Treatment of anisometropic amblyopia in children with refractive correction
Treatment of anisometropic amblyopia in children with refractive correction
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DOI：
10.1016/j.ophtha.2006.01.068
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发表时间：
2006-06-01
期刊：
影响因子：
13.7
通讯作者：
Weise, Katherine K.
中科院分区：
文献类型：
--
作者：
Cotter, Susan A.;Edwards, Allison R.;Weise, Katherine K.
目的：评价单纯屈光矫正治疗3 ~< 7岁儿童未经治疗的屈光参差性弱视的有效性。设计：前瞻性、多中心、非比较性干预。参与者：84名3 ~< 7岁儿童未经治疗的屈光参差性弱视，范围为20/40 ~ 20/250。提供最佳的屈光矫正，并在基线和每隔5周测量新眼镜矫正的视力（VA），直到VA稳定或弱视消退。主要结果测量：弱视眼最佳矫正视力的最大改善以及弱视消退的儿童比例（77%的患者眼间差异= 2行，27%的患者弱视消退）。改善需要长达30周才能达到稳定标准。稳定后，在随后的随机试验的对照组中观察到的34名患者中，21名患者单独使用眼镜时出现了额外的改善，其中6名患者的弱视消退。治疗结果与年龄无关，但与较好的基线VA和较少的屈光参差量有关。结论：在许多情况下，单独屈光矫正可改善VA，并导致至少三分之一的3至< 7岁未经治疗的屈光参差性弱视儿童的弱视消退。虽然大多数情况下的解决发生在中度（20/40-20/100）弱视，平均3线的VA改善导致的眼镜治疗可能会减轻负担，后续弱视治疗的弱视程度较重。
Objective: To evaluate the effectiveness of refractive correction alone for the treatment of untreated anisometropic amblyopia in children 3 to < 7 years old.Design: Prospective, multicenter, noncomparative intervention.Participants: Eighty-four children 3 to < 7 years old with untreated anisometropic amblyopia ranging from 20/40 to 20/250.Methods: Optimal refractive correction was provided, and visual acuity (VA) was measured with the new spectacle correction at baseline and at 5-week intervals until VA stabilized or amblyopia resolved.Main Outcome Measures: Maximum improvement in best-corrected VA in the amblyopic eye and proportion of children whose amblyopia resolved (interocular difference of = 2 lines in 77% of the patients and resolved in 27%. Improvement took up to 30 weeks for stabilization criteria to be met. After stabilization, additional improvement occurred with spectacles alone in 21 of 34 patients observed in a control group of a subsequent randomized trial, with amblyopia resolving in 6. Treatment outcome was not related to age, but was related to better baseline VA and lesser amounts of anisometropia.Conclusion: Refractive correction alone improves VA in many cases and results in resolution of amblyopia in at least one third of 3- to < 7-year-old children with untreated anisometropic amblyopia. Although most cases of resolution occur with moderate (20/40-20/100) amblyopia, the average 3-line improvement in VA resulting from treatment with spectacles may lessen the burden of subsequent amblyopia therapy for those with denser levels of amblyopia.