Patching vs atropine to treat amblyopia in children aged 7 to 12 years: A randomized trial

Mitchell M. Scheiman, Richard W. Hertle, Raymond T. Kraker, Roy W. Beck, Eileen E. Birch, Joost Felius, Jonathan M Holmes, James Kundart, David G. Morrison, Michael X. Repka, Susanna M. Tamkins

Research output: Contribution to journalArticle

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Abstract

Objective: To compare patching with atropine eye-drops in the treatment of moderate amblyopia (visual acuity, 20/40-20/100) in children aged 7 to 12 years. Methods: In a randomized, multicenter clinical trial, 193 children with amblyopia were assigned to receive weekend atropine or patching of the sound eye 2 hours per day. Main Outcome Measure: Masked assessment of visual acuity in the amblyopic eye using the electronic Early Treatment Diabetic Retinopathy Study testing protocol at 17 weeks. Results: At 17 weeks, visual acuity had improved from baseline by an average of 7.6 letters in the atropine group and 8.6 letters in the patching group. The mean difference between groups (patching - atropine) adjusted for baseline acuity was 1.2 letters (ends of complementary 1-sided 95% confidence intervals for noninferiority, -0.7, 3.1 letters). This difference met the prespecified definition for equivalence (confidence interval <5 letters). Visual acuity in the amblyopic eye was 20/25 or better in 15 participants in the atropine group (17%) and 20 in the patching group (24%; difference, 7%; 95% confidence interval, % to 17%). Conclusions: Treatment with atropine or patching led to similar degrees of improvement among 7- to 12-year-olds with moderate amblyopia. About 1 in 5 achieved visual acuity of 20/25 or better in the amblyopic eye. Clinical Relevance: Atropine and patching achieve similar results among older children with unilateral amblyopia. Trial Registration: clinicaltrials.gov Identifier: NCT00315328.

Original languageEnglish (US)
Pages (from-to)1634-1642
Number of pages9
JournalArchives of Ophthalmology
Volume126
Issue number12
DOIs
StatePublished - Dec 2008

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Amblyopia
Atropine
Visual Acuity
Confidence Intervals
Ophthalmic Solutions
Diabetic Retinopathy
Multicenter Studies
Therapeutics
Randomized Controlled Trials
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Scheiman, M. M., Hertle, R. W., Kraker, R. T., Beck, R. W., Birch, E. E., Felius, J., ... Tamkins, S. M. (2008). Patching vs atropine to treat amblyopia in children aged 7 to 12 years: A randomized trial. Archives of Ophthalmology, 126(12), 1634-1642. https://doi.org/10.1001/archophthalmol.2008.107

Patching vs atropine to treat amblyopia in children aged 7 to 12 years : A randomized trial. / Scheiman, Mitchell M.; Hertle, Richard W.; Kraker, Raymond T.; Beck, Roy W.; Birch, Eileen E.; Felius, Joost; Holmes, Jonathan M; Kundart, James; Morrison, David G.; Repka, Michael X.; Tamkins, Susanna M.

In: Archives of Ophthalmology, Vol. 126, No. 12, 12.2008, p. 1634-1642.

Research output: Contribution to journalArticle

Scheiman, MM, Hertle, RW, Kraker, RT, Beck, RW, Birch, EE, Felius, J, Holmes, JM, Kundart, J, Morrison, DG, Repka, MX & Tamkins, SM 2008, 'Patching vs atropine to treat amblyopia in children aged 7 to 12 years: A randomized trial', Archives of Ophthalmology, vol. 126, no. 12, pp. 1634-1642. https://doi.org/10.1001/archophthalmol.2008.107
Scheiman, Mitchell M. ; Hertle, Richard W. ; Kraker, Raymond T. ; Beck, Roy W. ; Birch, Eileen E. ; Felius, Joost ; Holmes, Jonathan M ; Kundart, James ; Morrison, David G. ; Repka, Michael X. ; Tamkins, Susanna M. / Patching vs atropine to treat amblyopia in children aged 7 to 12 years : A randomized trial. In: Archives of Ophthalmology. 2008 ; Vol. 126, No. 12. pp. 1634-1642.
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abstract = "Objective: To compare patching with atropine eye-drops in the treatment of moderate amblyopia (visual acuity, 20/40-20/100) in children aged 7 to 12 years. Methods: In a randomized, multicenter clinical trial, 193 children with amblyopia were assigned to receive weekend atropine or patching of the sound eye 2 hours per day. Main Outcome Measure: Masked assessment of visual acuity in the amblyopic eye using the electronic Early Treatment Diabetic Retinopathy Study testing protocol at 17 weeks. Results: At 17 weeks, visual acuity had improved from baseline by an average of 7.6 letters in the atropine group and 8.6 letters in the patching group. The mean difference between groups (patching - atropine) adjusted for baseline acuity was 1.2 letters (ends of complementary 1-sided 95{\%} confidence intervals for noninferiority, -0.7, 3.1 letters). This difference met the prespecified definition for equivalence (confidence interval <5 letters). Visual acuity in the amblyopic eye was 20/25 or better in 15 participants in the atropine group (17{\%}) and 20 in the patching group (24{\%}; difference, 7{\%}; 95{\%} confidence interval, {\%} to 17{\%}). Conclusions: Treatment with atropine or patching led to similar degrees of improvement among 7- to 12-year-olds with moderate amblyopia. About 1 in 5 achieved visual acuity of 20/25 or better in the amblyopic eye. Clinical Relevance: Atropine and patching achieve similar results among older children with unilateral amblyopia. Trial Registration: clinicaltrials.gov Identifier: NCT00315328.",
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AU - Felius, Joost

AU - Holmes, Jonathan M

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N2 - Objective: To compare patching with atropine eye-drops in the treatment of moderate amblyopia (visual acuity, 20/40-20/100) in children aged 7 to 12 years. Methods: In a randomized, multicenter clinical trial, 193 children with amblyopia were assigned to receive weekend atropine or patching of the sound eye 2 hours per day. Main Outcome Measure: Masked assessment of visual acuity in the amblyopic eye using the electronic Early Treatment Diabetic Retinopathy Study testing protocol at 17 weeks. Results: At 17 weeks, visual acuity had improved from baseline by an average of 7.6 letters in the atropine group and 8.6 letters in the patching group. The mean difference between groups (patching - atropine) adjusted for baseline acuity was 1.2 letters (ends of complementary 1-sided 95% confidence intervals for noninferiority, -0.7, 3.1 letters). This difference met the prespecified definition for equivalence (confidence interval <5 letters). Visual acuity in the amblyopic eye was 20/25 or better in 15 participants in the atropine group (17%) and 20 in the patching group (24%; difference, 7%; 95% confidence interval, % to 17%). Conclusions: Treatment with atropine or patching led to similar degrees of improvement among 7- to 12-year-olds with moderate amblyopia. About 1 in 5 achieved visual acuity of 20/25 or better in the amblyopic eye. Clinical Relevance: Atropine and patching achieve similar results among older children with unilateral amblyopia. Trial Registration: clinicaltrials.gov Identifier: NCT00315328.

AB - Objective: To compare patching with atropine eye-drops in the treatment of moderate amblyopia (visual acuity, 20/40-20/100) in children aged 7 to 12 years. Methods: In a randomized, multicenter clinical trial, 193 children with amblyopia were assigned to receive weekend atropine or patching of the sound eye 2 hours per day. Main Outcome Measure: Masked assessment of visual acuity in the amblyopic eye using the electronic Early Treatment Diabetic Retinopathy Study testing protocol at 17 weeks. Results: At 17 weeks, visual acuity had improved from baseline by an average of 7.6 letters in the atropine group and 8.6 letters in the patching group. The mean difference between groups (patching - atropine) adjusted for baseline acuity was 1.2 letters (ends of complementary 1-sided 95% confidence intervals for noninferiority, -0.7, 3.1 letters). This difference met the prespecified definition for equivalence (confidence interval <5 letters). Visual acuity in the amblyopic eye was 20/25 or better in 15 participants in the atropine group (17%) and 20 in the patching group (24%; difference, 7%; 95% confidence interval, % to 17%). Conclusions: Treatment with atropine or patching led to similar degrees of improvement among 7- to 12-year-olds with moderate amblyopia. About 1 in 5 achieved visual acuity of 20/25 or better in the amblyopic eye. Clinical Relevance: Atropine and patching achieve similar results among older children with unilateral amblyopia. Trial Registration: clinicaltrials.gov Identifier: NCT00315328.

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