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Middle East African Journal of Ophthalmology Middle East African Journal of Ophthalmology
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ORIGINAL ARTICLE
Year : 2016  |  Volume : 23  |  Issue : 2  |  Page : 201-207

"Combined occlusion and atropine therapy" versus "Augmented part-time patching" in children with refractory/residual amblyopia: A pilot study


1 Department of Pediatric Ophthalmology, Strabismus and Neuro ophthalmology, Nimmagada Prasad Children's Eye Care Centre, L. V. Prasad Eye Institute, Visakhapatnam, India
2 Department of Pediatric Ophthalmology, Strabismus and Neuro ophthalmology, Jasti V Ramanamma Children's Eye Care Centre, L. V. Prasad Eye Institute, Hyderabad, Andhra Pradesh, India
3 Centre for Clinical Epidemiology and Biostatistics, L. V. Prasad Eye Institute, Hyderabad, Andhra Pradesh, India

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-9233.175892

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Purpose: To compare the efficacy of "combined occlusion and atropine therapy (COAT)" and "augmented part-time patching" for the treatment of unilateral refractory/residual amblyopia. Methodology: This retrospective study evaluated children between 4 and 11 years with refractory/residual amblyopia who were treated with either additional atropine (COAT group) or increased hours of patching (augmented group). Data were collected on improvement in best-corrected visual acuity (BCVA; logarithm of the minimum angle of resolution [logMAR] units) at each follow-up visit. Results: There were 19 children in the COAT group and 17 children in the augmented group. The baseline BCVA of the amblyopic eye was 0.79 ± 0.36 logMAR in the COAT group and 0.72 ± 0.26 logMAR in augmented group. Children were statistically significantly younger in the COAT group (6.4 ± 2.2 years) compared to the augmented group (8.6 ± 3.3 years, P = 0.02). The mean duration of follow-up was statistically significantly longer in the augmented group (20.2 COAT group; 13.9 months augmented group) (P = 0.03). Compliance was similar in both groups. LogMAR BCVA (adjusted for difference in age and baseline BCVA) was statistically significantly better in the COAT group (0.56 ± 0.04) compared to the augmented group (0.80 ± 0.04) at 3 months (P = 0.000); 6 months (COAT group, 0.50 ± 0.04 vs. augmented group, 0.74 ± 0.04; P = 0.04) and at 1 year (COAT group, 0.42 ± 0.04 vs. augmented group, 0.67 ± 0.04, P = 0.000). There was statistically significantly greater improvement in logMAR BCVA at 6 months in COAT group (0.26 ± 0.15) compared to the augmented group (0.02 ± 0.14), (P = 0.0002). Age, gender, pretreatment BCVA, duration of follow-up, or compliance to patching did not affect improvement in BCVA. Conclusions: COAT may result in greater improvement in BCVA than augmented part-time patching in children with unilateral residual/refractory amblyopia.


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