THERAPEUTIC PERSPECTIVES ON THE EFFECTIVENESS OF AMBLYOPIA TREATMENT IN DIFFERENT AGE GROUPS: INTEGRATIVE LITERATURE REVIEW

Authors

  • Ueverton Barbosa de Souza Author
  • Rodrigo Gabriel Valverde Rodrigues Author
  • Eva Ida Reis Leite Machado Author
  • Laura Carrijo Martins Dias Queiroz Author
  • Anna Carolina de Melo Gomes Author
  • João Pedro Arantes Borges Author
  • Wilson Foré Author
  • Julio Cesar Souza Silva Author

DOI:

https://doi.org/10.56238/arev7n10-134

Keywords:

Amblyopia, Therapeutics, Effectiveness, Neural Plasticity, Age Groups

Abstract

Purpose: Amblyopia is characterized by reduced visual acuity due to differences in the quality of visual stimulation between the eyes during the critical period of visual development in childhood. This study aimed to conduct an integrative review of literature published in the last 5 years and to discuss the effectiveness of amblyopia treatment across different age groups. Methods: An integrative review was conducted with searches performed in the PubMed, Cochrane Library, and SciELO databases, using the following descriptors: “Amblyopia,” “Clinical Management,” “Age Groups,” and their English equivalents, as suggested by the DeCS/MeSH platform. A total of 114 potentially eligible articles were identified, but only 29 met the inclusion criteria. Results: The critical window for visual development varies depending on specific visual functions and types of amblyopia. As age advances, there is a reduction in neural plasticity within the visual pathways, which poses a challenge for amblyopia therapy in older children. However, some studies report that age is not a determining factor for the effectiveness of certain treatment modalities. Conclusion: Given the conflicting results regarding the effectiveness of amblyopia treatment with advancing age, further experimental studies are needed to clarify the role of age as a determining, complementary, or irrelevant factor in amblyopia therapy.

Downloads

Download data is not yet available.

References

ARAKAKI, M. R. et al. Adherence to amblyopia treatment. Arquivos Brasileiros de Oftalmologia, v. 67, n. 2, p. 201-205, abr. 2004. DOI: https://doi.org/10.1590/S0004-27492004000200004

ASPER, L.; WATT, K.; KHUU, S. Optical treatment of amblyopia: a systematic review and meta-analysis. Clinical and Experimental Optometry, v. 101, n. 4, p. 431-442, jul. 2018. DOI: https://doi.org/10.1111/cxo.12657

BIRCH, E. E.; KELLY, K. R. Amblyopia and the whole child. Progress in Retinal and Eye Research, v. 93, mar. 2023. DOI: https://doi.org/10.1016/j.preteyeres.2023.101168

BIRCH, E. E. et al. A pilot randomized trial of contrast-rebalanced binocular treatment for deprivation amblyopia. Journal of AAPOS, v. 24, n. 6, p. 344.e1-344.e5, 2020a. DOI: https://doi.org/10.1016/j.jaapos.2020.07.009

BIRCH, E. E. et al. Baseline and clinical factors associated with response to amblyopia treatment in a randomized clinical trial. Optometry and Vision Science, v. 97, n. 5, p. 316-323, 2020b. DOI: https://doi.org/10.1097/OPX.0000000000001514

BOLICHE, B. Kanski Clinical Ophthalmology. São Paulo: Grupo GEN, 2016. E-book. ISBN 9788595152175.

CHATURVEDI, I.; JAMIL, R.; SHARMA, P. Binocular vision therapy for the treatment of amblyopia – a review. Indian Journal of Ophthalmology, v. 71, n. 5, p. 1797-1803, 2023. DOI: https://doi.org/10.4103/IJO.IJO_3098_22

CHINN, R. N. et al. Effect of sequential and simultaneous patching regimes in unilateral amblyopia. American Journal of Ophthalmology, v. 233, p. 48-56, jan. 2022. DOI: https://doi.org/10.1016/j.ajo.2021.07.012

DA SILVA, F. K.; SONODA, R. T.; ALTAFINI, R. H. Amblyopia: relevance to educational development. Revista Internacional Integralize Scientific, v. 6, n. 1, p. 16-24, dez. 2021.

DOSHI, N. R.; RODRIGUEZ, M. L. Amblyopia. American Family Physician, v. 75, n. 3, p. 361-367, fev. 2007. PMID: 17304867. DOI: https://doi.org/10.1119/1.2372472

ELHUSSEINY, A. M. et al. Virtual reality prototype for binocular therapy in older children and adults with amblyopia. Journal of American Association for Pediatric Ophthalmology and Strabismus, v. 25, n. 4, p. 217.e1-217.e6, ago. 2021. DOI: https://doi.org/10.1016/j.jaapos.2021.03.008

FELIX, T. A. N.; PENHA, J. R.; SONODA, R. T. The importance of early diagnosis for the treatment of amblyopia. Recima21 – Revista Científica Multidisciplinar, v. 3, n. 11, p. 0-0, 1 nov. 2022. ISSN 2675-6218.

GAO, T. Y. et al. Effectiveness of a binocular video game vs placebo video game for improving visual functions in older children, teenagers, and adults with amblyopia: a randomized clinical trial. JAMA Ophthalmology, v. 136, n. 2, p. 172-181, 1 fev. 2018a. DOI: https://doi.org/10.1001/jamaophthalmol.2017.6090

GAO, T. Y. et al. Optical treatment of amblyopia in older children and adults is essential prior to enrolment in a clinical trial. Ophthalmic and Physiological Optics, v. 38, n. 2, p. 129-143, mar. 2018b. DOI: https://doi.org/10.1111/opo.12437

HASHEMI, H. et al. Global and regional estimates of prevalence of amblyopia: a systematic review and meta-analysis. Strabismus, v. 26, n. 4, p. 168-183, 30 jul. 2018. DOI: https://doi.org/10.1080/09273972.2018.1500618

HOLMES, J.; LEVI, D. Treatment of amblyopia as a function of age. Visual Neuroscience, v. 35, e015, 2018. DOI: https://doi.org/10.1017/S0952523817000220

HOLMES, J. M. et al. A randomized trial of binocular Dig Rush game treatment for amblyopia in children aged 7 to 12 years. Ophthalmology, v. 126, n. 3, p. 456-466, mar. 2019. DOI: https://doi.org/10.1016/j.ophtha.2018.10.032

HUANG, A. S. et al. Ophthalmology and social media: an in-depth investigation of ophthalmologic content on Instagram. Clinical Ophthalmology, v. 16, p. 685-694, 8 mar. 2022. DOI: https://doi.org/10.2147/OPTH.S353417

KÄMPF, U. et al. Visual acuity increase in meridional amblyopia by exercises with moving gratings as compared to stationary gratings. Strabismus, v. 30, n. 2, p. 99-110, 2022. DOI: https://doi.org/10.1080/09273972.2022.2062007

KAUR, S. et al. Comprehensive review of amblyopia: types and management. Indian Journal of Ophthalmology, v. 71, p. 2677-2686, jul. 2023. DOI: https://doi.org/10.4103/IJO.IJO_338_23

LAGAS, A. K. et al. The effect of combined patching and citalopram on visual acuity in adults with amblyopia: a randomized, crossover, placebo-controlled trial. Neural Plasticity, v. 2019, p. 1-10, 9 jun. 2019. DOI: https://doi.org/10.1155/2019/5857243

LEE, Y. H. et al. Short-term perceptual learning game does not improve patching-resistant amblyopia in older children. Journal of Pediatric Ophthalmology and Strabismus, v. 57, n. 3, p. 176-184, maio 2020. DOI: https://doi.org/10.3928/01913913-20200306-01

LEVI, D. M. Rethinking amblyopia 2020. Vision Research, v. 176, p. 118-129, 2020. DOI: https://doi.org/10.1016/j.visres.2020.07.014

LI, L. et al. Comparison of compliance among patients with pediatric amblyopia undergoing virtual reality-based and traditional patching method training. Frontiers in Public Health, v. 10, p. 1037412, 2022. DOI: https://doi.org/10.3389/fpubh.2022.1037412

LI, Y. et al. Efficacy of interventions for amblyopia: a systematic review and network meta-analysis. BMC Ophthalmology, v. 20, n. 203, 25 maio 2020. DOI: https://doi.org/10.1186/s12886-020-01442-9

LIANG, J. et al. Efficacy of binocular vision training and Fresnel press-on prism on children with esotropia and amblyopia. International Ophthalmology, v. 43, n. 2, p. 583-588, 2023. DOI: https://doi.org/10.1007/s10792-022-02461-9

LOCKWOOD, C.; MUNN, Z.; PORRITT, K. Qualitative research synthesis: methodological guidance for systematic reviewers utilizing meta-aggregation. International Journal of Evidence-Based Healthcare, v. 13, n. 3, p. 179-187, 2015. DOI: https://doi.org/10.1097/XEB.0000000000000062

ORÉFICE, N. L. Treatment of amblyopia in children over 7 years of age. Revista Brasileira de Oftalmologia, v. 51, p. 387-390, dez. 1992.

OSBORNE, D. C. et al. Atropine penalization versus occlusion therapies for unilateral amblyopia after the critical period of visual development: a systematic review. Ophthalmology and Therapy, v. 7, n. 2, p. 323-332, 2018. DOI: https://doi.org/10.1007/s40123-018-0151-9

PAGE, M. J. et al. PRISMA Declaration 2020: an updated guide for the publication of systematic reviews. Revista Española de Cardiología, v. 74, n. 9, p. 790-799, 2021.

PARK, S. H. Current management of childhood amblyopia. Korean Journal of Ophthalmology, v. 33, n. 6, p. 557-568, dez. 2019. DOI: https://doi.org/10.3341/kjo.2019.0061

QUOC, E. B. et al. Amblyopia: a review of unmet needs, current treatment options, and emerging therapies. Survey of Ophthalmology, v. 68, n. 3, p. 507-525, maio/jun. 2023. DOI: https://doi.org/10.1016/j.survophthal.2023.01.001

REPKA, M. X. Amblyopia outcomes through clinical trials and practice measurement: room for improvement: the LXXVII Edward Jackson Memorial Lecture. American Journal of Ophthalmology, v. 219, p. A1-A26, nov. 2020. DOI: https://doi.org/10.1016/j.ajo.2020.07.053

ROY, S. et al. Comparison of dichoptic therapy versus occlusion therapy in children with anisometropic amblyopia: a prospective randomized study. Journal of Pediatric Ophthalmology and Strabismus, v. 60, n. 3, p. 210-217, maio 2023. DOI: https://doi.org/10.3928/01913913-20220627-02

SEN, S.; SINGH, P.; SAXENA, R. Management of amblyopia in pediatric patients: current insights. Eye (London), v. 36, n. 1, p. 44-56, jan. 2022. DOI: https://doi.org/10.1038/s41433-021-01669-w

SHARIF, M. H. et al. Oral fluoxetine in the management of amblyopic patients aged between 10 and 40 years old: a randomized clinical trial. Eye, v. 33, n. 7, p. 1060-1067, 19 fev. 2019. DOI: https://doi.org/10.1038/s41433-019-0360-z

SOUZA, M. T.; SILVA, M. D.; CARVALHO, R. Integrative review: what it is and how to do it. Einstein (São Paulo), v. 8, p. 102-106, 2010. DOI: https://doi.org/10.1590/s1679-45082010rw1134

STREETON, R.; COOKE, M.; CAMPBELL, J. Researching the researchers: using a snowballing technique. Nurse Researcher, v. 12, n. 1, p. 35-47, 2004. ISSN 1351-5578. DOI: https://doi.org/10.7748/nr2004.07.12.1.35.c5929

TAILOR, V. et al. Binocular versus standard occlusion or blurring treatment for unilateral amblyopia in children aged three to eight years. Cochrane Database of Systematic Reviews, v. 2022, n. 2, CD011347, fev. 2022. DOI: https://doi.org/10.1002/14651858.CD011347.pub3

TEJEDOR, J.; GUTIÉRREZ-CARMONA, F. J. Bifocal use in hyperopic anisometropic amblyopia treated with atropine: a proof-of-concept randomized trial. Eye, v. 37, n. 9, p. 1840-1843, 20 set. 2022. DOI: https://doi.org/10.1038/s41433-022-02247-4

TORONTO, C. E.; REMINGTON, R. (ed.). A step-by-step guide to conducting an integrative review. Cham: Springer International Publishing, 2020. DOI: https://doi.org/10.1007/978-3-030-37504-1

VAGGE, A.; FERRO DESIDERI, L.; TRAVERSO, C. E. An update on pharmacological treatment options for amblyopia. International Ophthalmology, v. 40, n. 12, p. 3591-3597, dez. 2020. DOI: https://doi.org/10.1007/s10792-020-01535-w

WANG, S. et al. Effect of combined atropine and patching vs patching alone for treatment of severe amblyopia in children aged 3 to 12 years: a randomized clinical trial. JAMA Ophthalmology, v. 139, n. 9, p. 990-996, 1 set. 2021. DOI: https://doi.org/10.1001/jamaophthalmol.2021.2413

ZAGUI, R. Amblyopia: literature review, definition, advances and treatment. eOftalmo, [s. l.], v. 5, n. 3, 2019. DOI: https://doi.org/10.17545/eOftalmo/2019.0020

ZHU, Q. et al. Effectiveness of binocular therapy as a complementary treatment of part-time patching in older amblyopic children: a randomized clinical trial. International Ophthalmology, v. 43, n. 7, p. 2433-2445, 6 mar. 2023. DOI: https://doi.org/10.1007/s10792-023-02642-0

Published

2025-10-15

Issue

Section

Articles

How to Cite

DE SOUZA, Ueverton Barbosa; RODRIGUES, Rodrigo Gabriel Valverde; MACHADO, Eva Ida Reis Leite; QUEIROZ, Laura Carrijo Martins Dias; GOMES, Anna Carolina de Melo; BORGES, João Pedro Arantes; FORÉ, Wilson; SILVA, Julio Cesar Souza. THERAPEUTIC PERSPECTIVES ON THE EFFECTIVENESS OF AMBLYOPIA TREATMENT IN DIFFERENT AGE GROUPS: INTEGRATIVE LITERATURE REVIEW. ARACÊ , [S. l.], v. 7, n. 10, p. e8932, 2025. DOI: 10.56238/arev7n10-134. Disponível em: https://periodicos.newsciencepubl.com/arace/article/view/8932. Acesso em: 5 dec. 2025.