Efficacy and safety of continuous full-time patching therapy initiated in pure anisometropic amblyopic children aged 8 to 14 years

Abstract

To investigate the efficacy and safety of full-time patching therapy of anisometropic amblyopia in children aged 8-14 years. It was a prospective case series study.Forty-three patients with anisometropic amblyopia without strabismus (ranged from 8-14 years, mean 10.8 years) were included in this study. All of the patients received eye patching for the entire day, 29 days a month, during the first 3 months. Distance best corrected visual acuity in LogMAR units; cycloplegic refraction and contrast sensitivity function were performed on all the patients before treatment, at a month later of full-time patching therapy, and all recorded at 3 months later, and evaluation the spatial function with visual acuity, the area under the log contrast sensitivity function (AULCSF), the co-ordinates of the peak of the CSF (maximum sensitivity, Smax, and the spatial frequency at which it occurs, Frmax) and the cut-off spatial frequency. Difference among groups was evaluated by analysis of variance (One-Way ANOVA), and the Bonferroni test investigated the pairwise comparison of the groups. The degree of amblyopia and the D-value of binocular AULCSF of before full-cover treatment, after one month's and three months' full-cover treatment were -0.70 ± 0.30, -0.57 ± 0.29, -0.47 ± 0.28 and 0.78 ± 0.48, 0.63 ± 0.43, 0.53 ± 0.42, respectively, which showed statistically significant differences (F = 6.406, P < 0.01; F = 3.517, P = 0.028). The degree of amblyopia, the D-value of binocular AULCSF after three months' full-cover treatment had significant difference compared with those before full-cover treatment (P < 0.01; P = 0.02). There were statistically significant differences along with time in the best corrected visual acuity (BCVA) of the amblyopic eye, AULCSF and CutSF (F = 6.906, P < 0.01; F = 4.016, P = 0.02; F = 5.717, P < 0.01). The BCVA of the amblyopic eye, AULCSF and CutSF after three months' full-cover treatment had significant difference compared with those before full-cover treatment (P < 0.01; P = 0.028; P < 0.01). However, the BCVA, AULCSF of the normal eye, and Smax, Frmax of amblyopic eye showed no statistically significant differences among groups along with time (F = 0.243, P = 0.785; F = 0.265, P = 0.768; F = 0.949, P = 0.390; F = 2.934, P = 0.057). The present results show that continuous full-time patching in older children with anisometropic amblyopia improves visual acuity, and cut off spatial sensitivity with no serious complications. The use of continuous full-time patching in after-school children to improve amblyopia seems promising.