Long-term follow-up of occlusion therapy in amblyopia

Objective: To determine whether the results of occlusion therapy for amblyo pia are maintained into adulthood. Design: Prospective, observational case series. Participants: Fifty-four patients, who were successfully treated in childho od for unilateral amblyopia by occlusion, were followed up to the age of 9 years, were evaluated in 1984 for long-term results 6.4 years on average af ter cessation of treatment, and accepted our invitation for reevaluation in 1999. Methods: All patients were given a complete eye examination. The visual acu ity (VA) was measured. Results: The average period of follow-up was 21.5 ye ars (range, 17.2-25.1 years). The mean age at the most recent examination w as 29.0 +/- 2.1 years (range, 25.1-34). At this examination, a best-correct ed visual acuity (BCVA) of 20/40 or better was achieved by 72.3% of the pat ients. The mean BCVA was 20/35 (20/25-20/70) at the end of occlusion therap y, 20/45 (20/20-20/300) in 1984, and 20/34 (20/15-20/100) at the present ex amination. Relative to the results at the end of therapy, BCVA at the prese nt examination was maintained or improved in 66.7% of the patients. Relativ e to 1984, the BCVA in 1999 was maintained or improved in 87% of the patien ts. Main outcome measure: Visual acuity. Conclusion: Comparative evaluation of BCVA at a long-term follow-up examina tion, performed 21.5 years on average after cessation of occlusion therapy, showed that VA was maintained or improved in two thirds of patients who ha d been successfully treated by occlusion for unilateral amblyopia in childh ood. (C) 2001 by the American Academy of Ophthalmology.