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Ophthalmology. 2010 May;117(5):998-1004.e6. doi: 10.1016/j.ophtha.2009.10.014. Epub 2010 Feb 16.

A randomized trial comparing Bangerter filters and patching for the treatment of moderate amblyopia in children.

Author information

1
Jaeb Center for Health Research, Tampa, FL 33647, USA

Abstract

OBJECTIVE:

To determine whether visual acuity improvement with Bangerter filters is similar to improvement with patching as initial therapy for children with moderate amblyopia.

DESIGN:

Randomized, clinical trial.

PARTICIPANTS:

We enrolled 186 children, 3 to <10 years old, with moderate amblyopia (20/40-20/80).

METHODS:

Children were randomly assigned to receive either daily patching or to use a Bangerter filter on the spectacle lens in front of the fellow eye. Study visits were scheduled at 6, 12, 18, and 24 weeks.

MAIN OUTCOME MEASURES:

Visual acuity in amblyopic eyes at 24 weeks.

RESULTS:

At 24 weeks, amblyopic eye improvement averaged 1.9 lines in the Bangerter group and 2.3 lines in the patching group (difference in mean visual acuities between groups adjusted for baseline acuity = 0.38 line). The upper limit of a 1-sided 95% confidence interval was 0.76 line, which slightly exceeded a prespecified noninferiority limit of <0.75 line. Similar percentages of subjects in each group improved > or =3 lines (Bangerter group 38% vs patching group 35%; P = 0.61) or had > or =20/25 amblyopic eye acuity (36% vs 31%, respectively; P = 0.86). There was a lower treatment burden in the Bangerter group as measured with the Amblyopia Treatment Index. With Bangerter filters, neither a fixation switch to the amblyopic eye nor induced blurring in the fellow eye to worse than that of the amblyopic eye was required for visual acuity improvement.

CONCLUSIONS:

Because the average difference in visual acuity improvement between Bangerter filters and patching was less than half a line, and there was lower burden of treatment on the child and family, Bangerter filter treatment is a reasonable option to consider for initial treatment of moderate amblyopia.

PMID:
20163869
PMCID:
PMC2864338
DOI:
10.1016/j.ophtha.2009.10.014
[Indexed for MEDLINE]
Free PMC Article

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