Ophthalmology Group, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester LE2 7LX, UK.
Br J Ophthalmol. 2010 Aug;94(8):1007-11. doi: 10.1136/bjo.2008.154674. Epub 2009 Dec 2.
BACKGROUND/AIMS: Little is known about the effectiveness of occlusion therapy in hospital settings. A retrospective analysis was conducted to assess modalities, outcome and hospital costs of children treated for amblyopia with patching in a UK clinic.
Notes of 322 children with amblyopia discharged after occlusion treatment were selected consecutively and reviewed. Data collated included age at presentation, amblyopia type, visual acuity (VA; before/after occlusion and at discharge), number of prescribed hours of occlusion, duration of patching treatment, number of glasses prescribed and number of visits attended or failed to attend. Hospital treatment costs were estimated.
Mixed amblyopes were prescribed the longest amount of patching (mean 2815 h over 23 months) followed by strabismic (1984 h) and anisometropic (1238 h) amblyopes. 319 amblyopes received glasses and five atropine treatment. The percentage of patients reaching VA of 6/12 was best in the anisometropic and strabismic groups (>75%) and worse in mixed amblyopia (64%). Average hospital costs were estimated at pound1365.
Although the mean duration of treatment was long, involving many hospital visits, the visual outcome was variable, unsatisfactory (<6/9) and more expensive than necessary. As compliance has been identified as a major problem methods to improve amblyopia treatment are needed, possibly by using educational/motivational intervention.
背景/目的：在医院环境中，关于遮盖疗法的有效性知之甚少。本回顾性分析旨在评估在英国诊所中使用遮盖疗法治疗弱视的方式、结果和医院成本。
连续选择并回顾了 322 名在遮盖治疗后出院的弱视儿童的病历。收集的数据包括就诊时的年龄、弱视类型、视力（遮盖前后和出院时的视力）、规定的遮盖时间、遮盖治疗持续时间、配镜数量和就诊或未就诊的次数。估计了医院治疗费用。
混合性弱视者接受的遮盖时间最长（2815 小时，持续 23 个月），其次是斜视性（1984 小时）和屈光不正性（1238 小时）弱视者。319 名弱视者配了眼镜，5 名接受了阿托品治疗。在屈光不正性和斜视性弱视组中，达到 6/12 视力的患者比例最高（>75%），而混合性弱视组则较差（64%）。估计平均医院费用为 1365 英镑。
尽管治疗的平均持续时间较长，涉及多次医院就诊，但视觉结果是可变的，不理想（<6/9），而且费用过高。由于已经确定依从性是一个主要问题，因此需要采取方法来改善弱视治疗，可能通过使用教育/激励干预。
