Chopovska Yaroslava, Loudon Sjoukje E, Cirina Licia, Zubcov Alina, Simonsz Huibert J, Lüchtenberg Marc, Fronius Maria
Department of Ophthalmology, J. W. Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
Graefes Arch Clin Exp Ophthalmol. 2005 Jun;243(6):539-44. doi: 10.1007/s00417-004-1067-8. Epub 2004 Dec 17.
Approximately one third of all amblyopic eyes do not reach visual acuity of 20/40 in spite of occlusion therapy. One of the reasons is a lack of adherence to therapy, which, however, could not be quantified in the past. Experience with new devices (occlusion dose monitors, ODMs) for electronic recording of occlusion has recently been reported. The aim of the present study was to evaluate the potential of the ODMs developed in The Netherlands. Various features were tested, including the reliability of the ODM recordings compared to diaries, two ODMs used simultaneously on one patch, the influence of the ambient temperature, and the specificity of the recording pattern for measurements on the eye.
The ODMs were taped to the outside of the standard occlusion patch and measured the temperature difference between their front and back surfaces. Members of the research group and the families of two patients kept occlusion diaries while using the ODMs. Recorded and written occlusion periods were compared. Measurements were carried out under various conditions: patch with one ODM tightly on the eye or detached (allowing peeping); ODMs taped to various parts of the body; two ODMs simultaneously on one patch; variation of room temperature.
There was good correspondence between the occlusion times recorded by the ODMs and those from the diaries, as well as between the recordings of two ODMs used simultaneously on one patch. High ambient temperatures (33 degrees C to 37 degrees C) prevented reliable ODM measurements. Measurements on other parts of the body were misclassified with probabilities between P=0.099 and P=0.325 as measurements with the patch tightly on the eye.
In spite of some technical limitations, the ODMs provide a chance for reliable assessment of compliance and therefore objective information on dose-response function for occlusion therapy. This will lead to a more evidence-based treatment for amblyopia.
尽管进行了遮盖疗法，但约三分之一的弱视眼视力仍无法达到20/40。原因之一是患者对治疗的依从性差，不过过去无法对此进行量化。最近有报道称使用了新设备（遮盖剂量监测器，ODM）来电子记录遮盖情况。本研究的目的是评估荷兰研发的ODM的潜力。测试了其各种特性，包括与日记记录相比ODM记录的可靠性、在一块眼罩上同时使用两个ODM、环境温度的影响以及眼睛测量记录模式的特异性。
将ODM贴在标准遮盖眼罩外侧，测量其前后表面的温度差。研究小组的成员以及两名患者的家属在使用ODM时记录遮盖日记。比较记录的和书面记录的遮盖时间。在各种条件下进行测量：眼罩上紧密贴有一个ODM或眼罩取下（可偷看）；ODM贴在身体的不同部位；一块眼罩上同时使用两个ODM；室温变化。
ODM记录的遮盖时间与日记记录的遮盖时间之间以及一块眼罩上同时使用的两个ODM的记录之间具有良好的一致性。高环境温度（33摄氏度至37摄氏度）会妨碍ODM进行可靠测量。身体其他部位的测量被误分类为眼罩紧密贴在眼睛上进行测量的概率在P = 0.099至P = 0.325之间。
尽管存在一些技术限制，但ODM为可靠评估依从性提供了机会，从而为遮盖疗法的剂量反应功能提供客观信息。这将使弱视治疗更具循证依据。
