A randomized trial of increasing patching for amblyopia

David K. Wallace, Elizabeth L. Lazar, Jonathan M. Holmes, Michael X. Repka, Susan A. Cotter, Angela M. Chen, Raymond T. Kraker, Roy W. Beck, Michael P. Clarke, Ingryd J. Lorenzana, David B. Petersen, Joan T. Roberts, Donny W Suh

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective: After treatment with refractive correction and patching, some patients have residual amblyopia resulting from strabismus or anisometropia. We conducted a clinical trial to evaluate the effectiveness of increasing prescribed daily patching from 2 to 6 hours in children with stable residual amblyopia. Design: Prospective, randomized, multicenter clinical trial. Participants: A total of 169 children aged 3 to <8 years (mean, 5.9 years) with stable residual amblyopia (20/32-20/160) after 2 hours of daily patching for at least 12 weeks. Intervention: Random assignment to continue 2 hours of daily patching or increase patching time to an average of 6 hours/day. Main Outcome Measures: Best-corrected visual acuity (VA) in the amblyopic eye after 10 weeks. Results: Baseline VA was 0.44 logarithm of the minimum angle of resolution (logMAR) (20/50-2). Ten weeks after randomization, amblyopic eye VA had improved an average of 1.2 lines in the 6-hour group and 0.5 line in the 2-hour group (difference in mean VA adjusted for acuity at randomization = 0.6 line; 95% confidence interval, 0.3-1.0; P = 0.002). Improvement of 2 or more lines occurred in 40% of participants patched for 6 hours versus 18% of those who continued to patch for 2 hours (P = 0.003). Conclusions: When amblyopic eye VA stops improving with 2 hours of daily patching, increasing the daily patching dosage to 6 hours results in more improvement in VA after 10 weeks compared with continuing 2 hours daily. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Original languageEnglish (US)
Pages (from-to)2270-2277
Number of pages8
JournalOphthalmology
Volume120
Issue number11
DOIs
StatePublished - Nov 1 2013

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Amblyopia
Visual Acuity
Random Allocation
Anisometropia
Strabismus
Disclosure
Multicenter Studies
Randomized Controlled Trials
Outcome Assessment (Health Care)
Clinical Trials
Confidence Intervals

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Wallace, D. K., Lazar, E. L., Holmes, J. M., Repka, M. X., Cotter, S. A., Chen, A. M., ... Suh, D. W. (2013). A randomized trial of increasing patching for amblyopia. Ophthalmology, 120(11), 2270-2277. https://doi.org/10.1016/j.ophtha.2013.04.008

A randomized trial of increasing patching for amblyopia. / Wallace, David K.; Lazar, Elizabeth L.; Holmes, Jonathan M.; Repka, Michael X.; Cotter, Susan A.; Chen, Angela M.; Kraker, Raymond T.; Beck, Roy W.; Clarke, Michael P.; Lorenzana, Ingryd J.; Petersen, David B.; Roberts, Joan T.; Suh, Donny W.

In: Ophthalmology, Vol. 120, No. 11, 01.11.2013, p. 2270-2277.

Research output: Contribution to journalArticle

Wallace, DK, Lazar, EL, Holmes, JM, Repka, MX, Cotter, SA, Chen, AM, Kraker, RT, Beck, RW, Clarke, MP, Lorenzana, IJ, Petersen, DB, Roberts, JT & Suh, DW 2013, 'A randomized trial of increasing patching for amblyopia', Ophthalmology, vol. 120, no. 11, pp. 2270-2277. https://doi.org/10.1016/j.ophtha.2013.04.008
Wallace DK, Lazar EL, Holmes JM, Repka MX, Cotter SA, Chen AM et al. A randomized trial of increasing patching for amblyopia. Ophthalmology. 2013 Nov 1;120(11):2270-2277. https://doi.org/10.1016/j.ophtha.2013.04.008
Wallace, David K. ; Lazar, Elizabeth L. ; Holmes, Jonathan M. ; Repka, Michael X. ; Cotter, Susan A. ; Chen, Angela M. ; Kraker, Raymond T. ; Beck, Roy W. ; Clarke, Michael P. ; Lorenzana, Ingryd J. ; Petersen, David B. ; Roberts, Joan T. ; Suh, Donny W. / A randomized trial of increasing patching for amblyopia. In: Ophthalmology. 2013 ; Vol. 120, No. 11. pp. 2270-2277.
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abstract = "Objective: After treatment with refractive correction and patching, some patients have residual amblyopia resulting from strabismus or anisometropia. We conducted a clinical trial to evaluate the effectiveness of increasing prescribed daily patching from 2 to 6 hours in children with stable residual amblyopia. Design: Prospective, randomized, multicenter clinical trial. Participants: A total of 169 children aged 3 to <8 years (mean, 5.9 years) with stable residual amblyopia (20/32-20/160) after 2 hours of daily patching for at least 12 weeks. Intervention: Random assignment to continue 2 hours of daily patching or increase patching time to an average of 6 hours/day. Main Outcome Measures: Best-corrected visual acuity (VA) in the amblyopic eye after 10 weeks. Results: Baseline VA was 0.44 logarithm of the minimum angle of resolution (logMAR) (20/50-2). Ten weeks after randomization, amblyopic eye VA had improved an average of 1.2 lines in the 6-hour group and 0.5 line in the 2-hour group (difference in mean VA adjusted for acuity at randomization = 0.6 line; 95{\%} confidence interval, 0.3-1.0; P = 0.002). Improvement of 2 or more lines occurred in 40{\%} of participants patched for 6 hours versus 18{\%} of those who continued to patch for 2 hours (P = 0.003). Conclusions: When amblyopic eye VA stops improving with 2 hours of daily patching, increasing the daily patching dosage to 6 hours results in more improvement in VA after 10 weeks compared with continuing 2 hours daily. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.",
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AU - Wallace, David K.

AU - Lazar, Elizabeth L.

AU - Holmes, Jonathan M.

AU - Repka, Michael X.

AU - Cotter, Susan A.

AU - Chen, Angela M.

AU - Kraker, Raymond T.

AU - Beck, Roy W.

AU - Clarke, Michael P.

AU - Lorenzana, Ingryd J.

AU - Petersen, David B.

AU - Roberts, Joan T.

AU - Suh, Donny W

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N2 - Objective: After treatment with refractive correction and patching, some patients have residual amblyopia resulting from strabismus or anisometropia. We conducted a clinical trial to evaluate the effectiveness of increasing prescribed daily patching from 2 to 6 hours in children with stable residual amblyopia. Design: Prospective, randomized, multicenter clinical trial. Participants: A total of 169 children aged 3 to <8 years (mean, 5.9 years) with stable residual amblyopia (20/32-20/160) after 2 hours of daily patching for at least 12 weeks. Intervention: Random assignment to continue 2 hours of daily patching or increase patching time to an average of 6 hours/day. Main Outcome Measures: Best-corrected visual acuity (VA) in the amblyopic eye after 10 weeks. Results: Baseline VA was 0.44 logarithm of the minimum angle of resolution (logMAR) (20/50-2). Ten weeks after randomization, amblyopic eye VA had improved an average of 1.2 lines in the 6-hour group and 0.5 line in the 2-hour group (difference in mean VA adjusted for acuity at randomization = 0.6 line; 95% confidence interval, 0.3-1.0; P = 0.002). Improvement of 2 or more lines occurred in 40% of participants patched for 6 hours versus 18% of those who continued to patch for 2 hours (P = 0.003). Conclusions: When amblyopic eye VA stops improving with 2 hours of daily patching, increasing the daily patching dosage to 6 hours results in more improvement in VA after 10 weeks compared with continuing 2 hours daily. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

AB - Objective: After treatment with refractive correction and patching, some patients have residual amblyopia resulting from strabismus or anisometropia. We conducted a clinical trial to evaluate the effectiveness of increasing prescribed daily patching from 2 to 6 hours in children with stable residual amblyopia. Design: Prospective, randomized, multicenter clinical trial. Participants: A total of 169 children aged 3 to <8 years (mean, 5.9 years) with stable residual amblyopia (20/32-20/160) after 2 hours of daily patching for at least 12 weeks. Intervention: Random assignment to continue 2 hours of daily patching or increase patching time to an average of 6 hours/day. Main Outcome Measures: Best-corrected visual acuity (VA) in the amblyopic eye after 10 weeks. Results: Baseline VA was 0.44 logarithm of the minimum angle of resolution (logMAR) (20/50-2). Ten weeks after randomization, amblyopic eye VA had improved an average of 1.2 lines in the 6-hour group and 0.5 line in the 2-hour group (difference in mean VA adjusted for acuity at randomization = 0.6 line; 95% confidence interval, 0.3-1.0; P = 0.002). Improvement of 2 or more lines occurred in 40% of participants patched for 6 hours versus 18% of those who continued to patch for 2 hours (P = 0.003). Conclusions: When amblyopic eye VA stops improving with 2 hours of daily patching, increasing the daily patching dosage to 6 hours results in more improvement in VA after 10 weeks compared with continuing 2 hours daily. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

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