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Meta-Analysis
. 2011 Nov;129(11):1451-7.
doi: 10.1001/archophthalmol.2011.179. Epub 2011 Jul 11.

Effect of Age on Response to Amblyopia Treatment in Children

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Free PMC article
Meta-Analysis

Effect of Age on Response to Amblyopia Treatment in Children

Jonathan M Holmes et al. Arch Ophthalmol. .
Free PMC article

Abstract

Objective: To determine whether age at initiation of treatment for amblyopia influences the response among children 3 to less than 13 years of age with unilateral amblyopia who have 20/40 to 20/400 amblyopic eye visual acuity.

Methods: A meta-analysis of individual subject data from 4 recently completed randomized amblyopia treatment trials was performed to evaluate the relationship between age and improvement in logMAR amblyopic eye visual acuity. Analyses were adjusted for baseline amblyopic eye visual acuity, spherical equivalent refractive error in the amblyopic eye, type of amblyopia, prior amblyopia treatment, study treatment, and protocol. Age was categorized (3 to <5 years, 5 to <7 years, and 7 to <13 years) because there was a nonlinear relationship between age and improvement in amblyopic eye visual acuity.

Results: Children from 7 to less than 13 years of age were significantly less responsive to treatment than were younger age groups (children from 3 to <5 years of age or children from 5 to <7 years of age) for moderate and severe amblyopia (P < .04 for all 4 comparisons). There was no difference in treatment response between children 3 to less than 5 years of age and children 5 to less than 7 years of age for moderate amblyopia (P = .67), but there was a suggestion of greater responsiveness in children 3 to less than 5 years of age compared with children 5 to less than 7 years of age for severe amblyopia (P = .09).

Conclusions: Amblyopia is more responsive to treatment among children younger than 7 years of age. Although the average treatment response is smaller in children 7 to less than 13 years of age, some children show a marked response to treatment.

Figures

Figure 1
Figure 1
Relationship between age and amblyopic eye visual acuity improvement by treatment type in subjects ages 3 to <13 years with moderate amblyopia (A) and severe amblyopia (B)
Figure 2
Figure 2
Forest plots of adjusted mean amblyopic acuity improvement within age group in subjects with moderate amblyopia (A) and severe amblyopia (B). The dots indicate the adjusted mean for each age group for each protocol and the horizontal lines indicate the 95% CI for each mean.

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