title: A randomized trial of increasing patching for amblyopia.
abstract: OBJECTIVE
  After treatment with refractive correction and patching, some patients have residual amblyopia resulting from strabismus or anisometropia. We conducted a clinical trial to evaluate the effectiveness of increasing prescribed daily patching from 2 to 6 hours in children with stable residual amblyopia.
  
  
  METHODS
  Prospective, randomized, multicenter clinical trial.
  
  
  METHODS
  A total of 169 children aged 3 to <8 years (mean, 5.9 years) with stable residual amblyopia (20/32-20/160) after 2 hours of daily patching for at least 12 weeks.
  
  
  METHODS
  Random assignment to continue 2 hours of daily patching or increase patching time to an average of 6 hours/day.
  
  
  METHODS
  Best-corrected visual acuity (VA) in the amblyopic eye after 10 weeks.
  
  
  RESULTS
  Baseline VA was 0.44 logarithm of the minimum angle of resolution (logMAR) (20/50(-2)). Ten weeks after randomization, amblyopic eye VA had improved an average of 1.2 lines in the 6-hour group and 0.5 line in the 2-hour group (difference in mean VA adjusted for acuity at randomization = 0.6 line; 95% confidence interval, 0.3-1.0; P = 0.002). Improvement of 2 or more lines occurred in 40% of participants patched for 6 hours versus 18% of those who continued to patch for 2 hours (P = 0.003).
  
  
  CONCLUSIONS
  When amblyopic eye VA stops improving with 2 hours of daily patching, increasing the daily patching dosage to 6 hours results in more improvement in VA after 10 weeks compared with continuing 2 hours daily.
authors.affiliation: Duke University Eye Center, Durham, North Carolina. Electronic address: pediga15@jaeb.org.
authors.forename: David K
authors.initials: DK
authors.lastname: Wallace
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Lazar
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Holmes
authors.forename: Michael X
authors.initials: MX
authors.lastname: Repka
authors.forename: Susan A
authors.initials: SA
authors.lastname: Cotter
authors.forename: Angela M
authors.initials: AM
authors.lastname: Chen
authors.forename: Raymond T
authors.initials: RT
authors.lastname: Kraker
authors.forename: Roy W
authors.initials: RW
authors.lastname: Beck
authors.forename: Michael P
authors.initials: MP
authors.lastname: Clarke
authors.forename: Ingryd J
authors.initials: IJ
authors.lastname: Lorenzana
authors.forename: David B
authors.initials: DB
authors.lastname: Petersen
authors.forename: Joan T
authors.initials: JT
authors.lastname: Roberts
authors.forename: Donny W
authors.initials: DW
authors.lastname: Suh
mesh_terms: D000550:Amblyopia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D015858:Anisometropia / Q000150:complications; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010349:Patient Compliance; D011446:Prospective Studies; D012683:Sensory Deprivation; D013285:Strabismus / Q000150:complications; D013997:Time Factors; D016896:Treatment Outcome; D014787:Vision Tests; D014792:Visual Acuity / Q000502:physiology