title: Strabismus might be a risk factor for amblyopia recurrence.
abstract: BACKGROUND
  Previous reports have suggested that one-fourth of amblyopic subjects present with recurrence of amblyopia even after successful primary treatment. Risk factors for amblyopia recurrence are insufficiently studied, but therapy weaning has recently been suggested as a method for reducing the risk of recurrence.
  
  
  METHODS
  In the second phase of a prospective study examining the results of treatment for amblyopia, all 35 children with successful primary amblyopia treatment were put on maintenance therapy. Maintenance therapy consisted of low-intensity patching, atropine, or blurring filter, and all children were regularly examined up to at least 8 years of age. Mean age at start of maintenance therapy was 4.3 years (range, 2-7 years).
  
  
  RESULTS
  Of the 35 cases with successful primary treatment, 6 cases deteriorated >or=0.2 logMAR, which was considered recurrence of amblyopia. Two of these cases had a second recurrence. Notably, all six subjects presenting with recurrence had microstrabismus. This finding was just outside statistical significance at the 95% confidence level (p = 0.06), but the sample size was small. All but one of the recurrences appeared within 6 months after successful primary treatment. Age at successful primary treatment or initial interocular difference of visual acuity did not affect the risk of recurrence.
  
  
  CONCLUSIONS
  Recurrence of amblyopia occurred in 17% of patients despite maintenance therapy and was associated with microstrabismus. The majority of recurrences occurred within the first 6 months after primary treatment.
authors.affiliation: Department of Clinical Neurophysiology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden. josefin.nilsson@neuro.gu.se <josefin.nilsson@neuro.gu.se>
authors.forename: Josefin
authors.initials: J
authors.lastname: Nilsson
authors.forename: Melanie
authors.initials: M
authors.lastname: Baumann
authors.forename: Johan
authors.initials: J
authors.lastname: Sjöstrand
mesh_terms: D000550:Amblyopia / Q000209:etiology* / Q000628:therapy; D001285:Atropine / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D006801:Humans; D009184:Mydriatics / Q000627:therapeutic use; D011446:Prospective Studies; D012008:Recurrence; D012029:Refraction, Ocular / Q000502:physiology; D012307:Risk Factors; D012683:Sensory Deprivation; D013285:Strabismus / Q000150:complications*; D014792:Visual Acuity / Q000502:physiology
chemical_list: D009184:Mydriatics; D001285:Atropine