St. Erik Eye Hospital, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Acta Ophthalmol. 2013 Nov;91(7):678-84. doi: 10.1111/j.1755-3768.2012.02536.x. Epub 2012 Sep 23.
To compare spectacles plus alternate-day patching for 8 hr or more with spectacles plus patching for 8 hr or more 6 days weekly to treat strabismic amblyopia 1 year after a 1-year randomized trial.
Forty children (mean age, 4.3 years) participated. Refractive correction was provided. The children were assigned to alternate-day patching for 8 hr or more or patching for 8 hr or more daily 6 days weekly. VA, binocular function, and refractive errors were measured after 2 years. The main outcome measure was the median VA change in the amblyopic eye after 2 years.
The median VA change in the amblyopic eye at the 2-year visit was significantly (p = 0.0453) greater with alternate-day patching (0.8 log unit) versus patching daily 6 days weekly (0.6 log unit). The final median VA in the amblyopic eyes was 0.0 logMAR in the alternate-day patching group and 0.1 logMAR in the daily patching group. Binocular function improved with both treatments. The median spherical equivalent (SE) refractive error increased in the fellow eyes (alternate-day patching, p < 0.0001; patching daily 6 days weekly, p = 0.0033); no change was found in the amblyopic eyes in either group.
The magnitude of the VA change 2 years after treatment with spectacles plus alternate-day patching for 8 hr or more was significantly greater than with spectacles plus daily patching for 8 hr or more 6 days weekly for strabismic amblyopia. However, the final median VA did not differ significantly between the two treatments.
比较 1 年随机试验后 1 年内每日戴镜及 6 天每日遮盖 8 小时或以上与每日戴镜及隔日遮盖 8 小时或以上治疗斜视性弱视的疗效。
共 40 名儿童（平均年龄 4.3 岁）参与研究。所有儿童均进行屈光矫正，随机分为两组，一组为每日戴镜及 6 天每日遮盖 8 小时或以上，另一组为每日戴镜及隔日遮盖 8 小时或以上。2 年后检测视力（VA）、双眼视功能和屈光不正。主要观察指标为治疗 2 年后弱视眼的平均 VA 变化。
2 年后随访时，与每日戴镜及 6 天每日遮盖 8 小时或以上相比，每日戴镜及隔日遮盖 8 小时或以上弱视眼的 VA 变化中位数（0.8 对数单位）明显更高（p=0.0453）。治疗 2 年后，最终弱视眼的平均 VA 分别为每日戴镜及隔日遮盖组 0.0 logMAR 和每日戴镜及 6 天每日遮盖组 0.1 logMAR。两种治疗方法均能改善双眼视功能。对侧眼（每日戴镜及隔日遮盖组，p<0.0001；每日戴镜及 6 天每日遮盖组，p=0.0033）的等效球镜（SE）屈光度均有增加，而弱视眼的屈光度在两组中均无变化。
与每日戴镜及 6 天每日遮盖 8 小时或以上相比，每日戴镜及隔日遮盖 8 小时或以上治疗斜视性弱视 2 年后的 VA 变化幅度明显更大，但两种治疗方法的最终平均 VA 无显著差异。
