Treating amblyopia in adults with prosthetic occluding contact lenses

• Published in: Acta ophthalmologica (Oxford, England) Vol. 96; no. 3; pp. e347 - e354
• Main Authors: Garcia‐Romo, Esperanza, Perez‐Rico, Consuelo, Roldán‐Díaz, Isabel, Arévalo‐Serrano, Juan, Blanco, Román
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.05.2018
• Subjects: Acceptability; Acuity; amblyopia; Contact lenses; Eye; Feasibility studies; Latency; multifocal visual evoked potentials; Occlusion; Patching; Prostheses; prosthetic occluding contact lenses; Quality of life; Strabismus; Visual acuity; Visual evoked potentials; visual pathway; Visual perception; multifocal visual evoked potentials; amblyopia; visual pathway; prosthetic occluding contact lenses
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/aos.13585

Purpose To investigate the feasibility, effectiveness and acceptability of using prosthetic occluding contact lenses (OCLs) to treat moderate amblyopia in adults and of the role of the multifocal visual evoked potential (mfVEP) as a predictor of postamblyopic therapy. Methods A comparative, prospective, interventional, case series pilot study with amblyopic adults (mean age: 40 years, range 20–50 years) allocated into two intervention groups: eye patching and OCL. The primary outcome variable was logarithm of the minimum angle of resolution (logMAR) best‐corrected visual acuity (BCVA), and secondary outcomes were mfVEP amplitude and latency and patients’ health‐related quality of life National Eye Institute Visual Function Questionnaire (NEI VFQ‐25). Results Significant improvements in pre‐ to postamblyopic therapy BCVA were seen at 1.5 months in the OCL group [0.29 logMAR, 95% confidence interval (CI): 0.10–0.47 versus 0.11 logMAR, 95% CI: 0.02–0.19; p < 0.001] and eye patching group (0.29 logMAR, 95% CI: 0.17–0.40 versus 0.18 logMAR, 95% CI: 0.12–0.23; p < 0.01). Post‐treatment BCVA was inversely related to age (R: 0.009, 95% CI: −0.02 to −0.001; p = 0.04) and the presence of strabismus (R: −0.3, 95% CI: −0.434 to −0.17; p = 0.001). No significant changes in the number and size of the abnormal mfVEP amplitude and latency defects were observed after occlusion. The NEI VFQ‐25 composite score showed significant improvement in the OCL users at 12 months compared to eye patching. Conclusion Significant vision improvement can be achieved, making occlusion with OCLs an effective and more acceptable therapy for adults with amblyopia.