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    PEDIG making strides in amblyopia

    Treatment studies provide evidence of treatment effect; seek to determine effectiveness of other alternatives

    Take-home: Studies by the Pediatric Eye Disease Investigator Group have led to evidence-based treatment of amblyopia.

    Durham, NC—In the 18 years of the organization’s existence, The Pediatric Eye Disease Investigator Group (PEDIG) has tackled a number of challenges.

    Prime among them, according to PEDIG Chairman David K. Wallace, MD, MPH, are questions regarding how well glasses-alone treat amblyopia, the effectiveness of patching in older children, the effect of near activities on the results of patching, and cessation of visual acuity improvement with patching.

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    The most current and 18th of the Amblyopia Treatment Studies (ATS) is a comparison of binocular treatment of amblyopia with patching in a randomized trial of children aged 5 to less than 17 years old, with the primary goal of determining if binocular treatment is noninferior to patching in younger children.

    “If binocular treatment is just as good as patching, then that would be a game-changer, and we would likely want to offer this treatment option to parents,” said Dr. Wallace, professor of ophthalmology and pediatrics, Duke Eye Center, Durham, NC.

    The second study goal is to determine if binocular treatment is superior to patching in older children.

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    Among the inclusion criteria is an amblyopic eye visual acuity of 20/40 to 20/200 and wearing of appropriate spectacle correction for at least 16 weeks, or stable vision on two visits 4 weeks apart. Patients will be randomly assigned to play the binocular game “Hess falling blocks” (similar to Tetris) 1 hour daily or to 2 hours of daily patching.

    To be eligible for the study, patients must be able to align the nonius cross in the game and to score at least one line on the game, Dr. Wallace explained.

    Patients will be assessed at 4, 8, 12, and 16 weeks for monocular distance visual acuity, Randot stereoacuity, and ocular alignment, and patients and parents will complete a diplopia questionnaire.

    Highlights of the ATS

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