Author's reply

Abstract

Dr. Tiftikcioglu raises an important issue regarding the interpretation of our pilot study results as to whether patients who improved were those who had previous amblyopia treatment and were merely regaining the visual acuity lost after previous successful treatment. Among the 66 patients enrolled in our study, 38 (58%) of the 66 had been treated previously for amblyopia, and 13 (34%) of these had visual acuity improvement of 2 or more lines. Twenty-eight (42%) of our patients had no prior treatment, and 5 (18%) of these improved 2 or more lines. Although these data support Dr. Tiftikcioglu's suggestion that recovery of visual acuity, lost after previously successful amblyopia treatment, may have contributed to our results, the sample size is too small to conclude that improvement in visual acuity in 10- to 18-year-olds with amblyopia is more common in patients who have been previously treated than in those with no prior treatment. As we note in our article, this pilot study was conducted as a prelude to conducting a randomized trial. Recruitment has now been concluded for a multicenter amblyopia treatment trial for 7- to <18-year-olds, with 571 patients enrolled. Follow-up is now underway. In these 571 patients, 304 (53%) had been treated previously for amblyopia and 267 (47%) had no prior treatment. Data from this ongoing trial will better answer the question of whether previous treatment influences subsequent success. Additionally, data from an observation phase of the same trial in which patients who improve are followed for recurrence of amblyopia will also give us insight into long-term stability of any improvement. The results of this trial will be available in 2005. A prospective, pilot study of treatment of amblyopia in children 10 to <18 years oldAmerican Journal of OphthalmologyVol. 138Issue 4PreviewIn the article by the Pediatric Eye Disease Investigator Group (Am J Ophthalmol 2004;137:581–583), the authors mentioned that children 10 to <18 years old had also shown visual improvement (≥2 lines) with amblyopia treatment. They have achieved ≥2 lines of visual acuity improvement in 18/66 (27%) of the cases by patching. The authors also stated that 58% of these children had amblyopia treatment previously (primarily by patching). However they have not stated whether the patients with visual acuity improvement had previous amblyopia treatment and what the percentage of previous treatment in these cases was compared with those without visual acuity improvement. Full-Text PDF