Treatment of severe amblyopia with weekend atropine: results from 2 randomized clinical trials.

Abstract

PURPOSE:

To determine the effectiveness of weekend atropine for severe amblyopia from strabismus, anisometropia, or both combined among children 3 to 12 years of age.

METHODS:

We enrolled children into 2 prospective, randomized multicenter clinical trials of amblyopia therapy. Herein we report the results for severe amblyopia, 20/125 to 20/400. In Trial 1, 60 children 3 to 6 years of age (mean, 4.4 years) were randomized to weekend atropine plus a plano lens or weekend atropine plus full spectacle correction for the sound eye. In Trial 2, 40 children 7 to 12 years of age (mean, 9.3 years) were randomized to weekend atropine or 2 hours of daily patching. The visual acuity outcome was assessed at 18 weeks in Trial 1 and 17 weeks in Trial 2.

RESULTS:

In Trial 1, visual acuity improved by an average of 4.5 lines in the atropine plus correction group (95% CI, 3.2-5.8 lines) and 5.1 lines in the atropine plus plano lens group (95% CI, 3.7-6.4 lines). In Trial 2, visual acuity improved by an average of 1.5 lines in the atropine group (95% CI, 0.5-2.5 lines) and 1.8 lines in the patching group (95% CI, 1.1-2.6 lines).

CONCLUSIONS:

Weekend atropine can improve visual acuity in children 3 to 12 years of age with severe amblyopia. Improvement may be greater in younger children.

• Authors: Michael X Repka, Raymond T Kraker, Roy W Beck, Eileen Birch, Susan A Cotter, Jonathan M Holmes, Richard W Hertle, Darren L Hoover, Deborah L Klimek, Wendy Marsh-Tootle, Mitchell M Scheiman, Donny W Suh, David R Weakley, Pediatric Eye Disease Investigator Group
• Journal: Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus (J AAPOS) Vol. 13 Issue 3 Pg. 258-63 (Jun 2009) ISSN: 1528-3933 [Electronic] United States
• PMID: 19541265 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural)

Chemical References

• Ophthalmic Solutions
• Parasympatholytics
• Atropine

Topics

• Adolescent
• Amblyopia (drug therapy)
• Atropine (administration & dosage)
• Bandages
• Child
• Child, Preschool
• Drug Administration Schedule
• Female
• Humans
• Male
• Ophthalmic Solutions (administration & dosage)
• Parasympatholytics (administration & dosage)
• Pilot Projects
• Prospective Studies
• Severity of Illness Index
• Strabismus (complications)
• Treatment Outcome
• Visual Acuity (drug effects)