Treatment of bilateral refractive amblyopia in children three to less than 10 years of age.
OBJECTIVE
To determine the amount and time course of binocular visual acuity improvement during treatment of bilateral refractive amblyopia in children three to less than 10 years of age.


METHODS
Prospective, multicenter, noncomparative intervention.


METHODS
One hundred and thirteen children (mean age, 5.1 years) with previously untreated bilateral refractive amblyopia were enrolled at 27 community- and university-based sites and were provided with optimal spectacle correction. Bilateral refractive amblyopia was defined as 20/40 to 20/400 best-corrected binocular visual acuity in the presence of 4.00 diopters (D) or more of hypermetropia by spherical equivalent, 2.00 D or more of astigmatism, or both in each eye. Best-corrected binocular and monocular visual acuities were measured at baseline and at five, 13, 26, and 52 weeks. The primary study outcome was binocular acuity at one year.


RESULTS
Mean binocular visual acuity improved from 0.50 logarithm of the minimum angle of resolution (logMAR) units (20/63) at baseline to 0.11 logMAR units (20/25) at one year (mean improvement, 3.9 lines; 95% confidence interval [CI], 3.5 to 4.2). Mean improvement at one year for the 84 children with baseline binocular acuity of 20/40 to 20/80 was 3.4 lines (95% CI, 3.2 to 3.7) and for the 16 children with baseline binocular acuity of 20/100 to 20/320 was 6.3 lines (95% CI, 5.1 to 7.5). The cumulative probability of binocular visual acuity of 20/25 or better was 21% at five weeks, 46% at 13 weeks, 59% at 26 weeks, and 74% at 52 weeks.


CONCLUSIONS
Treatment of bilateral refractive amblyopia with spectacle correction improves binocular visual acuity in children three to less than 10 years of age, with most improving to 20/25 or better within one year.
Wallace
David K
DK
Jaeb Center for Health Research, 15310 Amberly Drive, Suite 350, Tampa, FL 33647, USA. pedig@jaeb.org
Chandler
Danielle L
DL
Beck
Roy W
RW
Arnold
Robert W
RW
Bacal
Darron A
DA
Birch
Eileen E
EE
Felius
Joost
J
Frazier
Marcela
M
Holmes
Jonathan M
JM
Hoover
Darren
D
Klimek
Deborah A
DA
Lorenzana
Ingryd
I
Quinn
Graham E
GE
Repka
Michael X
MX
Suh
Donny W
DW
Tamkins
Susanna
S
D000550:Amblyopia / Q000503:physiopathology / Q000628:therapy*; D001251:Astigmatism / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005139:Eyeglasses; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology*; D014792:Visual Acuity / Q000502:physiology*
J AAPOS. 2004 Aug;8(4):310-3
15314589
Am J Ophthalmol. 2001 Dec;132(6):903-9
11730656
Arch Ophthalmol. 2001 Sep;119(9):1345-53
11545641
J Pediatr Ophthalmol Strabismus. 1985 Sep-Oct;22(5):203-5
4045650
Am J Ophthalmol. 2003 Oct;136(4):655-61
14516805
Klin Monbl Augenheilkd. 1979 Feb;174(2):232-5
439701
Optom Vis Sci. 2006 Apr;83(4):206-12
16614575
J Pediatr Ophthalmol Strabismus. 1987 Mar-Apr;24(2):75-7
3585655
Optom Vis Sci. 1989 Oct;66(10):649-58
2587031
Binocul Vis Strabismus Q. 2006;21(2):93-100
16792524
Strabismus. 1993;1(2):63-7
21314500
J Pediatr Ophthalmol Strabismus. 1985 Mar-Apr;22(2):54-7
3989639