Characteristic of Objective Compliance with Intermittent Occlusion Therapy Glasses
Jingyun Wang; Jing Jin; Stefanie L. Davidson; Ayesha Malik; Ruth Shoge; Noah Tannen; Siva Meiyeppen; Yi Pang; Kelly Yin; Daniel E. Neely
Elkins Park, PA
Introduction: Intermittent occlusion therapy (IO-therapy) glasses (at 30-second opaque/transparent intervals) avoid the need for an adhesive patch, potentially improving compliance. Our previous clinical trial supports the effectiveness of this new device for amblyopia treatment.(Wang, et al 2016) However, there was no objective compliance measured for these glasses, which limits understanding of the dose-response for this treatment. This study reports pilot data of a microsensor to monitor objective compliance with IO-therapy glasses.
Methods: Fifteen children (3-8 yr) with unilateral amblyopia associated with strabismus and anisometropia were enrolled. At enrollment, they were prescribed 4 to 12 hours of intermittent occlusion therapy glasses. An microsensor was attached to the temple arm to monitor compliance with IO-therapy glasses wear for 4 to 12 weeks. Compliance was defined as the percentage of hours of actual glasses wearing compared to the hours of prescribed. Daily compliance and general compliance were analyzed. Mean daily compliance with IO-therapy was compared with mean daily objective compliance with patching.(Wallace, et al. 2013)
Results: General compliance over treatment period varied among individuals (ranged from 16% to 90%) and was averaged at 56%. Daily compliance declined with treatment time course for most patients; mean daily compliance decreased by 0.8% everyday. On average, the mean daily compliance is similar to the mean daily compliance with patching.
Discussion: Although these preliminary results are limited by the small sample size, improving compliance in children with amblyopia is still challenging.
Conclusion: Objective compliance with IO-therapy therapy glasses varies among individuals, but on average declines over time.
References: Wallace, M. P., C. E. Stewart, M. J. Moseley, D. A. Stephens, A. R. Fielder, C. Monitored Occlusion Treatment Amblyopia Study and C. Randomized Occlusion Treatment Amblyopia Study (2013). ‘Compliance with occlusion therapy for childhood amblyopia.’ Invest Ophthalmol Vis Sci 54(9): 6158-6166.
Wang, J., D. E. Neely, J. Galli, J. Schliesser, A. Graves, T. G. Damarjian, J. Kovarik, J. Bowsher, H. A. Smith, D. Donaldson, K. M. Haider, G. J. Roberts, D. T. Sprunger and D. A. Plager (2016). ‘A pilot randomized clinical trial of intermittent occlusion therapy liquid crystal glasses versus traditional patching for treatment of moderate unilateral amblyopia.’ J AAPOS 20(4): 326-331.