title: "Combined Occlusion and Atropine Therapy" Versus "Augmented Part-Time Patching" in Children with Refractory/Residual Amblyopia: A Pilot Study.
abstract: OBJECTIVE
  To compare the efficacy of combined occlusion and atropine therapy (COAT) and augmented part-time patching for the treatment of unilateral refractory/residual amblyopia.
  
  
  METHODS
  This retrospective study evaluated children between 4 and 11 years with refractory/residual amblyopia who were treated with either additional atropine (COAT group) or increased hours of patching (augmented group). Data were collected on improvement in best-corrected visual acuity (BCVA; logarithm of the minimum angle of resolution [logMAR] units) at each follow-up visit.
  
  
  RESULTS
  There were 19 children in the COAT group and 17 children in the augmented group. The baseline BCVA of the amblyopic eye was 0.79 ± 0.36 logMAR in the COAT group and 0.72 ± 0.26 logMAR in augmented group. Children were statistically significantly younger in the COAT group (6.4 ± 2.2 years) compared to the augmented group (8.6 ± 3.3 years, P = 0.02). The mean duration of follow-up was statistically significantly longer in the augmented group (20.2 COAT group; 13.9 months augmented group) (P = 0.03). Compliance was similar in both groups. LogMAR BCVA (adjusted for difference in age and baseline BCVA) was statistically significantly better in the COAT group (0.56 ± 0.04) compared to the augmented group (0.80 ± 0.04) at 3 months (P = 0.000); 6 months (COAT group, 0.50 ± 0.04 vs. augmented group, 0.74 ± 0.04; P = 0.04) and at 1 year (COAT group, 0.42 ± 0.04 vs. augmented group, 0.67 ± 0.04, P = 0.000). There was statistically significantly greater improvement in logMAR BCVA at 6 months in COAT group (0.26 ± 0.15) compared to the augmented group (0.02 ± 0.14), (P = 0.0002). Age, gender, pretreatment BCVA, duration of follow-up, or compliance to patching did not affect improvement in BCVA.
  
  
  CONCLUSIONS
  COAT may result in greater improvement in BCVA than augmented part-time patching in children with unilateral residual/refractory amblyopia.
authors.affiliation: Department of Pediatric Ophthalmology, Strabismus and Neuro ophthalmology, Nimmagada Prasad Children's Eye Care Centre, L. V. Prasad Eye Institute, Visakhapatnam, India.
authors.forename: Virender
authors.initials: V
authors.lastname: Sachdeva
authors.affiliation: Department of Pediatric Ophthalmology, Strabismus and Neuro ophthalmology, Nimmagada Prasad Children's Eye Care Centre, L. V. Prasad Eye Institute, Visakhapatnam, India.
authors.forename: Vaibhev
authors.initials: V
authors.lastname: Mittal
authors.affiliation: Department of Pediatric Ophthalmology, Strabismus and Neuro ophthalmology, Nimmagada Prasad Children's Eye Care Centre, L. V. Prasad Eye Institute, Visakhapatnam, India.
authors.forename: Varun
authors.initials: V
authors.lastname: Gupta
authors.affiliation: Department of Pediatric Ophthalmology, Strabismus and Neuro ophthalmology, Nimmagada Prasad Children's Eye Care Centre, L. V. Prasad Eye Institute, Visakhapatnam, India.
authors.forename: Rekha
authors.initials: R
authors.lastname: Gunturu
authors.affiliation: Department of Pediatric Ophthalmology, Strabismus and Neuro ophthalmology, Jasti V Ramanamma Children's Eye Care Centre, L. V. Prasad Eye Institute, Hyderabad, Andhra Pradesh, India.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Kekunnaya
authors.affiliation: Department of Pediatric Ophthalmology, Strabismus and Neuro ophthalmology, Jasti V Ramanamma Children's Eye Care Centre, L. V. Prasad Eye Institute, Hyderabad, Andhra Pradesh, India.
authors.forename: Anjali
authors.initials: A
authors.lastname: Chandrasekharan
authors.affiliation: Department of Pediatric Ophthalmology, Strabismus and Neuro ophthalmology, Jasti V Ramanamma Children's Eye Care Centre, L. V. Prasad Eye Institute, Hyderabad, Andhra Pradesh, India.
authors.forename: Preeti Patil
authors.initials: PP
authors.lastname: Chabblani
authors.affiliation: Centre for Clinical Epidemiology and Biostatistics, L. V. Prasad Eye Institute, Hyderabad, Andhra Pradesh, India.
authors.forename: Harsha L
authors.initials: HL
authors.lastname: Rao
mesh_terms: D000550:Amblyopia / Q000628:therapy*; D001285:Atropine / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009184:Mydriatics / Q000627:therapeutic use*; D010865:Pilot Projects; D012189:Retrospective Studies; D012683:Sensory Deprivation; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D009184:Mydriatics; D001285:Atropine
keywords: Atropine; Compliance; Occlusion Therapy; Refractory Amblyopia; Residual Amblyopia