2014 pedig amblyopia studies

download 2014 pedig amblyopia studies

Embed Size (px)

description

Outlines / summarized ppt presentation of PEDIG amblyopia studies as of July 2014

Transcript of 2014 pedig amblyopia studies

  • Amblyopia Treatment Studies Pediatric Eye Disease Investigator Group 2002-2013 (Publications as of July 2014)
  • http://pedig.jaeb.org/Studies.aspx http://www.abcd-vision.org/amblyopia/ats- pedig.html
  • Amblyopia Treatment Study-1 (ATS-01) Atropine vs part-time patch, moderate amblyopia n I. Arch Ophthalmol 2002: 120(3) 268-278 n II. Arch Ophthalmol 2002: 120 (3) 281-287 n III. Arch Ophthalmol 2003: 121 (11): 1625-32 n IV. Arch Ophthalmol 2005: 123 (2): 149-157 n V. J AAPOS 2005: 9 (6): 542-545 n VI. Arch Ophthalmol 2008: 1039-1044
  • Amblyopia Treatment Study-1 (ATS-1) Atropine vs part-time patch, moderate amblyopia n I. Arch Ophthalmol 2002: 120(3) 268-278 n VA 20/40-20/100 n 3 or more lines: n Atropine (74%) & Patching (79%) n Atropine & patching similar for age 3-7 yr n Atropine better acceptability
  • Amblyopia Treatment Study-1 (ATS-1) Atropine vs part-time patch, moderate amblyopia n II. Arch Ophthalmol 2002: 120 (3) 281-287 n Clinical profile of moderate amblyopia subjects n moderate amblyopia 20/40-20/100 n 7 yrs and below n Same effect for strabismic and anisometropic amblyopia
  • Amblyopia Treatment Study-1 (ATS-1) Atropine vs part-time patch, moderate amblyopia n III. Arch Ophthalmol 2003: 121 (11): 1625-32 n Impact of patching vs atropine n Both well tolerated by child and family n Atropine more favorable
  • Amblyopia Treatment Study-1 (ATS-1) Atropine vs part-time patch, moderate amblyopia n IV. Arch Ophthalmol 2005: 123 (2): 149-157 n 2 yr follow up after 6 month of patching or atropine n Similar results in both groups n Amblyopic eye still 2 lines worse than sound eye
  • Amblyopia Treatment Study-1 (ATS-1) Atropine vs part-time patch, moderate amblyopia n V. J AAPOS 2005: 9 (6): 542-545 n Effect of amblyopia tx on ocular alignment n Same rates of deterioration or improvement in both groups n New strabismus by 2 yrs: most resolved after cessation of treatment n 18% in patching: 2 greater than 8PD n 16% in atropine: 3 greater than 8PD
  • Amblyopia Treatment Study-1 (ATS-1) Atropine vs part-time patch, moderate amblyopia n VI. Arch Ophthalmol 2008: 1039-1044 n 10 year follow up n improvement of amblyopia maintained n Outcome similar for both groups n residual amblyopia common n treatment initiated at age 3-7 years
  • Amblyopia Treatment Study-2 (ATS-2) n I. Ophthalmology 2003: 110(11) 2075-2087 n II. Arch Ophthalmol 2003: 121 (5) 603-611 n III. J AAPOS 2004: 8(5): 420-428
  • Amblyopia Treatment Study-2A (ATS-2A) Patch 6 hrs vs full time, severe amblyopia n I. Ophthalmology 2003: 110(11) 2075-2087 n Full time: all waking hrs minus 1 hour off n Severe amblyopia: 20/100-20/400 n Age 3-7 years n After 4 months n 4.8 lines in 6 hrs group; vs 4.7 in full time
  • Amblyopia Treatment Study-2B (ATS-2B) Patch 2 hrs (minimal time) vs 6 hrs (part time) for Moderate amblyopia n II. Arch Ophthalmol 2003: 121 (5) 603-611 n moderate: 20/40-20/80 n ages 3-7 years n At 4 months: 2.4 lines in both groups with 1 hr of near visual activity
  • Amblyopia Treatment Study-2C (ATS-2C) Recurrence after cessation of patching / Atropine n III. J AAPOS 2004: 8(5): 420-428 n younger than age 8 n 3 months of amblyopia treatment n Recurrence same n 24% of patched patients; 21% of atropinized n 1/4 experience recurrence within 1st year of cessation n RCT for weaning vs. no-weaning
  • Amblyopia Treatment Study-3 (ATS-3) 7 to < 18: spectacles vs atropine/patch n Arch Ophthalmol 2005: 123: 437-477 (Control) n Am J Ophthalmol 2004: 137: 581-583 (10-18yrs) n Arch Ophthalmol 2007: 125: 655-659
  • Amblyopia Treatment Study-3 (ATS-3) 7 to < 18: spectacles vs atropine/patch n Arch Ophthalmol 2005: 123: 437-477 (Control) n Am J Ophthalmol 2004: 137: 581-583 (10-18yrs) n Arch Ophthalmol 2007: 125: 655-659
  • Amblyopia Treatment Study-3 (ATS-3) 7 to < 18: spectacles vs atropine/patch n Pediatric Eye Disease Investigator Group. Randomized trial of treatment of amblyopia in children aged 7 to 17 years. Arch Ophthalmol 2005;123:437-47. n Pediatric Eye Disease Investigator Group. Stability of visual acuity improvement following discontinuation of amblyopia treatment in children aged 7 to 12 years. Arch Ophthalmol 2007;125:655-9.
  • Amblyopia Treatment Study-3 (ATS-3) 7 to < 18: spectacles vs atropine/patch n ages 7-17 years n 20/40-20/400 n Given optimal optical correction then randomized n Tx: glasses, patch plus near activity, atropine n No Tx: glasses alone
  • Amblyopia Treatment Study-3 (ATS-3) 7 to < 18: spectacles vs atropine/patch n Responders: improved by >/= 10 letters / 2 lines n Amblyopia improves with Rx alone in 25% n Most patients left with residual VA deficit n Ages 7-12: tx improved amblyopia even if previously treated n Ages 13-17: tx improved if no previous tx for amblyopia n Unknown: if treatment results robust (if it will stay)
  • Amblyopia Treatment Study-4 (ATS-4) Atropine weekend vs daily; moderate amblyopia n Ophthalmology 2004: 111: 2076-2085 n 20/40-20/80 n ages 3-7 years n Similar results with weekend atropine vs daily atropine n 2.3 lines in both groups
  • Amblyopia Treatment Study-5 (ATS-5) 3 to < 7, spectacles alone vs patch 2 hrs + spectacles n Ophthalmology 2006: 113 (6) 895-903. n amblyopia improved with Rx by >/= 2 lines in 77% n amblyopia resolved in 27% with Rx alone n 3 line improvement average n Lessen the burden of amblyopia therapy
  • Amblyopia Treatment Study-5 (ATS-5) 3 to