Treatment of anisometropic amblyopia with spectacles or in combination with translucent Bangerter filters
(Traitement de l'amblyopie par anisométropie par correction optique seule ou en association avec des filtres translucides de Bangerter)

Agervi P, Kugelberg U, Kugelberg M, Simonsson G, Fornander M, Zetterström C.
St. Erik's Eye Hospital, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
pia.agervi@sankterik.se

PURPOSE: To compare spectacle correction alone with spectacle correction with Bangerter filters to treat anisometropic amblyopia in children.

DESIGN: Prospective, randomized clinical trial. PARTICIPANTS: Eighty children (mean age, 4.4 years) with untreated anisometropic amblyopia and a median best-corrected visual acuity (BCVA) in the amblyopic eye of 0.4 logarithm of the minimum angle of resolution (logMAR).

METHODS: Optimal refractive correction was provided, and the children were assigned to treatment with either spectacles or spectacles in combination with a Bangerter filter worn on the spectacle lens of the better eye. The BCVA, binocular function, and refractive errors were measured repeatedly over the course of 1 year.

MAIN OUTCOME MEASURES: The time course to resolution of the amblyopia (interocular difference, < or =1 line).

RESULTS: The difference in the mean time to the resolution of amblyopia was 3.9+/-3.2 months for the spectacles group versus 2.2+/-1.9 months for the filter group, and the difference reached significance (P<0.05). The BCVA in the amblyopic eye improved significantly (P<0.001 for both comparisons) in both groups. After 1 year, there was no significant difference in the BCVA between the groups. The binocular function improved in both groups; at 1 year there was no significant difference between the groups. The median spherical equivalent refractive error increased significantly during the study in the amblyopic eyes (P<0.05) and the fellow eyes (P<0.001). The median anisometropia decreased significantly from the first visit to the 1-year visit in both groups (P<0.001 for both comparisons).

CONCLUSIONS: We found a more rapid visual acuity recovery with the Bangerter filters than with spectacles alone in eyes with anisometropic amblyopia. However, the 1-year visual acuity outcome was not statistically significantly different between the 2 treatments.

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