A randomized trial of atropine vs patching for treatment of moderate amblyopia: follow-up at age 10 years.

Abstract

OBJECTIVE:

To determine the visual acuity outcome at age 10 years for children younger than 7 years when enrolled in a treatment trial for moderate amblyopia.

METHODS:

In a multicenter clinical trial, 419 children with amblyopia (visual acuity, 20/40-20/100) were randomized to patching or atropine eyedrops for 6 months. Two years after enrollment, a subgroup of 188 children entered long-term follow-up. Treatment after 6 months was at the discretion of the investigator; 89% of children were treated.

MAIN OUTCOME MEASURE:

Visual acuity at age 10 years with the electronic Early Treatment Diabetic Retinopathy Study test.

APPLICATION TO CLINICAL PRACTICE:

Patching and atropine eyedrops produce comparable improvement in visual acuity that is maintained through age 10 years.

RESULTS:

The mean amblyopic eye acuity, measured in 169 patients, at age 10 years was 0.17 logMAR (logarithm of the minimum angle of resolution) (approximately 20/32), and 46% of amblyopic eyes had an acuity of 20/25 or better. Age younger than 5 years at entry into the randomized trial was associated with a better visual acuity outcome (P < .001). Mean amblyopic and sound eye visual acuities at age 10 years were similar in the original treatment groups (P = .56 and P = .80, respectively).

CONCLUSIONS:

At age 10 years, the improvement of the amblyopic eye is maintained, although residual amblyopia is common after treatment initiated at age 3 years to younger than 7 years. The outcome is similar regardless of initial treatment with atropine or patching.

• Authors: Pediatric Eye Disease Investigator Group, Michael X Repka, Raymond T Kraker, Roy W Beck, Jonathan M Holmes, Susan A Cotter, Eileen E Birch, William F Astle, Danielle L Chandler, Joost Felius, Robert W Arnold, D Robbins Tien, Stephen R Glaser
• Journal: Archives of ophthalmology (Chicago, Ill. : 1960) (Arch Ophthalmol) Vol. 126 Issue 8 Pg. 1039-44 (Aug 2008) ISSN: 1538-3601 [Electronic] United States
• PMID: 18695096 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural)

Chemical References

• Mydriatics
• Atropine

Topics

• Amblyopia (physiopathology, therapy)
• Atropine (administration & dosage, therapeutic use)
• Child
• Child, Preschool
• Female
• Follow-Up Studies
• Humans
• Male
• Mydriatics (administration & dosage, therapeutic use)
• Refraction, Ocular (physiology)
• Sensory Deprivation
• Treatment Outcome
• Vision, Binocular (physiology)
• Visual Acuity (physiology)