Standard Amblyopia Therapy in Adults with Longstanding Amblyopia Improves Visual Acuity and Contrast Sensitivity

Figures & data

Table 1 Subject Demographics

Subject	Age	Sex	Habitual Correction	Correction During Study	Ocular Alignment	Type of Amblyopia
1	18	F	OD: +4.00/-1.75x170^‡	No Change in Correction for Study	No Strabismus	A^§
			OS: +6.00/-2.75x180^‡†
2	18	F	OD: Plano DS	OD: −0.25 DS	No Strabismus	A^×
			OS: +4.25/-0.50x075^†	OS: +3.75/-1.00x075^†
3	20	F	OD: +4.50 DS^†	OD: +3.75^†	IXT	A + S^§
			OS: Plano/-0.75x010	OS: −0.25/-0.75x010
4	22	F	OD: +5.00 DS	No Change in Correction for Study	CLXT	A + S^§
					CLHyperT
			OS: +7.00 DS^†
5	26	M	OD: +5.50/-3.50x015^†	No Change in Correction for Study	CRET	A + S^§
			OS: Plano DS
6	34	M	OD: Plano DS	No Change in Correction for Study	CLET	A + S^§
			OS: +4.00/-1.75x005^†
7	42	F	Near Rx: OD: +0.25 DS	OD: Plano/-0.25x105	CLXT	A + S^¶
			OS: +2.75 DS^†	OS: +1.75 DS^†	CLHyperT
				ADD: +0.75 (PALs)
8	56	M	OD: +1.00/-0.50x105^†	OD: +1.00/-0.50x015^†	No Strabismus	A^§
			OS: −1.00/-0.50x175	OS: −1.00/-0.50x120
			ADD: +2.25 (PALs)	ADD: +2.50 (PALs)
9	60	F	OD: +1.50/-0.50x165	No Change in Correction for Study	CLHyperT	A + S^§
					CLET
			OS: +3.50/-0.25x180^†
			ADD: 2.25 (PALs)
Ave	32.9
SD	16.3

Notes: ^†Denotes amblyopic eye, ^‡All subjects wore spectacles, except for subject 1, who wore contact lenses, ^§Patients with prior patching therapy, ^¶ Patients with prior strabismus surgery, ^×Patients with no prior treatment.

Abbreviations: C, constant; I, intermittent; L, left; R, right; HyperT, hypertropia; ET, esotropia; XT, exotropia; A, anisometropia; S, strabismus.

Figure 1 Average logMAR acuity (± SE) for all amblyopes for each office visit. An ANOVA (p < 0.001) indicated there was a change in acuity across visits. Post-hoc Dunnett multiple comparisons indicated that weeks 4 through 24 (indicated by the filled circles) are significantly different from baseline (week 0). Acuities at weeks 12 and 24 were not significantly different (paired t-test, t₈ = 1.34, p = 0.22).

Table 2 Amblyopic Eye Subject Data for the AULCSF and CSF VA in Cycles per Degree (Cpd) for Baseline and the Week 12 Visit. The logMAR VA is Shown for the Baseline and Weeks 12 and 24 Visits. The Baseline and Week 12 or 24 Data are Statistically Significantly Different (paired t-tests, p < 0.05).

Subject	Age	Amblyopic Eye AULCSF		Amblyopic Eye CSF VA (cpd)		Amblyopic Eye logMAR VA
		Baseline	12 Weeks	Baseline	12 Weeks	Baseline	12 Weeks	24 Weeks
1	18	0.87	1.04	8.9	9.8	0.56	0.28	0.16
2	18	1.09	1.40	11.1	14.4	0.46	0.20	0.20
3	20	0.57	0.63	4.5	4.8	0.84	0.70	0.70
4	22	0.12	0.34	2.1	3.3	1.00	0.84	0.76
5	26	1.12	1.40	10.0	14.4	0.46	0.44	0.50
6	34	0.85	1.01	6.5	7.5	0.70	0.48	0.44
7	42	1.10	1.15	11.6	10.2	0.40	0.36	0.32
8	56	1.30	1.30	12.7	13.4	0.24	0.16	0.22
9	60	1.42	1.56	12.7	15.6	0.26	0.26	0.16
Ave		0.94	1.09	8.90	10.38	0.55	0.41	0.38
SE		0.14	0.14	1.33	1.57	0.09	0.08	0.09
p			0.002		0.036		0.005	0.008

Figure 2 Average visual acuity (± SE) for all subjects (N = 9), anisometropic subjects (N = 3), and combined mechanism subjects (N = 6) for the baseline and week 24 visit. The baseline and week 24 acuities are different for all the subjects (p = 0.008) and the combined mechanism subjects (p = 0.04).

Figure 3 Patient acuity improvement in letters between baseline and week 12 versus age. The circles refer to patients that had prior patching therapy. The squares refer to patients that either had no prior patching therapy (18 year old patient) or had prior strabismus surgery (42 year old patient). The therapy compliance is given next to each data point. The data points with an “A” are the anisometropic subjects. The best fit line and equation are shown. The acuity improvement decreases 2.2 letters for each decade of life.

Figure 4 The average contrast sensitivity for all the subjects at baseline and week 12. An ANOVA indicated that the baseline and week 12 data are significantly different (p = 0.002). A post-hoc paired t-test analysis indicated that the data at 1.5, 3, and 6 cpd (p values below the symbols) are significantly different (indicated with an asterisk) at baseline and 12 weeks.

Table 3 The Baseline, 12-, and 24-Week Visit Stereopsis Results for the Subjects

Subject	Baseline	12 Weeks	24 Weeks
1	(-) RDS at D/N	(-) RDS at D/N	(-) RDS at D/N
	200” LD at N	140” LD at N	100” LD at N
2	(-) RDS at D/N	(-) RDS at D/N	Not Available
	400” LD at N	160” LD at N
3	(-) RDS at D/N	(-) RDS at D/N	(-) RDS at D/N
	(-) LD at N	(-) LD at N	200” LD at N
4	(-) RDS at D/N	(-) RDS at D, 400” RDS at N	(-) RDS at D/N
	800” LD at N	60” LD at N	70” LD at N
5	(-) RDS at D/N	(-) RDS at D/N	(-) RDS at D/N
	800” LD at N	140” LD at N	400” LD at N
6	(-) RDS at D/N	(-) RDS at D/N	(-) RDS at D/N
	(-) LD at N	400” LD at N	140” LD at N
7	(-) RDS at D/N	(-) RDS at D/N	(-) RDS at D/N
	800” LD at N	400” LD at N	400” LD at N
8	(-) RDS at D	(-) RDS at D	400” RDS at D
	100” RDS at N	200” RDS at N	(-) RDS at N
	60” LD at N	80” LD at N	60” LD at N
9	200” RDS at D	200” RDS at D	400” RDS at D
	(-) RDS at N	250” RDS at N	500” RDS at N
	100” LD at N	100” LD at N	100” LD at N

Abbreviations: RDS, random dot stereopsis; LD, lateral disparity; D, distance; N, near.