Treatment of Anisometropic Amblyopia with Spectacles or in Combination with Translucent Bangerter Filters
Received 6 November 2008; received in revised form 16 January 2009; accepted 23 February 2009. published online 04 June 2009.
Purpose
To compare spectacle correction alone with spectacle correction with Bangerter filters to treat anisometropic amblyopia in children.
Design
Prospective, randomized clinical trial.
Participants
Eighty children (mean age, 4.4 years) with untreated anisometropic amblyopia and a median best-corrected visual acuity (BCVA) in the amblyopic eye of 0.4 logarithm of the minimum angle of resolution (logMAR).
Methods
Optimal refractive correction was provided, and the children were assigned to treatment with either spectacles or spectacles in combination with a Bangerter filter worn on the spectacle lens of the better eye. The BCVA, binocular function, and refractive errors were measured repeatedly over the course of 1 year.
Main Outcome Measures
The time course to resolution of the amblyopia (interocular difference, ≤1 line).
Results
The difference in the mean time to the resolution of amblyopia was 3.9±3.2 months for the spectacles group versus 2.2±1.9 months for the filter group, and the difference reached significance (P<0.05). The BCVA in the amblyopic eye improved significantly (P<0.001 for both comparisons) in both groups. After 1 year, there was no significant difference in the BCVA between the groups. The binocular function improved in both groups; at 1 year there was no significant difference between the groups. The median spherical equivalent refractive error increased significantly during the study in the amblyopic eyes (P<0.05) and the fellow eyes (P<0.001). The median anisometropia decreased significantly from the first visit to the 1-year visit in both groups (P<0.001 for both comparisons).
Conclusions
We found a more rapid visual acuity recovery with the Bangerter filters than with spectacles alone in eyes with anisometropic amblyopia. However, the 1-year visual acuity outcome was not statistically significantly different between the 2 treatments.
Financial Disclosure(s)
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Available online: June 4, 2009.
1St. Erik's Eye Hospital, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
2Department of Ophthalmology, University of Oslo, Norway
Correspondence: Pia Agervi, MD, Department of Paediatric Ophthalmology and Strabismus, St Erik's Eye Hospital, Danderyd's Hospital, S-182 88 Stockholm, Sweden
Manuscript no. 2008-1319.
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Financial support was provided through the regional agreement on medical training and clinical research between Stockholm County Council and the Karolinska Institutet.
Supported in part by the Sigvard and Marianne Bernadotte Research Foundation and the Karin Sandqvist Foundation.
ABSTRACT