Factors associated with treatment failure of anisometropic amblyopia

Purpose: to evaluate of factors which result in treatment failure of anisometropic amblyopia Methods: we retrospectively reviewed the records of 200 anisometropic amblyopia patients who were under patch therapy with treatment failure and followed for at least 10 years. Treatment failure was defined in two ways.1:absolute failure indicating final visual acuity in amblyopic eye less than 20/30. 2: relative failure defined as less than 2 lines of Log Mar visual acuity improvements. We evaluated the factors that effective in treatment failure Results: One hundred-twenty children enrolled in our study with average aged 6.5year old (4-10y) under patch therapy for anisometropic amblyopia that result in treatment failure during two years follow up. About 20% of patients developed relative failure and 30% of them achieved absolute failure. Treatment failure factors were evident as: 1-age above 7 year at the onset of treatment , 2-presence of astigmatism more than 1.5 diopter in amblyopic eye,3difference in refractive error over two diopter between eyes,4-poor compliance, and 5-initial visual acuity in amblyopic eye less than 20/200 Conclusion: Our study showed that presence of significant astigmatism, poor compliance with treatment, significant difference in refractive error between eyes, initial visual acuity less than 20/200, and age above 7 year were effective in treatment failure of anisometropic amblyopia