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Evidence summaries

Interventions for Strabismic Amblyopia

Two hours daily occlusion combined with necessary refractive correction appears to be more beneficial than refractive correction alone for strabismic amblyopia. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 3 studies. The studies reported mean logMAR visual acuity achieved. Mean difference in visual acuity was calculated. When comparing conventional part-time occlusion (with any necessary glasses), PEDIG 2006 reported that this treatment was more beneficial than glasses alone for strabismic amblyopia; the mean difference between groups was -0.18 LogMAR (statistically significant 95% confidence interval (CI) -0.32 to -0.04). Supplementing occlusion therapy with near activities may produce a better visual outcome compared to non-near activities after four weeks of treatment (PEDIG 2005). The results of the pilot study showed mean difference between groups was -0.17 LogMAR (95% CI -0.53 to 0.19). Results from a larger RCT (PEDIG 2008) are now available, showing that supplementing occlusion therapy with near activities may produce a better visual outcome after eight weeks of treatment; the mean difference between groups was -0.02 LogMAR (95% CI -0.10 to 0.06).

Comment: The quality of evidence is downgraded by indirectness (results are based on subgroup analyses).

    References

    • :Taylor K, Elliott S. Interventions for strabismic amblyopia. Cochrane Database Syst Rev 2014;(7):CD006461. [PubMed]

Primary/Secondary Keywords