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

Stephen R. Glaser, Andrea M. Matazinski, David M. Sclar, Nicholas A. Sala, Chrissy M. Vroman, Cindy E. Tanner, David R. Stager, Priscilla M. Berry, David R. Stager, Joost Felius, Jennifer A. Wilkerson, Maria Petrova Pesheva, Eileen E. Birch, Brett G. Jeffrey, Anna R. O'Connor, David Robbins Tien, Glenn E. Bulan, Heidi C. Christ, Lauren B. DeWaele, David A. YoungWilliam F. Astle, Anna L. Ells, Cheryl R. Hayduk, Catriona I. Kerr, Mary S. McAlester, Heather J. Peddie, Heather M. Vibert, Richard W. Hertle, Susan D. Mellow, Ed J. Fitzgibbon, Guy E. Foster, Robert W. Arnold, Mary Diane Armitage, Nancy H. Brusseau, Mark S. Ruttum, Jane D. Kivlin, Veronica R. Picard, Merelyn J. Chesner, Susan A. Cotter, Carmen N. Barnhardt, Susan M. Shin, Raymond H. Chu, Lourdes Asiain, Yvonne F. Flores, Gen Lee, John H. Lee, Sherene C. Fort, Jennifer L. Slutsky, Evelyn A. Paysse, David K. Coats, Kathryn M. Brady-McCreery, Alma D. Sanchez, Viviana Correodor, Sean Donahue, Cindy Foss, Julie A. Ozier, Ronald J. Biernacki, Evelyn Tomlinson, David T. Wheeler, Kimberley A. Beaudet, Christin L. Bateman, Michele A. Hartwell, James B. Ruben, Dipti Desai, Sue Ann Parrish, Tracy D. Louie, Robert P. Rutstein, Wendy L. Marsh-Tootle, Cathy H. Baldwin, Kristine T. Becker, Michael X. Repka, David G. Hunter, Jana S. Mattheu, Sheena O. Broome, Carole R. Goodman, Daniel E. Neely, David A. Plager, Derek T. Sprunger, Donna J. Bates, Jay Galli, Michele E. Whitaker, Susanna M. Tamkins, Michele Gonzalez, Siby Jacobs, Mary Louise Z. Collins, Cheryl L. McCarus, Jaime N. Brown, Dorothy B. Conlan, Scott R. Lambert, Lucy Yang, Alexander T. Elliott, Nicole Fallaha, Oscar A. Cruz, Bradley V. Davitt, Susan A. Havertape, Emily A. Miyazaki, Molly B. Bosch, Andrew J. Levada, Roy W. Beck

Research output: Contribution to journalArticle

332 Scopus citations

Abstract

Objective: To compare patching and atropine as treatments for moderate amblyopia in children younger than 7 years. Methods: In a randomized clinical trial, 419 children younger than 7 years with amblyopia and visual acuity in the range of 20/40 to 20/100 were assigned to receive either patching or atropine at 47 clinical sites. Main Outcome Measure: Visual acuity in the amblyopic eye and sound eye after 6 months. Results: Visual acuity in the amblyopic eye improved in both groups (improvement from baseline to 6 months was 3.16 lines in the patching group and 2.84 lines in the atropine group). Improvement was initially faster in the patching group, but after 6 months, the difference in visual acuity between treatment groups was small and clinically inconsequential (mean difference at 6 months, 0.034 logMAR units; 95% confidence interval, 0.005-0.064 logMAR units). The 6-month acuity was 20/30 or better in the amblyopic eye and/or improved from baseline by 3 or more lines in 79% of the patching group and 74% of the atropine group. Both treatments were well tolerated, although atropine had a slightly higher degree of acceptability on a parental questionnaire. More patients in the atropine group than in the patching group had reduced acuity in the sound eye at 6 months, but this did not persist with further follow-up. Conclusion: Atropine and patching produce improvement of similar magnitude, and both are appropriate modalities for the initial treatment of moderate amblyopia in children aged 3 to less than 7 years.

Original languageEnglish (US)
Pages (from-to)268-278
Number of pages11
JournalArchives of Ophthalmology
Volume120
Issue number3
DOIs
StatePublished - Jan 1 2002
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology

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    Glaser, S. R., Matazinski, A. M., Sclar, D. M., Sala, N. A., Vroman, C. M., Tanner, C. E., Stager, D. R., Berry, P. M., Stager, D. R., Felius, J., Wilkerson, J. A., Pesheva, M. P., Birch, E. E., Jeffrey, B. G., O'Connor, A. R., Tien, D. R., Bulan, G. E., Christ, H. C., DeWaele, L. B., ... Beck, R. W. (2002). A randomized trial of atropine vs patching for treatment of moderate amblyopia in children. Archives of Ophthalmology, 120(3), 268-278. https://doi.org/10.1001/archopht.120.3.268