Clinical Features and Counterplans of Monocular Amblyopia Failed to Occlusion Therapy

ABSTRACT

PURPOSE: To investigate the clinical features of monocular amblyopia which failed to respond to occlusion therapy. METHODS: We retrospectively reviewed the records of 57 children who failed to respond to occlusion therapy. Treatment failure was defined in two ways visual improvement failure indicating less than two lines of visual acuity improvement, and functional failure indicating a final visual acuity in the amblyopic eye worse than 20/40 after more than 3 months of occlusion therapy. We investigated the clinical features of the patients and also classified and analyzed the factors related to prognosis into fixed factors and adjustable factors according to the adjustability during treatment. RESULTS: The visual acuity of the amblyopic and sound eyes was and average of 0.20+/-0.12 (0.02~0.5) and 0.80+/-0.18 (0.5~1.0), respectively. Forty-one patients (71.9%) had strabismus and esotropia was most frequent (65.9%). According to the age distribution, the 5~6-year-old group was most frequent (21 patients, 36.8%). Four adjustable factors, the interval from diagnosis to treatment, good compliance, full term occlusion, and sufficient occlusion, were insufficiently applied to the visual improvement failure group and the functional failure group as 60% and 53.1%, respectively. CONCLUSIONS: Clinical features of monocular amblyopia which failed to respond to occlusion therapy were moderate amblyopia with strabismus and relatively younger children. There was room for improvement to additional treatment of 50~60%.