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A randomized trial of atropine regimens for treatment of moderate amblyopia in children
Michael X Repka1, Susan A Cotter, Roy W Beck
1Jaeb Center for Health Research, 15310 Amberly Drive, Suite 350, Tampa, FL 33647, USA. rbeck@jaeb.org
Insights
Weekend atropine is as effective as daily atropine for treating moderate amblyopia in young children. This study found similar visual acuity improvements in both treatment groups for children younger than 7 years.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Clinical Trials
Background:
- Amblyopia, or lazy eye, is a common cause of reduced vision in children.
- Current treatments often involve patching or atropine eye drops.
- The optimal dosing regimen for atropine in amblyopia management requires further investigation.
Purpose of the Study:
- To compare the efficacy of daily low-dose atropine versus weekend low-dose atropine for treating moderate amblyopia in children younger than 7 years.
- To evaluate visual acuity outcomes after 4 months of treatment.
Main Methods:
- A prospective, randomized, multicenter clinical trial involving 168 children aged 3-7 years with moderate amblyopia (20/40-20/80).
- Participants were randomized to receive either daily or weekend atropine eye drops for 4 months.
- Visual acuity was the primary outcome measure, assessed at the end of the 4-month period.
Main Results:
- Both daily and weekend atropine groups showed an average improvement of 2.3 lines in amblyopic eye visual acuity.
- At study completion, 47% of the daily atropine group and 53% of the weekend atropine group achieved a visual acuity of 20/25 or better, or equal to the sound eye.
- Stereoacuity outcomes were comparable between the two treatment groups.
Conclusions:
- Weekend atropine administration is a viable and effective alternative to daily atropine for treating moderate amblyopia in young children.
- The visual acuity improvements achieved with weekend atropine are comparable to those seen with daily atropine.
- This finding supports less frequent atropine dosing as a potential strategy to improve treatment adherence and reduce side effects.
Objective:
To compare daily atropine to weekend atropine as prescribed treatments for moderate amblyopia in children younger than 7 years.
Design:
Prospective, randomized multicenter clinical trial (30 sites).
Participants:
One hundred sixty-eight children younger than 7 years with amblyopia in the range of 20/40 to 20/80 associated with strabismus, anisometropia, or both.
Intervention:
Randomization either to daily atropine or to weekend atropine for 4 months. Partial responders were continued on the randomized treatment until no further improvement was noted.
Main Outcome Measure:
Visual acuity (VA) in the amblyopic eye after 4 months.
Results:
The improvement in VA of the amblyopic eye from baseline to 4 months averaged 2.3 lines in each group. The VA of the amblyopic eye at study completion was either (1) at least 20/25 or (2) better than or equal to that of the sound eye in 39 children (47%) in the daily group and 45 children (53%) in the weekend group. The VA of the sound eye at the end of follow-up was reduced by 2 lines in one patient in each group. Stereoacuity outcomes were similar in the 2 groups.
Conclusions:
Weekend atropine provides an improvement in VA of a magnitude similar to that of the improvement provided by daily atropine in treating moderate amblyopia in children 3 to 7 years old. This article contains additional online-only material available at http://www.ophsource.com/periodicals/ophtha.
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