Patching vs atropine to treat amblyopia in children aged 7 to 12 years: a randomized trial.

Abstract

OBJECTIVE:

To compare patching with atropine eyedrops in the treatment of moderate amblyopia (visual acuity, 20/40-20/100) in children aged 7 to 12 years.

METHODS:

In a randomized, multicenter clinical trial, 193 children with amblyopia were assigned to receive weekend atropine or patching of the sound eye 2 hours per day. Main Outcome Measure Masked assessment of visual acuity in the amblyopic eye using the electronic Early Treatment Diabetic Retinopathy Study testing protocol at 17 weeks.

RESULTS:

At 17 weeks, visual acuity had improved from baseline by an average of 7.6 letters in the atropine group and 8.6 letters in the patching group. The mean difference between groups (patching - atropine) adjusted for baseline acuity was 1.2 letters (ends of complementary 1-sided 95% confidence intervals for noninferiority, -0.7, 3.1 letters). This difference met the prespecified definition for equivalence (confidence interval <5 letters). Visual acuity in the amblyopic eye was 20/25 or better in 15 participants in the atropine group (17%) and 20 in the patching group (24%; difference, 7%; 95% confidence interval, -3% to 17%).

CONCLUSIONS:

Treatment with atropine or patching led to similar degrees of improvement among 7- to 12-year-olds with moderate amblyopia. About 1 in 5 achieved visual acuity of 20/25 or better in the amblyopic eye.

CLINICAL RELEVANCE:

Atropine and patching achieve similar results among older children with unilateral amblyopia.

TRIAL REGISTRATION:

(clinicaltrials.gov) Identifier: NCT00315328.

• Authors: Mitchell M Scheiman, Richard W Hertle, Raymond T Kraker, Roy W Beck, Eileen E Birch, Joost Felius, Jonathan M Holmes, James Kundart, David G Morrison, Michael X Repka, Susanna M Tamkins, Pediatric Eye Disease Investigator Group
• Journal: Archives of ophthalmology (Chicago, Ill. : 1960) (Arch Ophthalmol) Vol. 126 Issue 12 Pg. 1634-42 (Dec 2008) ISSN: 1538-3601 [Electronic] United States
• PMID: 19064841 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Mydriatics
• Ophthalmic Solutions
• Atropine

Topics

• Amblyopia (drug therapy, physiopathology, therapy)
• Atropine (therapeutic use)
• Child
• Female
• Humans
• Male
• Mydriatics (therapeutic use)
• Ophthalmic Solutions (therapeutic use)
• Sensory Deprivation
• Treatment Outcome
• Vision, Binocular (physiology)
• Visual Acuity (physiology)