OBJECTIVE

To compare the effectiveness of patching plus telescopic magnification vs patching alone in treating refractory amblyopia.

METHODS

Children aged 4 to 17 years who failed previous amblyopia treatment were recruited into this prospective study. Subjects were randomly assigned to either 30 minutes per day of patching of the fellow eye only (n = 7) or 30 minutes per day of patching of the fellow eye plus concurrent use of a telescope in the amblyopic eye (n = 8).

MAIN OUTCOME MEASURE

Best-corrected logMAR visual acuity score of the amblyopic eye after 17 weeks of treatment.

RESULTS

Both treatment groups demonstrated significant improvement in visual acuity in the amblyopic eye after 17 weeks (P = .001). Improvements in the patching-only group were slightly greater over the course of treatment, but this difference was not statistically significant (P = .06). At 17 weeks, mean visual acuity improvement from baseline was 0.14 logMAR (SD, 0.13 logMAR) in the patching-only group and 0.06 logMAR (SD, 0.17 logMAR) in the patching plus telescope group (P = .11). The 17-week visual acuity was at least 0.2 logMAR and/or improved from baseline by at least 0.2 logMAR in 2 patients in the patching-only group and none in the patching plus telescope group (P = .08).

CONCLUSION

Treatment of refractory amblyopia in children using telescopic magnification did not appear to confer any additional benefits over patching alone.

APPLICATION TO CLINICAL PRACTICE

Occlusion and penalization remain the standard of care for patients with amblyopia and should remain the benchmark against which other treatments are compared in clinical trials for amblyopia therapy.

TRIAL REGISTRATION

clinicaltrials.gov Identifier: NCT00970554.