A randomized trial of adding a plano lens to atropine for amblyopia.

Abstract

BACKGROUND:

Some children have residual amblyopia after treatment with atropine eyedrops for amblyopia due to strabismus and/or anisometropia. We conducted a randomized clinical trial to evaluate the effectiveness of augmenting the effect of atropine by changing the lens over the fellow eye to plano in children with residual amblyopia.

METHODS:

A total of 73 children 3 to <8 years of age (mean, 5.8 years) with stable residual amblyopia (range, 20/32 to 20/160, mean 20/63(+1)) were enrolled after at least 12 weeks of atropine treatment of the fellow eye. Participants were randomly assigned to continuing weekend atropine alone or wearing a plano lens over the fellow eye (while continuing atropine). The primary outcome was assessed at 10 weeks, and participants were followed until improvement ceased.

RESULTS:

At the 10-week primary outcome visit, amblyopic-eye visual acuity had improved an average of 1.1 lines with the plano lens and 0.6 lines with atropine only (difference adjusted for baseline visual acuity = + 0.5 line; 95% CI, -0.1 to +1.2). At the primary outcome or later visit when the best-measured visual acuity was observed, the mean amblyopic-eye improvement from baseline was 1.9 lines with the plano lens and 0.8 lines with atropine only.

CONCLUSIONS:

When amblyopic-eye visual acuity stops improving with atropine treatment, there may be a small benefit to augmenting atropine therapy with a plano lens over the fellow eye. However, the effect was not statistically significant, and the large confidence interval raises the possibility of no benefit or a benefit larger than we observed. A larger study would be necessary to get a more precise estimate of the treatment effect.

• Authors: Pediatric Eye Disease Investigator Group, David K Wallace, Elizabeth L Lazar, Michael X Repka, Jonathan M Holmes, Raymond T Kraker, Darren L Hoover, Katherine K Weise, Amy L Waters, Melissa L Rice, Robert J Peters
• Journal: Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus (J AAPOS) Vol. 19 Issue 1 Pg. 42-8 (Feb 2015) ISSN: 1528-3933 [Electronic] United States
• PMID: 25727586 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2015 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Chemical References

• Mydriatics
• Ophthalmic Solutions
• Atropine

Topics

• Amblyopia (etiology, therapy)
• Anisometropia (complications)
• Atropine (therapeutic use)
• Child
• Child, Preschool
• Combined Modality Therapy
• Eyeglasses
• Female
• Humans
• Male
• Mydriatics (therapeutic use)
• Ophthalmic Solutions
• Strabismus (complications)
• Visual Acuity (physiology)