More Efficacious Amblyopia Therapies Are Needed for Adults, Severe Disease

More efficacious amblyopia therapies are needed to improve patient outcomes for adults and individuals with greater disease severity, according to a study published in the Journal of the American Association for Pediatric Ophthalmology and Strabismus. 

Investigators retrospectively analyzed 2 year’s worth of electronic health record data from 456,818 patients from the Intelligent Research in Sight (IRIS) registry, which included pediatric patients (age range, 3-12 years; n=65,308), teenagers (age range, 13-17 years; n=65,308), and adults (age range, 18-50 years; n=193,927). The team reviewed amblyopia degree and type, stereopsis, patient demographics, eye-related comorbidities, and treatment modalities among the cohorts.

Unilateral amblyopia was more common than bilateral amblyopia in all age cohorts (pediatric, 55% vs 45%; teen, 61% vs 39%; adult, 63% vs 37%) and severe unilateral amblyopia was more frequent in adults (21%) than in pediatric patients (12%) and teenagers (13%). In individuals with bilateral amblyopia, the severity was comparable in the pediatric and adult cohorts (4% for both). 

Pediatric patients with severe unilateral amblyopia at baseline demonstrated the most significant visual acuity improvements among the cohort. Children showed significant improvement in stereopsis over time at 1 (P =.000033) and 2 years (P =.000039) at the population level (per χ2 test vs baseline), according to the report.

Glasses were the preferred treatment modality, with 37%-48% of participants using spectacle lenses at 2 years across all cohorts. Patching and atropine treatment were used in 19% and 9% of participants within the pediatric cohort, respectively. 

“Collectively, these findings strongly suggest the need for more efficacious amblyopia therapies in teenagers and adults with residual or refractory amblyopia from childhood as well as a renewed emphasis on early disease screening and therapy,” according to the researchers. 

Study limitations include a lack of stereopsis measurements for the adult and teenage cohorts, a lack of standardization for obtaining stereopsis measurements in the pediatric cohort, and variations in coding practices within the IRIS registry.