影响阿托品压抑治疗对非遮盖治疗反应不佳的弱视患者疗效的因素。
Factors Influencing the Success of Atropine Penalization Treatment in Amblyopia Patients Non-Responsive to Occlusion Treatment.
机构信息
Istanbul Training and Research Hospital, Ophthalmology Department, University of Health Sciences, Istanbul, Turkey.
出版信息
J Binocul Vis Ocul Motil. 2022 Oct-Dec;72(4):212-218. Epub 2022 Sep 6.
PURPOSE
To evaluate the efficacy of atropine penalization after non-response to patch therapy in amblyopic children and investigate the factors associated with treatment success.
PATIENTS AND METHODS
In this retrospective study, 26 children with amblyopia who were non-responders to patch therapy who were then switched to 1% atropine eye drops in the sound eye for a minimum follow-up of one year were included. All patients underwent detailed eye examinations, including optical coherence tomography and fundus autofluorescence (FAF) imaging. Response to treatment was defined as a two-line improvement in best-corrected visual acuity (BCVA) in the amblyopic eye, and patients were divided into two groups: the responder group and the non-responder group. Demographic and clinical parameters were compared between the two groups. The average central macular thickness and FAF were analyzed.
RESULTS
Sixteen of 26 patients (61.5%) showed treatment response. The mean age of the patients was 10.62 ± 3.42 (5-17) years. There was no difference between the groups in age, age at start of patch therapy, sex, follow-up period, refractive errors, type of amblyopia, reason for patch therapy non-response, or mean effective patching time per day. In the responder group, the LogMAR values of pretreatment BCVA, BCVA after optical correction, and BCVA after occlusion were significantly higher, but BCVA after atropine treatment showed no difference. FAF images of all patients were normal, and the mean central macular thickness did not significantly differ between the groups.
CONCLUSIONS
Atropine penalization can improve BCVA in children with amblyopia who are non-responders to patch therapy. Atropine penalization may be more successful in children with poor BCVA at the start of atropine penalization in the amblyopic eye. The results of FAF imaging and mean central macular thickness were not associated with treatment outcomes.
目的
评估阿托品压抑治疗对弱视儿童经弱视治疗后无反应的疗效，并探讨与治疗成功相关的因素。
方法
本回顾性研究纳入了 26 名弱视治疗无反应的儿童，他们在弱视眼转为 1%阿托品滴眼液治疗，至少随访一年。所有患者均接受详细的眼部检查，包括光学相干断层扫描和眼底自发荧光（FAF）成像。治疗反应定义为弱视眼最佳矫正视力（BCVA）提高两行，患者分为两组：反应组和无反应组。比较两组之间的人口统计学和临床参数。分析平均中心黄斑厚度和 FAF。
结果
26 例患者中有 16 例（61.5%）显示治疗反应。患者的平均年龄为 10.62±3.42（5-17）岁。两组在年龄、开始戴眼罩治疗的年龄、性别、随访时间、屈光不正、弱视类型、戴眼罩治疗无反应的原因或每天有效戴眼罩时间的平均值等方面均无差异。在反应组中，治疗前 BCVA、光学矫正后 BCVA 和遮盖后 BCVA 的 LogMAR 值显著较高，但阿托品治疗后的 BCVA 无差异。所有患者的 FAF 图像均正常，两组之间平均中心黄斑厚度无显著差异。
结论
阿托品压抑治疗可改善弱视治疗后无反应的儿童的 BCVA。在开始阿托品压抑治疗时，弱视眼的 BCVA 较差的儿童，阿托品压抑治疗可能更成功。FAF 成像结果和平均中心黄斑厚度与治疗结果无关。
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