The need for consolidation therapy after amblyopia cure

  Amblyopia is one of the common eye diseases in children, which seriously affects the normal development of children’s visual function. The prevalence of amblyopia in children in China is 2.43%. The main causes are refractive error and strabismus, followed by refractive aberration and form deprivation. According to statistics, there are 10 million amblyopic children among more than 300 million children in China, and the prevalence is gradually increasing; therefore, early detection and early treatment are crucial to the prognosis of amblyopia.  The most commonly used and classical treatment for amblyopia in the past pointed out that amblyopia treatment has two basic principles: one is to make the refractive interstitial transparency on the visual axis, correct refractive error, and make the object image on the retina of the amblyopic eye clear; the second is to use masking therapy and suppression therapy to temporarily restrict the input of information from the healthy eye to the cortex and expand the processing of information input from the cortex to the amblyopic eye. The goal of the treatments is the equal quantification of visual input in both eyes, or normalization of the type of gaze, and to induce the development of the brain and visual pathways to achieve equal visual acuity in both eyes. However, they are not effective in all cases of amblyopia. With the increasing research on perceptual learning in recent years, the clinical significance of perceptual learning in amblyopia treatment has received more and more attention and has become a new approach for effective treatment of amblyopia. Unlike traditional amblyopia treatments, perceptual learning is an active and participatory process. Perceptual learning may have better compliance in amblyopia treatment.  Due to the unique nature of amblyopia, the longer treatment time becomes one of the challenges that parents and children need to overcome. Patient and parent compliance is a key factor in the treatment of amblyopia, and many treatment failures and failures to consolidate are closely related to this. Many studies have shown that the chance of regression of normal vision at the end of treatment is high and that the causes of relapse are multiple. Therefore, consolidation and improvement of the long-term and even lifelong cure rate is a difficult task in amblyopia treatment. Studies have shown that the type of amblyopia is an important factor in the regression of visual acuity after amblyopia treatment. Refractive error amblyopia has a good outcome and a low regression rate. The more severe the amblyopia, the higher the regression rate, with the regression rate of severe amblyopia being as high as 83.3% after stopping treatment.  Therefore, foreign countries advocate that amblyopia patients should also be observed with a 5-year cure rate like tumor patients. In China, Liu Jiaqi proposed that the follow-up observation of amblyopia cure should be 3 years. After successful amblyopia treatment, the monitoring of amblyopic patients, especially those with strabismic amblyopia and severe amblyopia before treatment, should still be paid attention to, and amblyopia treatment should be resumed to consolidate the efficacy once visual acuity regression occurs. It is generally recommended to continue consolidation therapy for six months-1.5 years after normal amblyopia treatment, with an average of 1 year. This largely reduces the regression of visual acuity.