A randomized trial of atropine vs patching for treatment of moderate amblyopia

Follow-up at age 10 years

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

Research output: Contribution to journalArticle

68 Citations (Scopus)

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 Identifier: NCT00000170.

Original languageEnglish (US)
Pages (from-to)1039-1044
Number of pages6
JournalArchives of Ophthalmology
Volume126
Issue number8
DOIs
StatePublished - Aug 2008

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Amblyopia
Atropine
Visual Acuity
Ophthalmic Solutions
Therapeutics
Diabetic Retinopathy
Multicenter Studies
Research Personnel
Outcome Assessment (Health Care)
Clinical Trials

ASJC Scopus subject areas

  • Ophthalmology

Cite this

A randomized trial of atropine vs patching for treatment of moderate amblyopia : Follow-up at age 10 years. / Repka, Michael X.; Kraker, Raymond T.; Beck, Roy W.; Holmes, Jonathan M; Cotter, Susan A.; Birch, Eileen E.; Astle, William F.; Chandler, Danielle L.; Felius, Joost; Arnold, Robert W.; Tien, D. Robbins; Glaser, Stephen R.

In: Archives of Ophthalmology, Vol. 126, No. 8, 08.2008, p. 1039-1044.

Research output: Contribution to journalArticle

Repka, MX, Kraker, RT, Beck, RW, Holmes, JM, Cotter, SA, Birch, EE, Astle, WF, Chandler, DL, Felius, J, Arnold, RW, Tien, DR & Glaser, SR 2008, 'A randomized trial of atropine vs patching for treatment of moderate amblyopia: Follow-up at age 10 years', Archives of Ophthalmology, vol. 126, no. 8, pp. 1039-1044. https://doi.org/10.1001/archopht.126.8.1039
Repka, Michael X. ; Kraker, Raymond T. ; Beck, Roy W. ; Holmes, Jonathan M ; Cotter, Susan A. ; Birch, Eileen E. ; Astle, William F. ; Chandler, Danielle L. ; Felius, Joost ; Arnold, Robert W. ; Tien, D. Robbins ; Glaser, Stephen R. / A randomized trial of atropine vs patching for treatment of moderate amblyopia : Follow-up at age 10 years. In: Archives of Ophthalmology. 2008 ; Vol. 126, No. 8. pp. 1039-1044.
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AU - Repka, Michael X.

AU - Kraker, Raymond T.

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AU - Holmes, Jonathan M

AU - Cotter, Susan A.

AU - Birch, Eileen E.

AU - Astle, William F.

AU - Chandler, Danielle L.

AU - Felius, Joost

AU - Arnold, Robert W.

AU - Tien, D. Robbins

AU - Glaser, Stephen R.

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N2 - 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 Identifier: NCT00000170.

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