Stability of visual acuity improvement following discontinuation of amblyopia treatment in children aged 7 to 12 years

Abstract

Objective: To assess the stability of visual acuity improvement during the first year after cessation of amblyopia treatment other than spectacle wear in children aged 7 to 12 years.

Methods: At the completion of a multicenter randomized trial during which amblyopia treated with patching and atropine improved by at least 2 lines on the electronic Early Treatment of Diabetic Retinopathy Study testing protocol, 80 patients aged 7 to 12 years were followed up while not receiving treatment (other than spectacle wear) for 1 year.

Main outcome measure: Ten letters or more (> or =2 lines) worsening of visual acuity (measured using the electronic Early Treatment of Diabetic Retinopathy Study testing protocol) during the year following treatment discontinuation.

Results: During the year following cessation of treatment, the cumulative probability of worsening visual acuity (> or =2 lines) was 7% (95% confidence interval, 3%-17%); 82% of patients maintained an increase in visual acuity of 10 letters or more compared with their visual acuity before starting treatment.

Conclusion: Visual acuity improvement occurring during amblyopia treatment is sustained in most children aged 7 to 12 years for at least 1 year after discontinuing treatment other than spectacle wear.

Trial registration: ClinicalTrials.gov identifier: NCT00094692.

Figures

Figure 1. Visual Acuity At Treatment Discontinuation Versus One-Year Post-Treatment Discontinuation Visual Acuity (N=67)

Plot includes all patients who completed the observation phase, defined as completing one year of follow up or experiencing a decrease of acuity of 10 or more letters during follow up. For the 1 patient who experienced an acuity decrease of 10 or more letters prior to the one-year visit, the one-year acuity is the acuity at the time of the decrease. A letter score of 85 corresponds to 20/20, with 5 letters representing one line. Lower letter scores indicate worse visual acuity.

Figure 2. Visual Acuity At Pre-treatment Versus One-Year Post-Treatment Discontinuation Visual Acuity (N=67)

Plot includes all patients who completed the observation phase, defined as completing one year of follow up or experiencing a decrease of acuity of 10 or more letters during follow up. For the 1 patient who experienced an acuity decrease of 10 or more letters prior to the one-year visit, the one-year acuity is the acuity at the time of the decrease. A letter score of 85 corresponds to 20/20, with 5 letters representing one line. Lower letter scores indicate worse visual acuity.