Pharmacological plus optical penalization treatment for amblyopia

Results of a randomized trial

Susan A. Cotter, David R. Weakley, Samara F. Strauber, Roy W. Beck, Eileen E. Birch, Sean Donahue, Jonathan M. Holmes, Darren L. Hoover, Pamela A. Huston, B. Michele Melia, Michael X. Repka, David T. Wheeler

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Objective: To compare weekend atropine sulfate use augmented by a plano lens for the sound eye with weekend atropine use alone for moderate amblyopia in children aged 3 years to younger than 7 years. Methods: In a multicenter clinical trial, 180 children with moderate amblyopia (visual acuities of 20/40-20/100) were randomized to weekend atropine use augmented by a plano lens or weekend atropine use alone. Main Outcome Measure: Masked assessment of amblyopic eye visual acuity using the Amblyopia Treatment Study HOTV testing protocol at 18 weeks. Results: At 18 weeks, amblyopic eye improvement averaged 2.8 lines in the group that received atropine plus a plano lens and 2.4 lines in the group that received atropine alone (mean difference between groups adjusted for baseline acuity, 0.3 line; 95% confidence interval, -0.2 to 0.8 line). Amblyopic eye visual acuity was 20/25 or better in 24 patients (29%) in the group that received atropine only and 35 patients (40%) in the group that received atropine plus a plano lens (P=.03). More patients in the group that received atropine plus a plano lens had reduced sound eye visual acuity at 18 weeks; however, there were no cases of persistent reverse amblyopia. Conclusions: As an initial treatment for moderate amblyopia, the augmentation of weekend atropine use with a plano lens does not substantially improve amblyopic eye visual acuity when compared with weekend atropine use alone. Application to Clinical Practice: Treatment of children with unilateral amblyopia. Trial Registration: clinicaltrials.org Identifier: NCT00315302.

Original languageEnglish (US)
Pages (from-to)22-30
Number of pages9
JournalArchives of Ophthalmology
Volume127
Issue number1
DOIs
StatePublished - Jan 2009

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Amblyopia
Atropine
Pharmacology
Lenses
Visual Acuity
Therapeutics
Crystalline Lens
Multicenter Studies
Outcome Assessment (Health Care)
Clinical Trials
Confidence Intervals

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Pharmacological plus optical penalization treatment for amblyopia : Results of a randomized trial. / Cotter, Susan A.; Weakley, David R.; Strauber, Samara F.; Beck, Roy W.; Birch, Eileen E.; Donahue, Sean; Holmes, Jonathan M.; Hoover, Darren L.; Huston, Pamela A.; Melia, B. Michele; Repka, Michael X.; Wheeler, David T.

In: Archives of Ophthalmology, Vol. 127, No. 1, 01.2009, p. 22-30.

Research output: Contribution to journalArticle

Cotter, SA, Weakley, DR, Strauber, SF, Beck, RW, Birch, EE, Donahue, S, Holmes, JM, Hoover, DL, Huston, PA, Melia, BM, Repka, MX & Wheeler, DT 2009, 'Pharmacological plus optical penalization treatment for amblyopia: Results of a randomized trial', Archives of Ophthalmology, vol. 127, no. 1, pp. 22-30. https://doi.org/10.1001/archophthalmol.2008.520
Cotter, Susan A. ; Weakley, David R. ; Strauber, Samara F. ; Beck, Roy W. ; Birch, Eileen E. ; Donahue, Sean ; Holmes, Jonathan M. ; Hoover, Darren L. ; Huston, Pamela A. ; Melia, B. Michele ; Repka, Michael X. ; Wheeler, David T. / Pharmacological plus optical penalization treatment for amblyopia : Results of a randomized trial. In: Archives of Ophthalmology. 2009 ; Vol. 127, No. 1. pp. 22-30.
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abstract = "Objective: To compare weekend atropine sulfate use augmented by a plano lens for the sound eye with weekend atropine use alone for moderate amblyopia in children aged 3 years to younger than 7 years. Methods: In a multicenter clinical trial, 180 children with moderate amblyopia (visual acuities of 20/40-20/100) were randomized to weekend atropine use augmented by a plano lens or weekend atropine use alone. Main Outcome Measure: Masked assessment of amblyopic eye visual acuity using the Amblyopia Treatment Study HOTV testing protocol at 18 weeks. Results: At 18 weeks, amblyopic eye improvement averaged 2.8 lines in the group that received atropine plus a plano lens and 2.4 lines in the group that received atropine alone (mean difference between groups adjusted for baseline acuity, 0.3 line; 95{\%} confidence interval, -0.2 to 0.8 line). Amblyopic eye visual acuity was 20/25 or better in 24 patients (29{\%}) in the group that received atropine only and 35 patients (40{\%}) in the group that received atropine plus a plano lens (P=.03). More patients in the group that received atropine plus a plano lens had reduced sound eye visual acuity at 18 weeks; however, there were no cases of persistent reverse amblyopia. Conclusions: As an initial treatment for moderate amblyopia, the augmentation of weekend atropine use with a plano lens does not substantially improve amblyopic eye visual acuity when compared with weekend atropine use alone. Application to Clinical Practice: Treatment of children with unilateral amblyopia. Trial Registration: clinicaltrials.org Identifier: NCT00315302.",
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AU - Cotter, Susan A.

AU - Weakley, David R.

AU - Strauber, Samara F.

AU - Beck, Roy W.

AU - Birch, Eileen E.

AU - Donahue, Sean

AU - Holmes, Jonathan M.

AU - Hoover, Darren L.

AU - Huston, Pamela A.

AU - Melia, B. Michele

AU - Repka, Michael X.

AU - Wheeler, David T.

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N2 - Objective: To compare weekend atropine sulfate use augmented by a plano lens for the sound eye with weekend atropine use alone for moderate amblyopia in children aged 3 years to younger than 7 years. Methods: In a multicenter clinical trial, 180 children with moderate amblyopia (visual acuities of 20/40-20/100) were randomized to weekend atropine use augmented by a plano lens or weekend atropine use alone. Main Outcome Measure: Masked assessment of amblyopic eye visual acuity using the Amblyopia Treatment Study HOTV testing protocol at 18 weeks. Results: At 18 weeks, amblyopic eye improvement averaged 2.8 lines in the group that received atropine plus a plano lens and 2.4 lines in the group that received atropine alone (mean difference between groups adjusted for baseline acuity, 0.3 line; 95% confidence interval, -0.2 to 0.8 line). Amblyopic eye visual acuity was 20/25 or better in 24 patients (29%) in the group that received atropine only and 35 patients (40%) in the group that received atropine plus a plano lens (P=.03). More patients in the group that received atropine plus a plano lens had reduced sound eye visual acuity at 18 weeks; however, there were no cases of persistent reverse amblyopia. Conclusions: As an initial treatment for moderate amblyopia, the augmentation of weekend atropine use with a plano lens does not substantially improve amblyopic eye visual acuity when compared with weekend atropine use alone. Application to Clinical Practice: Treatment of children with unilateral amblyopia. Trial Registration: clinicaltrials.org Identifier: NCT00315302.

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