Sains Malaysiana 40(11)(2011): 1325–1329

Patching Therapy in Patients with Strabismic Amblyopia and Refractive Amblyopia

(Terapi Pengatupan pada Pesakit dengan Ambliopia Strabismik dan Ambliopia Refraktif)

Sharanjeet-Kaur* & Norliza Mohd Fadzil

Department of Optometry, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia

Jalan Raja Muda 50300 Kuala Lumpur, Malaysia

Waheeda Azwa

Department of Ophthalmology, Hospital Raja Perempuan Zainab II, 15586 Kota Bahru, Kelantan

Azrin E Ariffin

Faculty of Optometry & Vision Sciences, SEGI University College, No 9, Jalan Teknologi

Taman Sains Selangor, Kota Damansara, PJU5 47810 Petaling Jaya, Selangor

Malaysia

Received: 16 June 2010 / Accepted: 26 April 2011

ABSTRACT

This study was conducted to compare the treatment outcome using patching in patients with strabismic amblyopia and refractive amblyopia. The treatment outcome was measured by visual acuity and refractive error. A total of 28 patients participated in this study. One group comprised of strabismic amblyopes who had either congenital esotropia or intermittent exotropia and spherical equivalent refractive error of less than -3.00 DS. Another group of patients were purely refractive amblyopes. Patients were first corrected with the best correction for a month. When the VA in the amblyopic eye did not improve over the month, then patching treatment was started. Patching was done daily for 2 h together with near activity. The treatment was carried out for 4 months, with the patients reviewed once every month. The results of the study revealed that VA improved by 17 alphabets or 3 lines after patching treatment for patients with strabismic amblyopia. In the refractive amblyopia group, the VA only improved by 8 alphabets or 1 line 3 alphabets. The mean spherical equivalent refractive error changed by less than -0.50DS and therefore was clinically not significant in both groups. This present study showed that patching treatment was better at improving the VA of patients with strabismic amblyopia.

Keywords: Refractive amblyopia; refractive error; strabismic amblyopia; visual acuity

ABSTRAK

Kajian ini dijalankan untuk membandingkan keputusan rawatan menggunakan cara pengatupan pada pesakit dengan ambliopia strabismik dan ambliopia refraktif. Keputusan rawatan diukur dengan akuiti visual dan ralat refraksi. Seramai 28 pesakit mengambil bahagian dalam kajian ini. Satu kumpulan terdiri daripada pesakit yang mempunyai ambliopia jenis strabismik dengan strabismus sama ada jenis esotropia kongenital atau eksotropia sekali-sekala dan ralat refraksi sfera setara kurang daripada -3.00 DS. Kumpulan yang lagi satu pula terdiri daripada pesakit yang mempunyai ambliopia jenis refraktif sahaja. Pesakit pada mulanya diberi pembetulan ralat refraksi terbaik selama sebulan. Sekiranya VA pada mata ambliopia tidak meningkat, barulah rawatan pengatupan dimulakan. Pengatupan dilakukan setiap hari untuk 2 jam semasa melakukan aktiviti dekat. Rawatan ini dilakukan selama 4 bulan. Pesakit diperiksa semula sekali setiap bulan. Keputusan kajian ini menunjukkan VA meningkat sebanyak 17 huruf atau 3 barisan selepas rawatan pengatupan bagi pesakit dengan ambliopia strabismik. Untuk kumpulan pesakit dengan ambliopia refraktif, VA hanya meningkat sebanyak 8 huruf atau 1 baris 3 huruf. Ralat refraksi sfera setara berubah sebanyak kurang daripada -0.50 DS pada kedua kumpulan. Oleh itu, ia tidak signifikan secara klinikal pada kedua kumpulan pesakit. Kajian ini menunjukkan rawatan pengatupan lebih berkesan dalam meningkatkan VA pesakit dengan ambliopia strabismik berbanding pesakit dengan ambliopia refraktif.

Kata kunci: Akuiti visual; ambliopia refraktif; ambliopia strabismik; ralat refraksi;

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*Corresponding author; email: sharan@medic.ukm.my