Pang Yi, Allison Christine, Frantz Kelly A, Block Sandra, Goodfellow Geoffrey W
Illinois College of Optometry, 3241 S Michigan Ave, Chicago, IL 60616, USA.
Arch Ophthalmol. 2012 May;130(5):579-84. doi: 10.1001/archopthalmol.2011.1203.
To determine the efficacy of refractive correction alone and patching treatment with near activities on amblyopia associated with myopic anisometropia in children aged 4 to less than 14 years. The associations of visual acuity (VA) improvement with age,degree of anisometropia, patching compliance, presence of strabismus, and presence of eccentric fixation were also investigated.
Seventeen amblyopic children were recruited(range of VA in the amblyopic eye, 20/80 to 20/400). Visual acuity was assessed at 4, 8, 12, and 16 weeks while participants wore spectacles and/or contact lenses for full refractive correction. Patching treatment was initiate dat the 16-week visit. The primary outcome was VA after 16 weeks of refractive correction alone and final VA after 16 weeks of patching.
The mean (SD) baseline VA in the amblyopiceye was 0.96 (0.27) logMAR, which improved to a mean(SD) of 0.84 (0.24) logMAR with refractive correction and to a mean (SD) of 0.71 (0.30) logMAR after the addition of patching (P.001). Comparing the final VA with the baseline VA, we found that VA improvement averaged 2.59 lines. The final VA in the amblyopic eye was associated with the baseline VA in the amblyopic eye(P.001), the magnitude of anisometropia (P.001),and the level of patching compliance (P=.04). The improvement in VA with patching was inversely associated with participants' age (P=.03) and presence of eccentric fixation (P=.02).
Both refractive correction and patching significantly improved the VA of the amblyopic eye associated with myopic anisometropia, with 88% of participants' eyes improving 2 lines or more. Further improvement in VA was observed when patching plus near activities was added to refractive correction and patients were followed for 16 more weeks. We recommend that clinicians treat myopic anisometropic amblyopia with refractive correction and patching plus near activities.
确定单纯屈光矫正以及遮盖治疗联合近距活动对4至未满14岁儿童近视性屈光参差性弱视的疗效。同时研究视力（VA）改善与年龄、屈光参差程度、遮盖依从性、斜视的存在以及旁中心注视的存在之间的关联。
招募了17名弱视儿童（弱视眼的视力范围为20/80至20/400）。在4周、8周、12周和16周时评估视力，此时参与者佩戴眼镜和/或隐形眼镜进行完全屈光矫正。遮盖治疗在第16周就诊时开始。主要结局是单纯屈光矫正16周后的视力以及遮盖16周后的最终视力。
弱视眼的平均（标准差）基线视力为0.96（0.27）logMAR，屈光矫正后提高到平均（标准差）0.84（0.24）logMAR，添加遮盖后提高到平均（标准差）0.71（0.30）logMAR（P<0.001）。将最终视力与基线视力进行比较，我们发现视力平均提高了2.59行。弱视眼的最终视力与弱视眼的基线视力（P<0.001）、屈光参差的程度（P<0.001）以及遮盖依从性水平（P = 0.04）相关。遮盖治疗后视力的改善与参与者的年龄（P = 0.03）和旁中心注视的存在（P = 0.02）呈负相关。
屈光矫正和遮盖均显著改善了近视性屈光参差性弱视眼的视力，88%的参与者眼睛视力提高了2行或更多。当在屈光矫正基础上增加遮盖联合近距活动并再随访16周时，观察到视力有进一步改善。我们建议临床医生采用屈光矫正、遮盖联合近距活动来治疗近视性屈光参差性弱视。
