De Weger Christine, Van Den Brom Henry J B, Lindeboom Robert
Orthoptic Unit, Wilhelmina Ziekenhuis, Assen, The Netherlands.
J Pediatr Ophthalmol Strabismus. 2010 Nov-Dec;47(6):338-46. doi: 10.3928/01913913-20100218-03. Epub 2010 Feb 23.
This study estimated when it is safe to stop follow-up visits after cessation of amblyopia treatment and to identify factors associated with deterioration of visual acuity.
Study patients included 282 patients aged 7 to 13 years who were monitored for deterioration after cessation of amblyopia treatment (median follow-up: 3.9 years).
Six (2.1%) patients lost 2 or more logarithm of the minimum angle of resolution levels of visual acuity and 77 (27.3%) patients lost 1 or more Snellen lines of visual acuity. Good compliance with re-treatment stopped further deterioration and lost visual acuity was regained (average follow-up after re-treatment: 3.3 years). Life table analysis indicated that 95% of the cases that deteriorated occurred within 24 months after cessation of treatment. Multivariable analysis corrected for duration of treatment uncovered factors independently associated with deterioration.
A clinically important risk of deterioration of visual acuity was found during the first 2 years after cessation of amblyopia treatment. Follow-up time longer than 2 years is recommended in the presence of a developing risk factor such as increasing anisometropia. With prompt re-treatment and good compliance, deterioration can be stopped and visual acuity can be restored.
本研究旨在评估弱视治疗停止后何时停止随访是安全的，并确定与视力下降相关的因素。
研究对象包括282例7至13岁的患者，在弱视治疗停止后对其进行视力下降监测（中位随访时间：3.9年）。
6例（2.1%）患者的视力最小分辨角对数下降2级或更多，77例（27.3%）患者的视力下降1行或更多Snellen视力表行数。重新治疗的良好依从性阻止了视力的进一步下降，且视力下降得到恢复（重新治疗后的平均随访时间：3.3年）。生命表分析表明，95%的视力下降病例发生在治疗停止后的24个月内。校正治疗持续时间的多变量分析发现了与视力下降独立相关的因素。
弱视治疗停止后的前2年发现了临床上重要的视力下降风险。在存在诸如屈光参差增加等发展性危险因素的情况下，建议随访时间超过2年。通过及时重新治疗和良好的依从性，可以阻止视力下降并恢复视力。
