Atropine Mydriasis Versus Occlusion As The Therapeutic Method Of Amblyopia

Objective:To explore the use of atropine mydriasis in the treatment of amblyopia by comparing the therapeutic effect of atropine mydriasis with traditional occlusion in amblyopic children and by comparing their compliances.Methods:In this retrospective controlled clinical tria, 72 patients between 3 and 7 years who were newly diagnosed monocular amblyopia in Qilu Hospital of Shandong University were analyzed . They were divided randomly into atropine mydriasis group (A group) and patch therapy group( P group). The A group had 30 patients with mean age of 4.26±1.29 years and the P group had 42 cases with mean age of 4.60±1.21. The visual acuities were 0.40±0.22 in A group and 0.32±0.20 in P group. Of the A group, 10 were ametropic, 10 amisometropic cases, and 7 squint, while 12 ametropic, 11 amisomet-ropic, and 6 squint in P group. At each follow-up visit, the parents' compliance, visual acuity, and stereo function were recorded. We used 5 meter E chart for checking visual acuity. At every follow-up visit, the parents were asked about the compliance, the patients were reassessed visual acuity, and examined by the Titmus Stereo Tests. Group P were placed an occlusive patch over the non-amblyopia eye at least 4 hours a day. For the Group A, one drop of atropine 1% was put in the conjunctival fornix of the non-amblyopic eye every night. The interval of the follow-up visit increases one week when the children add one year. The children were mydriasised and re-checked with optometry uni every 6 to 12 months, and adjust glasses.Results:1. There was no significant difference in the time needed for the patients to get normal vision in A group (16.90±1.26 months) and P group (17.24±1.60 months).2. The largest difference of vision increasing occurred at the second follow-up visit.3. 27 patients in A Group and 29 patients in P Group had good compliance. There was no statistically significant difference in the rebuilding stereoscopic vision of the two groups.4. The rate compliance in P group (90%) was significantly lower than that in A group (69%).Conclusions:1. Both atropine mydriasis and occlusion therapy were effective to amblyopic children aged 3-7 years.2. The visual acuity of occlusion group improved faster than that of the atropine group.3. Occlusion therapy had a worse compliance than the atropine mydriasis group.