Treatment of severe amblyopia with weekend atropine: results from 2 randomized clinical trials.
OBJECTIVE
To determine the effectiveness of weekend atropine for severe amblyopia from strabismus, anisometropia, or both combined among children 3 to 12 years of age.


METHODS
We enrolled children into 2 prospective, randomized multicenter clinical trials of amblyopia therapy. Herein we report the results for severe amblyopia, 20/125 to 20/400. In Trial 1, 60 children 3 to 6 years of age (mean, 4.4 years) were randomized to weekend atropine plus a plano lens or weekend atropine plus full spectacle correction for the sound eye. In Trial 2, 40 children 7 to 12 years of age (mean, 9.3 years) were randomized to weekend atropine or 2 hours of daily patching. The visual acuity outcome was assessed at 18 weeks in Trial 1 and 17 weeks in Trial 2.


RESULTS
In Trial 1, visual acuity improved by an average of 4.5 lines in the atropine plus correction group (95% CI, 3.2-5.8 lines) and 5.1 lines in the atropine plus plano lens group (95% CI, 3.7-6.4 lines). In Trial 2, visual acuity improved by an average of 1.5 lines in the atropine group (95% CI, 0.5-2.5 lines) and 1.8 lines in the patching group (95% CI, 1.1-2.6 lines).


CONCLUSIONS
Weekend atropine can improve visual acuity in children 3 to 12 years of age with severe amblyopia. Improvement may be greater in younger children.
Repka
Michael X
MX
Wilmer Ophthalmological Institute, Johns Hopkins University, Baltimore, Maryland, USA. pedig@jaeb.org
Kraker
Raymond T
RT
Beck
Roy W
RW
Birch
Eileen
E
Cotter
Susan A
SA
Holmes
Jonathan M
JM
Hertle
Richard W
RW
Hoover
Darren L
DL
Klimek
Deborah L
DL
Marsh-Tootle
Wendy
W
Scheiman
Mitchell M
MM
Suh
Donny W
DW
Weakley
David R
DR
D000293:Adolescent; D000550:Amblyopia / Q000188:drug therapy*; D001285:Atropine / Q000008:administration & dosage*; D001458:Bandages; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D010276:Parasympatholytics / Q000008:administration & dosage*; D010865:Pilot Projects; D011446:Prospective Studies; D012720:Severity of Illness Index; D013285:Strabismus / Q000150:complications; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects*
D009883:Ophthalmic Solutions; D010276:Parasympatholytics; D001285:Atropine