“Compliance and patching and atropine amblyopia treatments” – Reply to Letter to the Editor

''Compliance and patching and atropine amblyopia treatments " – Reply to Letter to the Editor Dear Editor, I would like to thank Drs. Loudon, Tjiam, and Simonsz for their constructive criticism of my review article entitled ''Compliance and patching and atropine amblyopia treatments " (Wang, 2015). As noted in their letter, several summary conclusions in this review article that were derived from their compliance studies need to be clarified. First, I classified individual components of intervention programs as ''for children " or ''for parents " in an attempt to summarize interventions that are currently used in prospective studies of patching therapy compliance. I did not intend to imply that the previous studies performed by the used only one type of intervention. In the earlier investigation, the intervention group received all three components: an ''educational cartoon story " and ''rewarding stickers " for children as well as an ''information-leaflet " for parents (Loudon et al., 2006). Using occlusion dose monitors, compliance monitoring was implemented for a one-week period during each three months of the treatment period. Later, Tjiam et al. (2013, 2012) reexamined the impact of each of the three separate components to enhance compliance. In their 2012 study, they examined the efficacy of the Educational Cartoon alone for an extended time, and found that the increase in mean compliance rates from 52% to 62.3% was not statistically significant (see Abstract) (Tjiam et al., 2012). Their follow-up study in 2013 showed a highly significant improvement in compliance for the Cartoon-only group although ''Compliance was measured over a 1-week period " (see Method); in Page 327, they explained ''compliance measurements obtained over only 1 week in the first 3 months of the occlusion therapy best represented actual compliance " (Tjiam et al., 2013). While I appreciate their viewpoint, I also agree with their earlier study (Loudon et al., 2006) and another study which have shown that compliance during the first week of treatment may overestimate the dynamic compliance over treatment period. Therefore, I was careful in my review to state that the Educational Cartoon-only impact on compliance is only known for the 1-week treatment. Additionally, I wanted to showcase the dosage equation reported by this experienced group from The Hague (my review section 3.2). I reported this as a general example to emphasize the factors of age and visual acuity when determining dosage. I did not intend to present the formula for …