Termination of amblyopia treatment: when to stop follow-up visits and risk factors for recurrence

J Pediatr Ophthalmol Strabismus. 2010 Nov-Dec;47(6):338-46. doi: 10.3928/01913913-20100218-03. Epub 2010 Feb 23.

Abstract

Background: This study estimated when it is safe to stop follow-up visits after cessation of amblyopia treatment and to identify factors associated with deterioration of visual acuity.

Methods: Study patients included 282 patients aged 7 to 13 years who were monitored for deterioration after cessation of amblyopia treatment (median follow-up: 3.9 years).

Results: Six (2.1%) patients lost 2 or more logarithm of the minimum angle of resolution levels of visual acuity and 77 (27.3%) patients lost 1 or more Snellen lines of visual acuity. Good compliance with re-treatment stopped further deterioration and lost visual acuity was regained (average follow-up after re-treatment: 3.3 years). Life table analysis indicated that 95% of the cases that deteriorated occurred within 24 months after cessation of treatment. Multivariable analysis corrected for duration of treatment uncovered factors independently associated with deterioration.

Conclusion: A clinically important risk of deterioration of visual acuity was found during the first 2 years after cessation of amblyopia treatment. Follow-up time longer than 2 years is recommended in the presence of a developing risk factor such as increasing anisometropia. With prompt re-treatment and good compliance, deterioration can be stopped and visual acuity can be restored.

MeSH terms

  • Adolescent
  • Amblyopia / diagnosis
  • Amblyopia / physiopathology
  • Amblyopia / therapy*
  • Child
  • Continuity of Patient Care*
  • Female
  • Follow-Up Studies
  • Humans
  • Life Tables
  • Male
  • Monitoring, Physiologic
  • Office Visits*
  • Risk Factors
  • Secondary Prevention
  • Sensory Deprivation
  • Time Factors
  • Treatment Outcome
  • Visual Acuity / physiology
  • Withholding Treatment*