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Arch Ophthalmol. 2008 Aug;126(8):1039-44. doi: 10.1001/archopht.126.8.1039.

A randomized trial of atropine vs patching for treatment of moderate amblyopia: follow-up at age 10 years.

Collaborators (171)

Sala NA, Hodde RM, Glaser SR, Luck JA, Glaser PE, Mason JE, Sirk KA, Tien DR, McGuinness MB, Christ HC, Toro BG, Arnold RW, Armitage MD, Astle WF, Ells AL, Peddie HJ, Ingram AD, Gillis CD, Hayduk CR, Kerr CI, Repka MX, Christoff AX, Goodman CR, Liu X, Cotter SA, Barnhardt CN, Chu RH, Nguyen MM, Shin SM, Parker S, Stager DR Sr, Berry PM, Alters MK, Felius J, Perez AB, Paysse EA, Coats DK, Kivlin JD, Ruttum MS, Picard VR, Holmes JM, Sease JM, Nielsen RA, Holmquist JA, Kroening RM, Levisen ML, Priebe DM, Spitzer JA, Levada AJ, Walker TL, Schleif C, Marcil LA, Rannazzisi NG, Rutstein RP, Marsh-Tootle WL, Baldwin CH, Droste PJ, Peters RJ, Hilbrands J, Rogers SK, Summers CG, Christiansen SP, Holleschau AM, Downes SJ, Hogue KM, Lavoie JD, Merrill KS, Donahue S, Kinder KM, Franklin CC, Owings SA, Biernacki R, Fukuda N, Wheeler DT, Beaudet KA, Rauch PK, Cruz OA, Davitt BV, Miyazaki EA, Keech RV, Olson RJ, Scott WE, Pfeifer WI, Ruben JB, Desai D, Parrish SA, Whitfill CR, Johnson DA, Kulp MT, Dallas FD, Weakley DR Jr, Dias CL, Silbert DI, Matta NS, Keene AB, Lindsey MM, Crouch ER Jr, Ventura GG, Ruark KD, Beck RW, Becker BD, Boyle NM, Cagnina-Morales CM, Cagnina D, Chandler DL, Clark LE, Constantine SR, Donahue Q, Drew MD, Dupre M, Horsley KL, Gillespie HA, Kraker RT, Lee SV, Lester LA, Mares ST, Melia BM, Moke PS, Pyner JL, Reese NT, Strayer HJ, Everett DF, Beck RW, Birch EE, Christiansen SP, Cotter SA, Donahue SP, Everett DF, Holmes JM, Hoover DL, Huston PA, Kraker RT, Repka MX, Sala NA, Scheiman MM, Wallace DK, Beck RW, Birch EE, Cotter SA, Donahue SP, Everett DF, Edwards AR, Glaser SR, Hertle RW, Hill MP, Hodde RM, Holmes JM, Huston PA, Klimek DL, Lyon DW, Matta NS, Mohney BG, Moke PS, Quinn GE, Repka MX, Rutstein RP, Sala NA, Scheiman MM, Wallace DK, Weakley DR Jr, Barlow W, Buckley EG, Davis B, Diener-West MD, Dobson V, Keltner JL, Osman H, Palmer EA, Phelps DL, Poff SW, Saunders RA.

Abstract

OBJECTIVE:

To determine the visual acuity outcome at age 10 years for children younger than 7 years when enrolled in a treatment trial for moderate amblyopia.

METHODS:

In a multicenter clinical trial, 419 children with amblyopia (visual acuity, 20/40-20/100) were randomized to patching or atropine eyedrops for 6 months. Two years after enrollment, a subgroup of 188 children entered long-term follow-up. Treatment after 6 months was at the discretion of the investigator; 89% of children were treated.

MAIN OUTCOME MEASURE:

Visual acuity at age 10 years with the electronic Early Treatment Diabetic Retinopathy Study test.

APPLICATION TO CLINICAL PRACTICE:

Patching and atropine eyedrops produce comparable improvement in visual acuity that is maintained through age 10 years.

RESULTS:

The mean amblyopic eye acuity, measured in 169 patients, at age 10 years was 0.17 logMAR (logarithm of the minimum angle of resolution) (approximately 20/32), and 46% of amblyopic eyes had an acuity of 20/25 or better. Age younger than 5 years at entry into the randomized trial was associated with a better visual acuity outcome (P < .001). Mean amblyopic and sound eye visual acuities at age 10 years were similar in the original treatment groups (P = .56 and P = .80, respectively).

CONCLUSIONS:

At age 10 years, the improvement of the amblyopic eye is maintained, although residual amblyopia is common after treatment initiated at age 3 years to younger than 7 years. The outcome is similar regardless of initial treatment with atropine or patching.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00000170.

Comment in

PMID:
18695096
PMCID:
PMC2614351
DOI:
10.1001/archopht.126.8.1039
[Indexed for MEDLINE]
Free PMC Article

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