title: The effect on refractive error of unilateral atropine as compared with patching for the treatment of amblyopia.
abstract: Our objective was to determine whether the use of unilateral atropine as amblyopia therapy leads to an asymmetric change in refractive error compared with patching. Patients were enrolled in a clinical trial in which atropine 1% solution or occlusion with an adhesive patch was administered daily to the sound eye of children 3 to less than 7 years of age for a period of at least 6 months to a maximum of 2 years. Refractive error at entry and at 2 years was determined with cycloplegic retinoscopy for 282 of 419 patients enrolled. The baseline mean refractive error was + 3.13 diopters (D) in patients assigned randomly to receive atropine and + 2.58 D in patients assigned randomly to wear the patch. The mean change in refractive error of the sound eye was + 0.10 D in the atropine group (N = 134) and + 0.08 D in the patch group (N = 148). Patients also were subdivided into those treated with atropine only (n = 41) and patching only (n = 64) because some children changed treatments during their study participation. The mean change for the sound eyes was -0.21 D for the patients receiving only atropine and -0.06 D for the patients receiving only patching. Unilateral atropine applied to the sound eye compared with occlusion was not associated with any adverse effect on refractive error following up to 2 years of treatment.
authors.affiliation: Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. mrepka@jhmi.edu <mrepka@jhmi.edu>
authors.forename: Michael X
authors.initials: MX
authors.lastname: Repka
authors.forename: Michele
authors.initials: M
authors.lastname: Melia
authors.forename: Maya
authors.initials: M
authors.lastname: Eibschitz-Tsimhoni
authors.forename: Richard
authors.initials: R
authors.lastname: London
authors.forename: Elbert
authors.initials: E
authors.lastname: Magoon
mesh_terms: D000550:Amblyopia / Q000503:physiopathology / Q000628:therapy*; D001285:Atropine / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D008027:Light; D009184:Mydriatics / Q000627:therapeutic use*; D012029:Refraction, Ocular; D012030:Refractive Errors / Q000503:physiopathology*; D012683:Sensory Deprivation
chemical_list: D009184:Mydriatics; D001285:Atropine