Fronius Maria, Cirina Licia, Ackermann Hanns, Kohnen Thomas, Diehl Corinna M
Department of Ophthalmology, Child Vision Research Unit, Goethe University Hospital, Theodor-Stern-Kai 7, D-60590 Frankfurt/Main, Germany.
Institute of Biostatistics, Goethe University Hospital, Theodor-Stern-Kai 7, D-60590 Frankfurt/Main, Germany.
Vision Res. 2014 Oct;103:11-9. doi: 10.1016/j.visres.2014.07.018. Epub 2014 Aug 15.
The notion of a limited, early period of plasticity of the visual system has been challenged by more recent research demonstrating functional enhancement even into adulthood. In amblyopia ("lazy eye") it is still unclear to what extent the reduced effect of treatment after early childhood is due to declining plasticity or lower compliance with prescribed patching. The aim of this study was to determine the dose-response relationship and treatment efficiency from acuity gain and electronically recorded patching dose rates, and to infer from these parameters on a facet of age dependence of functional plasticity related to occlusion for amblyopia. The Occlusion Dose Monitor was used to record occlusion in 27 participants with previously untreated strabismic and/or anisometropic amblyopia aged between 5.4 and 15.8 (mean 9.2) years during 4months of conventional treatment. Group data showed improvement of acuity throughout the age span, but significantly more in patients younger than 7years despite comparable patching dosages. Treatment efficiency declined with age, with the most pronounced effects before the age of 7years. Thus, electronic recording allowed this first quantitative insight into occlusion treatment spanning the age range from within to beyond the conventional age for patching. Though demonstrating improvement in over 7year old patients, it confirmed the importance of early detection and treatment of amblyopia. Treatment efficiency is presented as a tool extending insight into age-dependent functional plasticity of the visual system, and providing a basis for comparisons of effects of patching vs. emerging alternative treatment approaches for amblyopia.
视觉系统可塑性的有限早期阶段这一概念，已受到最近研究的挑战，这些研究表明，即使在成年期功能也会增强。在弱视（“懒眼症”）中，幼儿期后治疗效果降低在多大程度上是由于可塑性下降还是对规定的遮盖疗法依从性较低，目前仍不清楚。本研究的目的是根据视力提高情况和电子记录的遮盖剂量率确定剂量反应关系和治疗效果，并从这些参数推断与弱视遮盖相关的功能可塑性的年龄依赖性方面。在27名年龄在5.4至15.8岁（平均9.2岁）之间、患有未经治疗的斜视性和/或屈光参差性弱视的参与者接受4个月传统治疗期间，使用遮盖剂量监测仪记录遮盖情况。组数据显示，在整个年龄范围内视力均有改善，但尽管遮盖剂量相当，7岁以下患者的改善更为明显。治疗效果随年龄下降，7岁之前效果最为显著。因此，电子记录首次让我们能够对涵盖传统遮盖年龄范围内外的遮盖治疗进行定量洞察。尽管显示7岁以上患者有改善，但它证实了弱视早期检测和治疗的重要性。治疗效果被视为一种工具，可扩展对视觉系统年龄依赖性功能可塑性的认识，并为比较遮盖疗法与新兴的弱视替代治疗方法的效果提供依据。
