弱視的全時遮蓋與部分時間遮蓋之比較研究

        其實弱視的遮眼睛對小朋友的心靈影響蠻大的，在團體中容易產生自卑的心理，或是造成危險。若弱視並不是太嚴重，可考慮減少遮眼時間或調整遮眼時段，例如回到家中才遮眼。相關論文可參考以下這篇。

此篇論文的目的在比較弱視的遮蓋療法中全時遮蓋與部分時間遮蓋的效果差異。

對象為100位7~12歲兒童，其中屈光不等57位，斜視25位，混合18位之單側性弱視。隨機分配到四個實驗組，接受2小時、4小時、6小時或全時遮蓋。孩童以6周的間隔接受至少三次的隨訪。

結果在18周遮蓋療法後，所有四組都顯示了明顯視覺改進的效果。

100位中總共73位對遮蓋療法有反應，四組的比例分別為44%、68%、88%、92%。兩小時遮蓋組最低。

在中低程度的弱視中(視力20/30~20/80，0.67~0.4)，四組之間並沒有明顯的差別。

但在嚴重弱視中(視力20/100或以下)，6小時與全時遮蓋的效果勝過2小時遮蓋。

結論是在中低程度的弱視中，部分時間遮蓋的效果與全時遮蓋並無明顯差別，而嚴重弱視孩童，則需要6小時以上的遮蓋時間。

Indian J Ophthalmol. 2008 Nov-Dec;56(6):459-63.
Part-time occlusion therapy for amblyopia in older children.
Singh I, Sachdev N, Brar GS, Kaushik S.

Grewal Eye Institute, Chandigarh-160 009, India.
Abstract
AIM: To compare the efficacy of part-time versus full-time occlusion for treatment of amblyopia in children aged 7-12 years.

MATERIALS AND METHODS: Prospective interventional case series. One hundred children between 7-12 years of age with anisometropic (57), strabismic (25) and mixed (18) unilateral amblyopia were randomized (simple randomization) into four groups (25 each) to receive two hours, four hours, six hours or full-time occlusion therapy. Children were regularly followed up at six-weekly intervals for a minimum of three visits.

STATISTICAL ANALYSIS: Intragroup visual improvement was analyzed using paired t-test while intergroup comparisons were done using ANOVA and unpaired t-test.

RESULTS: All four groups showed significant visual improvement after 18 weeks of occlusion therapy ( P < 0.001). Seventy-three (73%) of the total 100 eyes responded to amblyopia therapy with 11 eyes (44%), 17 eyes (68%), 22 eyes (88%) and 23 eyes (92%) being amblyopia responders in the four groups respectively, with the least number of responders in the two hours group. In mild to moderate amblyopia (vision 20/30 to 20/80), there was no significant difference in visual outcome among the four groups ( P =0.083). However, in severe amblyopia (vision 20/100 or worse), six hours ( P =0.048) and full-time occlusion ( P =0.027) treatment were significantly more effective than two hours occlusion.

CONCLUSION: All grades of part-time occlusion are comparable to full-time occlusion in effectiveness of treatment for mild to moderate amblyopia in children between 7-12 years of age unlike in severe amblyopia, where six hours and full-time occlusion were more effective than two hours occlusion therapy.

PMID: 18974515 [PubMed - indexed for MEDLINE]PMCID: PMC2612980Free PMC Article