Am J Ophthalmol. 2003 Oct;136(4):620-9. doi: 10.1016/s0002-9394(03)00392-1.
To assess the course of the response to patching treatment of moderate amblyopia and to assess factors predictive of the response in children 3 years old to younger than 7 years old.
Multicenter, randomized clinical trial comparing patching and atropine (one of the amblyopia treatment studies).
A total of 209 children 3 years old to younger than 7 years of age with amblyopia in the range of 20/40 to 20/100 from the patching treatment arm of this trial were treated with patching of the sound eye from 6 hours per day up to all waking hours. Follow-up examinations were performed at 5 weeks, 16 weeks, and 6 months. The primary outcome measure was visual acuity in the amblyopic eye at 6 months.
After 5 weeks of treatment, mean amblyopic eye acuity improved from baseline by 2.2 lines. For patients with baseline acuity of 20/80 or 20/100, a greater number of hours of prescribed patching was associated with greater improvement in the first 5 weeks (P =.05). However, this relationship was not present when baseline acuity was 20/40 to 20/60 (P =.57). At 6 months, visual acuity was improved from baseline by a mean of 3.1 lines, with the amount of improvement no longer related to the number of hours patching prescribed at baseline (P =.93). Among the 157 patients improving at least 3 lines from baseline, 15% achieved their maximum improvement by 5 weeks and 52% by 16 weeks. None of the demographic or clinical factors assessed was predictive of the response to treatment.
In the treatment of moderate amblyopia, a beneficial effect of patching is present throughout the age range of 3 years old to younger than 7 years old and the acuity range of 20/40 to 20/100. At 6 months, the amount of improvement appears to be similar when 6 hours of daily patching are initially prescribed vs a greater number of hours. However, when the baseline acuity is 20/80 to 20/100, a greater number of hours of prescribed patching may improve acuity faster.
评估中度弱视患儿对遮盖治疗的反应过程，并评估3岁至7岁以下儿童对该治疗反应的预测因素。
多中心随机临床试验，比较遮盖疗法和阿托品疗法（弱视治疗研究之一）。
本试验遮盖治疗组中共有209名3岁至7岁以下、弱视程度在20/40至20/100之间的儿童，对其优势眼进行遮盖治疗，每天遮盖6小时直至全天清醒时间。在5周、16周和6个月时进行随访检查。主要观察指标是6个月时弱视眼的视力。
治疗5周后，弱视眼平均视力较基线提高了2.2行。对于基线视力为20/80或20/100的患者，在前5周内，规定的遮盖时间越长，视力改善越明显（P = 0.05）。然而，当基线视力为20/40至20/60时，这种关系并不存在（P = 0.57）。6个月时，视力较基线平均提高了3.1行，改善程度与基线时规定的遮盖时间不再相关（P = 0.93）。在157名视力较基线至少提高3行的患者中，15%在5周时达到最大改善，52%在16周时达到最大改善。所评估的人口统计学或临床因素均不能预测治疗反应。
在中度弱视的治疗中，遮盖疗法在3岁至7岁以下、视力范围在20/40至20/100之间的患儿中均有有益效果。6个月时，最初规定每天遮盖6小时与更长时间遮盖相比，视力改善程度似乎相似。然而，当基线视力为20/80至20/100时，规定更长时间的遮盖可能会使视力改善更快。
