Two-year follow-up of a 6-month randomized trial of atropine vs patching for treatment of moderate amblyopia in children.
OBJECTIVE
To compare patching and atropine sulfate as treatments for moderate amblyopia in children 18 months after completion of a 6-month randomized trial.


METHODS
In a randomized, multicenter (47 sites) clinical trial, 419 children younger than 7 years with amblyopia (20/40 to 20/100 in the affected eye) were assigned to receive either patching or atropine eye drops for 6 months. Between 6 months and 2 years, treatment was at the discretion of the investigator. Main Outcome Measure Visual acuity in the amblyopic eye and sound eye after 2 years.


RESULTS
At 2 years, visual acuity in the amblyopic eye improved from baseline a mean of 3.7 lines in the patching group and 3.6 lines in the atropine group. The difference in visual acuity between treatment groups was small: 0.01 logMAR (95% confidence interval, -0.02 to 0.04). In both treatment groups, the mean amblyopic eye acuity was approximately 20/32, 1.8 lines worse than the mean sound eye acuity, which was approximately 20/20.


CONCLUSIONS
Atropine or patching for 6 months followed by best clinical care until 2 years produced similar improvement of moderate amblyopia in children between 3 and 7 years of age at enrollment. However, on average the amblyopic eye acuity was still approximately 2 lines worse than the sound eye.
Repka
Michael X
MX
Jaeb Center for Health Research, Tampa, FL 33647, USA. pedig@jaeb.org
Wallace
David K
DK
Beck
Roy W
RW
Kraker
Raymond T
RT
Birch
Eileen E
EE
Cotter
Susan A
SA
Donahue
Sean
S
Everett
Donald F
DF
Hertle
Richard W
RW
Holmes
Jonathan M
JM
Quinn
Graham E
GE
Scheiman
Mitchell M
MM
Weakley
David R
DR
D000550:Amblyopia / Q000503:physiopathology / Q000628:therapy*; D001285:Atropine / Q000627:therapeutic use*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009184:Mydriatics / Q000627:therapeutic use*; D009883:Ophthalmic Solutions; D012683:Sensory Deprivation; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology
D009184:Mydriatics; D009883:Ophthalmic Solutions; D001285:Atropine