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S. Khayali, N. Khuddus, T. Toskes; Homatropine vs Atropine for the Treatment of Amblyopia. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4345.
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Objective: To compare the outcomes of using homatropine vs atropine for the treatment of amblyopia.
A retrospective chart review was performed on 117 children aged 8 months to 8 years old with the diagnosis of amblyopia treated with either homatropine or atropine with or without concurrent patching to determine if there was any difference in outcome between the two groups.Main Outcome Measure: Visual acuity in the amblyopic eye from baseline once treatment was completed.
72% of children treated with atropine alone had improvement in their amblyopia compared to 40% of patients treated with homatropine. The mean lines of improvement in the atropine group was 1.817 vs 1.625 for the homatropine group. 67% of patients with mild amblyopia showed improvement in their amblyopia in the atropine group compared to 0% in the homatropine group. In those patients treated less than three months duration 77% of patients treated with atropine improved whereas 0% of homatropine patients improved. There was no statistically significant difference in percentage of patients improved in those patients with systemic disease. Patients who were initially treated with homatropine who were then switched to atropine showed an added 1.15 lines of visual acuity improvement.
Atropine showed a greater percentage of patients with overall improvement, however the mean lines of improvement were similar for both the atropine and homatropine groups. For mild amblyopia there is a tendency towards greater improvement with atropine over homatropine and healthy patients also did better with atropine treatment. A faster recovery of vision was present in the first three months with atropine treatment. Homatropine users further improved in vision when switched to atropine. These results suggest that atropine should be considered as primary treatment for mild amblyopia and in children with no underlying systemic illness. For those with systemic illness, who are likely to be more susceptible to anticholinergic medications, homatropine may have a role as primary treatment for amblyopia.
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