Part-time versus full-time occlusion therapy for treatment of amblyopia: A meta-analysis

Negareh Yazdani, Ramin Sadeghi, Hamed Momeni-Moghaddam, Leili Zarifmahmoudi, Asieh Ehsaei, Brendan T Barrett, Negareh Yazdani, Ramin Sadeghi, Hamed Momeni-Moghaddam, Leili Zarifmahmoudi, Asieh Ehsaei, Brendan T Barrett

Abstract

Purpose: To compare full-time occlusion (FTO) and part-time occlusion (PTO) therapy in the treatment of amblyopia, with the secondary aim of evaluating the minimum number of hours of part-time patching required for maximal effect from occlusion.

Methods: A literature search was performed in PubMed, Scopus, Science Direct, Ovid, Web of Science and Cochrane library. Methodological quality of the literature was evaluated according to the Oxford Center for Evidence Based Medicine and modified Newcastle-Ottawa scale. Statistical analyses were performed using Comprehensive Meta-Analysis (version 2, Biostat Inc., USA).

Results: The present meta-analysis included six studies [three randomized controlled trials (RCTs) and three non-RCTs]. Pooled standardized difference in the mean changes in the visual acuity was 0.337 [lower and upper limits: -0.009, 0.683] higher in the FTO as compared to the PTO group; however, this difference was not statistically significant (P = 0.056, Cochrane Q value = 20.4 (P = 0.001), I2 = 75.49%). Egger's regression intercept was 5.46 (P = 0.04). The pooled standardized difference in means of visual acuity changes was 1.097 [lower and upper limits: 0.68, 1.513] higher in the FTO arm (P < 0.001), and 0.7 [lower and upper limits: 0.315, 1.085] higher in the PTO arm (P < 0.001) compared to PTO less than two hours.

Conclusions: This meta-analysis shows no statistically significant difference between PTO and FTO in treatment of amblyopia. However, our results suggest that the minimum effective PTO duration, to observe maximal improvement in visual acuity is six hours per day.

Keywords: Amblyopia; Full-time; Occlusion; Part-time.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of studies evaluated in detail. FTO: Full-time occlusion, PTO: Part-time Occlusion.
Fig. 2
Fig. 2
(A): Random-effect meta-analysis according to study design. (B): Random effects meta-analysis according to the duration of occlusion in the full-time group (>10 hrs and all waking hours). (C): Random effects meta-analysis according to the duration of part-time occlusion. (D): Random effects meta-analysis according to less than two hours of occlusion (minimal) analysis. PEDIG: Pediatric Eye Disease Investigator Group.
Fig. 2
Fig. 2
(A): Random-effect meta-analysis according to study design. (B): Random effects meta-analysis according to the duration of occlusion in the full-time group (>10 hrs and all waking hours). (C): Random effects meta-analysis according to the duration of part-time occlusion. (D): Random effects meta-analysis according to less than two hours of occlusion (minimal) analysis. PEDIG: Pediatric Eye Disease Investigator Group.
Fig. 3
Fig. 3
Funnel plot of standard error by standard difference in means. PEDIG: Pediatric Eye Disease Investigator Group.

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Source: PubMed

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