Long-term follow-up of L-dopa treatment in children with amblyopia.
OBJECTIVE
To assess regression of visual acuity in children who previously participated in three longitudinal studies of therapy with levodopa-carbidopa (L-dopa) plus occlusion for amblyopia.


METHODS
Thirty (91%) of 33 subjects contacted who participated in three similar 7-week, longitudinal dosing studies returned for follow-up. The three previous studies were undertaken approximately 27 (study 1), 21 (study 2), and 9 (study 3) months prior to this follow-up test session. All subjects received L-dopa for 7 weeks combined with part-time occlusion of the dominant eye after the termination of standard, occlusion only, therapy. Some subjects in study 2 received L-dopa without occlusion. Sixteen subjects with amblyopia who received occlusion only served as a control group.


RESULTS
Subjects who received L-dopa plus occlusion demonstrated significant, but similar, amounts of regression of visual acuity from the end of their respective L-dopa studies to the follow-up test session. Subjects in study 1 regressed 1.3 lines, subjects in study 2 regressed 1.5 lines, and subjects in study 3 regressed 1.4 lines. The control group regressed, on average, 1.1 lines. This was similar to the overall regression found in the groups receiving L-dopa plus occlusion. Subjects in study 2 who received L-dopa without occlusion regressed 2.1 lines, significantly more than the occlusion only group or the L-dopa plus occlusion group.


CONCLUSIONS
Children with amblyopia show similar amounts of regression of visual acuity after therapy with L-dopa plus occlusion and after therapy with occlusion only. Given that therapy with L-dopa plus occlusion initially improved visual acuity by approximately 1.7 lines following the termination of standard therapy, L-dopa plus occlusion may reset baseline visual acuity and lead to long-term improvement in visual acuity after recidivism.
Leguire
Lawrence E
LE
Department of Ophthalmology, Children's Hospital, Columbus, Ohio 43205-2696, USA.
Komaromy
Kelly L
KL
Nairus
Theresa M
TM
Rogers
Gary L
GL
D000550:Amblyopia / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D002230:Carbidopa / Q000627:therapeutic use*; D002648:Child; D015259:Dopamine Agents / Q000627:therapeutic use*; D004338:Drug Combinations; D005500:Follow-Up Studies; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D009779:Occlusive Dressings; D016896:Treatment Outcome; D014792:Visual Acuity
D015259:Dopamine Agents; D004338:Drug Combinations; D007980:Levodopa; D002230:Carbidopa