Amblyopia Therapy: An Update
Amblyopia Therapy: An Update
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DOI：
10.3109/09273972.2011.600421
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发表时间：
2011-01-01
期刊：
影响因子：
0.9
通讯作者：
Fielder, Alistair
中科院分区：
文献类型：
--
作者：
Stewart, Catherine;Moseley, Merrick;Fielder, Alistair
我们回顾了过去5年内进行的主要弱视治疗试验的结果。这些已经证实，初始阶段的全时屈光矫正对所有类型的弱视都是有益的。采用这种做法可以使多达30%的儿童避免任何进一步的治疗。研究表明，对于中度和重度弱视儿童，“周末阿托品”与贴片一样有效。如果规定使用遮盖，每天2-4小时的遮盖似乎足以为大多数儿童提供最佳结果，尽管6岁以上的儿童往往需要更大的剂量才能达到最佳结果，他们的弱视对治疗更有抵抗力。旨在提高依从性的教育干预措施，如漫画和书面和视频解释治疗，似乎可以将那些依从性差或退出治疗的人的依从性提高到治疗水平。正式的，以证据为基础的实践指南弱视的管理已经出现，虽然他们通过从业者，至少在英国，一直受到质疑。
We review the findings of trials of mainstay amblyopia treatment conducted within the last 5 years. These have confirmed that an initial period of full-time refractive correction is beneficial in all types of amblyopia. Adopting this practice may allow up to 30% of children to avoid any further treatment. Studies that have investigated the role of atropine occlusion as a first-line treatment for amblyopia have shown "weekend atropine" to be as effective as patching for children with both moderate and severe amblyopia. Where patching is prescribed, 2-4 hours/day of occlusion appears sufficient to provide an optimum outcome for the majority of children, although those over 6 years tend to require a larger dose to achieve best outcome, their amblyopia being more resistant to treatment. Educational interventions such as cartoons and written and video explanations of treatment aimed at improving compliance appear to raise it to a therapeutic level in those who may otherwise have poor compliance or drop out from treatment. Formal, evidence-based practice guidelines for the management of amblyopia have emerged although their adoption by practitioners, at least in the United Kingdom, has been questioned.