A randomized trial of atropine vs. patching for treatment of moderate amblyopia in children.
OBJECTIVE
To compare patching and atropine as treatments for moderate amblyopia in children younger than 7 years.


METHODS
In a randomized clinical trial, 419 children younger than 7 years with amblyopia and visual acuity in the range of 20/40 to 20/100 were assigned to receive either patching or atropine at 47 clinical sites.


METHODS
Visual acuity in the amblyopic eye and sound eye after 6 months.


RESULTS
Visual acuity in the amblyopic eye improved in both groups (improvement from baseline to 6 months was 3.16 lines in the patching group and 2.84 lines in the atropine group). Improvement was initially faster in the patching group, but after 6 months, the difference in visual acuity between treatment groups was small and clinically inconsequential (mean difference at 6 months, 0.034 logMAR units; 95% confidence interval, 0.005-0.064 logMAR units). The 6-month acuity was 20/30 or better in the amblyopic eye and/or improved from baseline by 3 or more lines in 79% of the patching group and 74% of the atropine group. Both treatments were well tolerated, although atropine had a slightly higher degree of acceptability on a parental questionnaire. More patients in the atropine group than in the patching group had reduced acuity in the sound eye at 6 months, but this did not persist with further follow-up.


CONCLUSIONS
Atropine and patching produce improvement of similar magnitude, and both are appropriate modalities for the initial treatment of moderate amblyopia in children aged 3 to less than 7 years.
D000550:Amblyopia / Q000628:therapy*; D001285:Atropine / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009184:Mydriatics / Q000627:therapeutic use*; D009883:Ophthalmic Solutions; D010349:Patient Compliance; D012683:Sensory Deprivation; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
D009184:Mydriatics; D009883:Ophthalmic Solutions; D001285:Atropine