Menon Vimla, Shailesh Gadaginamath, Sharma Pradeep, Saxena Rohit
Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
J AAPOS. 2008 Oct;12(5):493-7. doi: 10.1016/j.jaapos.2008.03.006. Epub 2008 Jun 5.
To compare conventional patching therapy with atropine penalization in the treatment of anisometropic amblyopia.
Prospective, randomized, institution-based clinical trial of patching versus atropine penalization in patients aged 8-20 years. Patients received either conventional, full-time patching, or atropine penalization.
Fifty-seven patients were enrolled, with visual acuity ranging from 6/12 to 6/60 in the amblyopic eye. Twenty-nine patients received conventional full-time patching; 28 received atropine penalization. At 6 months, visual acuity improved by 2.38 lines in the conventional patching group and 2.34 lines in the atropine group (p = 0.889). The speed of visual recovery was faster in the patching group (3.7 months) than in the atropine group (4.7 months; p = 0.013). There was significant improvement in near vision and contrast sensitivity in both groups, but improvement in the patching group was significantly better than in the atropine group. No patient had reduced visual acuity in the unaffected eye. Redness of eyes was observed more in the atropine group than in the patching group. Treatment tended to be better-accepted by parents and patients in the atropine group, but not significantly more.
In patients aged 8-20 years with anisometropic amblyopia, both patching and atropine therapy improved visual acuity. Although recovery was faster with patching, the 2 modalities of treatment appeared to be equally effective.
比较传统遮盖疗法与阿托品压抑疗法治疗屈光参差性弱视的效果。
对8至20岁患者进行基于机构的前瞻性随机临床试验，比较遮盖疗法与阿托品压抑疗法。患者分别接受传统的全天遮盖或阿托品压抑疗法。
共纳入57例患者，弱视眼视力范围为6/12至6/60。29例患者接受传统全天遮盖；28例接受阿托品压抑疗法。6个月时，传统遮盖组视力提高2.38行，阿托品组提高2.34行（p = 0.889）。遮盖组视力恢复速度（3.7个月）快于阿托品组（4.7个月；p = 0.013）。两组近视力和对比敏感度均有显著改善，但遮盖组改善明显优于阿托品组。未发现患者非弱视眼视力下降。阿托品组眼部发红情况比遮盖组更常见。阿托品组家长和患者对治疗的接受度倾向于更高，但差异无统计学意义。
对于8至20岁的屈光参差性弱视患者，遮盖疗法和阿托品疗法均能提高视力。虽然遮盖疗法视力恢复更快，但两种治疗方式似乎同样有效。
