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March 2004

The Role of Compliance in 2 vs 6 Hours of Patching in Children WithAmblyopia

Arch Ophthalmol. 2004;122(3):422-423. doi:10.1001/archopht.122.3.422-b

We read with interest the article in the May 2003 issue of the ARCHIVES1 showing no difference in improvement of visualacuity between 2 groups of children with amblyopia who were prescribed 2 or6 hours of patching. However, we think that we should not rush to conclusionswithout considering the important issue of compliance. Our results, shownhere, support this concept. In the ARCHIVES study, the mean increase in visualacuity was 2.4 lines in both groups, and 62% of patients reached a visualacuity of 20/32 or an increase in visual acuity of 3 or more lines. A bettervisual acuity outcome would have been desirable because the children had onlymoderate amblyopia, and thus a better improvement would have been expected.The main change in visual acuity occurred in the first 5 weeks (mean, 0.19logMAR lines), while the change in visual acuity in the next 12 weeks wasminimal (mean, 0.05 logMAR lines). Therefore, it is unlikely that the sameocclusion regimen would produce further substantial improvement if the patientswere treated longer, even though the authors suggest further improvement.

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