement in VA by optotypes or a change from unmaintained to maintained fixation preference during the course of occlusion therapy were included. A recurrence of amblyopia was defined as > or =2 logMAR levels of VA reduction or reversal of fixation preference within 1 year after a decrease or cessation of occlusion therapy.


METHODS
Recurrence of amblyopia after a decrease or cessation of occlusion therapy and its relationship with patient age and VA of the amblyopic eye at the time of decrease or cessation of occlusion therapy.


RESULTS
Of 653 occlusion trials, 179 (27%) resulted in recurrence of amblyopia. The recurrence was found to be inversely correlated with patient age. There was no statistically significant association between the recurrence of amblyopia and VA of the amblyopic eye at the end of maximal occlusion therapy.


CONCLUSIONS
There is a clinically important risk of amblyopia recurrence when occlusion therapy is decreased before the age of 10 years. The risk of recurrence is inversely correlated with age (P<0.0001).
Bhola
Rahul
R
Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52246, USA.
Keech
Ronald V
RV
Kutschke
Pamela
P
Pfeifer
Wanda
W
Scott
William E
WE
D000375:Aging; D000550:Amblyopia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D015858:Anisometropia / Q000150:complications; D002648:Child; D002675:Child, Preschool; D006801:Humans; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012683:Sensory Deprivation; D013285:Strabismus / Q000150:complications; D014792:Visual Acuity