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M. X. Repka, R. T. Kraker, R. W. Beck, E. Birch, S. A. Cotter, J. M. Holmes, R. W. Hertle, D. L. Hoover, D. L. Klimek, Pediatric Eye Disease Investigator Group; Treatment of Severe Amblyopia With Atropine: Results From Two Randomized Clinical Trials. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4753.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the effectiveness of weekend atropine for severe amblyopia from strabismus, anisometropia or both combined among children 3 to 12 years of age.
We enrolled children into two prospective, randomized multi-center clinical trials of amblyopia therapy. Herein we report the results for severe amblyopia, 20/125 to 20/400. In Trial 1, 60 children 3 to 6 years of age (mean age 4.4 years) were randomized to weekend atropine plus a plano lens with weekend atropine with full spectacle correction for the sound eye. In Trial 2, 40 children 7 to 12 years of age (mean age 9.3 years) were randomized to weekend atropine or two hours of daily patching. The visual acuity outcome was assessed at 18 weeks in Trial 1 and 17 weeks in Trial 2.
In Trial 1, visual acuity improved by an average of 4.5 lines in the atropine plus correction group (95% confidence interval (CI) 3.2 to 5.8 lines) and 5.1 lines in the atropine plus plano lens group (95% CI 3.7 to 6.4 lines). In Trial 2, visual acuity improved by an average of 1.5 lines in the atropine group (95% CI 0.5 to 2.5 lines) and 1.8 lines in the patching group (95% CI 1.1 to 2.6 lines).
Atropine can improve visual acuity in children 3 to 12 years of age with severe amblyopia. Improvement may be greater in younger children.
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