Repka M X, Ray J M
Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Ophthalmology. 1993 May;100(5):769-74; discussion 774-5. doi: 10.1016/s0161-6420(93)31577-0.
Optical and pharmacological penalization of sound eyes are infrequently used alternatives to occlusion for treating amblyopia. The authors evaluated the efficacy of penalization as their primary treatment of amblyopia.
One hundred sixty-six patients underwent penalization treatment for strabismic or anisometropic amblyopia for a minimum of 3 months. Both atropine and optical penalization methods were used.
Visual acuity improved in 67 (77%) of 87 patients treated with optical penalization. There was a significant improvement of the geometric mean visual acuity of the amblyopic eyes from 20/38 to 20/28 (P < 0.001). Visual acuity of 60 (76%) of 79 patients treated with pharmacological penalization improved. There was a significant improvement of mean visual acuity of the amblyopic eyes from 20/61 to 20/40 (P < 0.001). Neither therapy produced an instance of occlusion amblyopia. Thirteen patients discontinued therapy because of blur or discomfort.
This study demonstrates that penalization methods are effective methods for the treatment of amblyopia, with a low risk of occlusion amblyopia. Patient acceptance of these methods was excellent. Penalization should be considered more often for the primary treatment of amblyopia.
对视力正常的眼睛进行光学和药物抑制是治疗弱视时很少使用的替代遮盖疗法的方法。作者评估了抑制疗法作为弱视主要治疗方法的疗效。
166例斜视性或屈光参差性弱视患者接受了至少3个月的抑制治疗。使用了阿托品和光学抑制两种方法。
87例接受光学抑制治疗的患者中，67例（77%）视力提高。弱视眼的几何平均视力从20/38显著提高到20/28（P<0.001）。79例接受药物抑制治疗的患者中，60例（76%）视力提高。弱视眼的平均视力从20/61显著提高到20/40（P<0.001）。两种治疗方法均未导致遮盖性弱视病例。13例患者因视物模糊或不适而停止治疗。
本研究表明，抑制疗法是治疗弱视的有效方法，发生遮盖性弱视的风险较低。患者对这些方法的接受度很高。在弱视的主要治疗中应更频繁地考虑抑制疗法。
