Two-year follow-up of a randomized trial of spectacles plus alternate-day patching to treat strabismic amblyopia

. Purpose: To compare spectacles plus alternate-day patching for 8hr or more with spectacles plus patching for 8hr or more 6days weekly to treat strabismic amblyopia 1year after a 1-year randomized trial. Methods: Forty children (mean age, 4.3years) participated. Refractive correction was provided. The children were assigned to alternate-day patching for 8hr or more or patching for 8hr or more daily 6days weekly. VA, binocular function, and refractive errors were measured after 2years. The main outcome measure was the median VA change in the amblyopic eye after 2years. Results: The median VA change in the amblyopic eye at the 2-year visit was significantly (p=0.0453) greater with alternate-day patching (0.8log unit) versus patching daily 6days weekly (0.6log unit). The final median VA in the amblyopic eyes was 0.0logMAR in the alternate-day patching group and 0.1logMAR in the daily patching group. Binocular function improved with both treatments. The median spherical equivalent (SE) refractive error increased in the fellow eyes (alternate-day patching, p<0.0001; patching daily 6days weekly, p=0.0033); no change was found in the amblyopic eyes in either group. Conclusions: The magnitude of the VA change 2years after treatment with spectacles plus alternate-day patching for 8hr or more was significantly greater than with spectacles plus daily patching for 8hr or more 6days weekly for strabismic amblyopia. However, the final median VA did not differ significantly between the two treatments.