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Authors
Pediatric Eye Disease Investigator Group; Michael X Repka, Raymond T Kraker, Roy W Beck, Jonathan M Holmes, Susan A Cotter, Eileen E Birch, William F Astle, Danielle L Chandler, Joost Felius, Robert W Arnold, D Robbins Tien, Stephen R Glaser

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

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Abstract/Introduction

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.


Conclusion/Results

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.


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Peter G.

Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!


Kinkie F.

I have always found Dr Kavner's work, expertise and wisdom of the highest caliber. As one of the fathers of OT, occupational othomology, his depth and breadth of knowledge about the eyes' health and wellbeing of the patient is exemplary. Cannot say enough good things about him.


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