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 Neely, David 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

327 Citations (Scopus)

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
StatePublished - 2002
Externally publishedYes

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Amblyopia
Atropine
Visual Acuity
Therapeutics
Randomized Controlled Trials
Outcome Assessment (Health Care)
Confidence Intervals

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Glaser, S. R., Matazinski, A. M., Sclar, D. M., Sala, N. A., Vroman, C. M., Tanner, C. E., ... 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.

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

In: Archives of Ophthalmology, Vol. 120, No. 3, 2002, p. 268-278.

Research output: Contribution to journalArticle

Glaser, SR, Matazinski, AM, Sclar, DM, Sala, NA, Vroman, CM, Tanner, CE, Stager, DR, Berry, PM, Stager, DR, Felius, J, Wilkerson, JA, Pesheva, MP, Birch, EE, Jeffrey, BG, O'Connor, AR, Tien, DR, Bulan, GE, Christ, HC, DeWaele, LB, Young, DA, Astle, WF, Ells, AL, Hayduk, CR, Kerr, CI, McAlester, MS, Peddie, HJ, Vibert, HM, Hertle, RW, Mellow, SD, Fitzgibbon, EJ, Foster, GE, Arnold, RW, Armitage, MD, Brusseau, NH, Ruttum, MS, Kivlin, JD, Picard, VR, Chesner, MJ, Cotter, SA, Barnhardt, CN, Shin, SM, Chu, RH, Asiain, L, Flores, YF, Lee, G, Lee, JH, Fort, SC, Slutsky, JL, Paysse, EA, Coats, DK, Brady-McCreery, KM, Sanchez, AD, Correodor, V, Donahue, S, Foss, C, Ozier, JA, Biernacki, RJ, Tomlinson, E, Wheeler, DT, Beaudet, KA, Bateman, CL, Hartwell, MA, Ruben, JB, Desai, D, Parrish, SA, Louie, TD, Rutstein, RP, Marsh-Tootle, WL, Baldwin, CH, Becker, KT, Repka, MX, Hunter, DG, Mattheu, JS, Broome, SO, Goodman, CR, Neely, D, Plager, D, Sprunger, DT, Bates, DJ, Galli, J, Whitaker, ME, Tamkins, SM, Gonzalez, M, Jacobs, S, Collins, MLZ, McCarus, CL, Brown, JN, Conlan, DB, Lambert, SR, Yang, L, Elliott, AT, Fallaha, N, Cruz, OA, Davitt, BV, Havertape, SA, Miyazaki, EA, Bosch, MB, Levada, AJ & Beck, RW 2002, 'A randomized trial of atropine vs patching for treatment of moderate amblyopia in children', Archives of Ophthalmology, vol. 120, no. 3, pp. 268-278.
Glaser SR, Matazinski AM, Sclar DM, Sala NA, Vroman CM, Tanner CE et al. A randomized trial of atropine vs patching for treatment of moderate amblyopia in children. Archives of Ophthalmology. 2002;120(3):268-278.
Glaser, Stephen R. ; Matazinski, Andrea M. ; Sclar, David M. ; Sala, Nicholas A. ; Vroman, Chrissy M. ; Tanner, Cindy E. ; Stager, David R. ; Berry, Priscilla M. ; Stager, David R. ; Felius, Joost ; Wilkerson, Jennifer A. ; Pesheva, Maria Petrova ; Birch, Eileen E. ; Jeffrey, Brett G. ; O'Connor, Anna R. ; Tien, David Robbins ; Bulan, Glenn E. ; Christ, Heidi C. ; DeWaele, Lauren B. ; Young, David A. ; Astle, William F. ; Ells, Anna L. ; Hayduk, Cheryl R. ; Kerr, Catriona I. ; McAlester, Mary S. ; Peddie, Heather J. ; Vibert, Heather M. ; Hertle, Richard W. ; Mellow, Susan D. ; Fitzgibbon, Ed J. ; Foster, Guy E. ; Arnold, Robert W. ; Armitage, Mary Diane ; Brusseau, Nancy H. ; Ruttum, Mark S. ; Kivlin, Jane D. ; Picard, Veronica R. ; Chesner, Merelyn J. ; Cotter, Susan A. ; Barnhardt, Carmen N. ; Shin, Susan M. ; Chu, Raymond H. ; Asiain, Lourdes ; Flores, Yvonne F. ; Lee, Gen ; Lee, John H. ; Fort, Sherene C. ; Slutsky, Jennifer L. ; Paysse, Evelyn A. ; Coats, David K. ; Brady-McCreery, Kathryn M. ; Sanchez, Alma D. ; Correodor, Viviana ; Donahue, Sean ; Foss, Cindy ; Ozier, Julie A. ; Biernacki, Ronald J. ; Tomlinson, Evelyn ; Wheeler, David T. ; Beaudet, Kimberley A. ; Bateman, Christin L. ; Hartwell, Michele A. ; Ruben, James B. ; Desai, Dipti ; Parrish, Sue Ann ; Louie, Tracy D. ; Rutstein, Robert P. ; Marsh-Tootle, Wendy L. ; Baldwin, Cathy H. ; Becker, Kristine T. ; Repka, Michael X. ; Hunter, David G. ; Mattheu, Jana S. ; Broome, Sheena O. ; Goodman, Carole R. ; Neely, Daniel ; Plager, David ; Sprunger, Derek T. ; Bates, Donna J. ; Galli, Jay ; Whitaker, Michele E. ; Tamkins, Susanna M. ; Gonzalez, Michele ; Jacobs, Siby ; Collins, Mary Louise Z ; McCarus, Cheryl L. ; Brown, Jaime N. ; Conlan, Dorothy B. ; Lambert, Scott R. ; Yang, Lucy ; Elliott, Alexander T. ; Fallaha, Nicole ; Cruz, Oscar A. ; Davitt, Bradley V. ; Havertape, Susan A. ; Miyazaki, Emily A. ; Bosch, Molly B. ; Levada, Andrew J. ; Beck, Roy W. / A randomized trial of atropine vs patching for treatment of moderate amblyopia in children. In: Archives of Ophthalmology. 2002 ; Vol. 120, No. 3. pp. 268-278.
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title = "A randomized trial of atropine vs patching for treatment of moderate amblyopia in children",
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.",
author = "Glaser, {Stephen R.} and Matazinski, {Andrea M.} and Sclar, {David M.} and Sala, {Nicholas A.} and Vroman, {Chrissy M.} and Tanner, {Cindy E.} and Stager, {David R.} and Berry, {Priscilla M.} and Stager, {David R.} and Joost Felius and Wilkerson, {Jennifer A.} and Pesheva, {Maria Petrova} and Birch, {Eileen E.} and Jeffrey, {Brett G.} and O'Connor, {Anna R.} and Tien, {David Robbins} and Bulan, {Glenn E.} and Christ, {Heidi C.} and DeWaele, {Lauren B.} and Young, {David A.} and Astle, {William F.} and Ells, {Anna L.} and Hayduk, {Cheryl R.} and Kerr, {Catriona I.} and McAlester, {Mary S.} and Peddie, {Heather J.} and Vibert, {Heather M.} and Hertle, {Richard W.} and Mellow, {Susan D.} and Fitzgibbon, {Ed J.} and Foster, {Guy E.} and Arnold, {Robert W.} and Armitage, {Mary Diane} and Brusseau, {Nancy H.} and Ruttum, {Mark S.} and Kivlin, {Jane D.} and Picard, {Veronica R.} and Chesner, {Merelyn J.} and Cotter, {Susan A.} and Barnhardt, {Carmen N.} and Shin, {Susan M.} and Chu, {Raymond H.} and Lourdes Asiain and Flores, {Yvonne F.} and Gen Lee and Lee, {John H.} and Fort, {Sherene C.} and Slutsky, {Jennifer L.} and Paysse, {Evelyn A.} and Coats, {David K.} and Brady-McCreery, {Kathryn M.} and Sanchez, {Alma D.} and Viviana Correodor and Sean Donahue and Cindy Foss and Ozier, {Julie A.} and Biernacki, {Ronald J.} and Evelyn Tomlinson and Wheeler, {David T.} and Beaudet, {Kimberley A.} and Bateman, {Christin L.} and Hartwell, {Michele A.} and Ruben, {James B.} and Dipti Desai and Parrish, {Sue Ann} and Louie, {Tracy D.} and Rutstein, {Robert P.} and Marsh-Tootle, {Wendy L.} and Baldwin, {Cathy H.} and Becker, {Kristine T.} and Repka, {Michael X.} and Hunter, {David G.} and Mattheu, {Jana S.} and Broome, {Sheena O.} and Goodman, {Carole R.} and Daniel Neely and David Plager and Sprunger, {Derek T.} and Bates, {Donna J.} and Jay Galli and Whitaker, {Michele E.} and Tamkins, {Susanna M.} and Michele Gonzalez and Siby Jacobs and Collins, {Mary Louise Z} and McCarus, {Cheryl L.} and Brown, {Jaime N.} and Conlan, {Dorothy B.} and Lambert, {Scott R.} and Lucy Yang and Elliott, {Alexander T.} and Nicole Fallaha and Cruz, {Oscar A.} and Davitt, {Bradley V.} and Havertape, {Susan A.} and Miyazaki, {Emily A.} and Bosch, {Molly B.} and Levada, {Andrew J.} and Beck, {Roy W.}",
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pages = "268--278",
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TY - JOUR

T1 - A randomized trial of atropine vs patching for treatment of moderate amblyopia in children

AU - Glaser, Stephen R.

AU - Matazinski, Andrea M.

AU - Sclar, David M.

AU - Sala, Nicholas A.

AU - Vroman, Chrissy M.

AU - Tanner, Cindy E.

AU - Stager, David R.

AU - Berry, Priscilla M.

AU - Stager, David R.

AU - Felius, Joost

AU - Wilkerson, Jennifer A.

AU - Pesheva, Maria Petrova

AU - Birch, Eileen E.

AU - Jeffrey, Brett G.

AU - O'Connor, Anna R.

AU - Tien, David Robbins

AU - Bulan, Glenn E.

AU - Christ, Heidi C.

AU - DeWaele, Lauren B.

AU - Young, David A.

AU - Astle, William F.

AU - Ells, Anna L.

AU - Hayduk, Cheryl R.

AU - Kerr, Catriona I.

AU - McAlester, Mary S.

AU - Peddie, Heather J.

AU - Vibert, Heather M.

AU - Hertle, Richard W.

AU - Mellow, Susan D.

AU - Fitzgibbon, Ed J.

AU - Foster, Guy E.

AU - Arnold, Robert W.

AU - Armitage, Mary Diane

AU - Brusseau, Nancy H.

AU - Ruttum, Mark S.

AU - Kivlin, Jane D.

AU - Picard, Veronica R.

AU - Chesner, Merelyn J.

AU - Cotter, Susan A.

AU - Barnhardt, Carmen N.

AU - Shin, Susan M.

AU - Chu, Raymond H.

AU - Asiain, Lourdes

AU - Flores, Yvonne F.

AU - Lee, Gen

AU - Lee, John H.

AU - Fort, Sherene C.

AU - Slutsky, Jennifer L.

AU - Paysse, Evelyn A.

AU - Coats, David K.

AU - Brady-McCreery, Kathryn M.

AU - Sanchez, Alma D.

AU - Correodor, Viviana

AU - Donahue, Sean

AU - Foss, Cindy

AU - Ozier, Julie A.

AU - Biernacki, Ronald J.

AU - Tomlinson, Evelyn

AU - Wheeler, David T.

AU - Beaudet, Kimberley A.

AU - Bateman, Christin L.

AU - Hartwell, Michele A.

AU - Ruben, James B.

AU - Desai, Dipti

AU - Parrish, Sue Ann

AU - Louie, Tracy D.

AU - Rutstein, Robert P.

AU - Marsh-Tootle, Wendy L.

AU - Baldwin, Cathy H.

AU - Becker, Kristine T.

AU - Repka, Michael X.

AU - Hunter, David G.

AU - Mattheu, Jana S.

AU - Broome, Sheena O.

AU - Goodman, Carole R.

AU - Neely, Daniel

AU - Plager, David

AU - Sprunger, Derek T.

AU - Bates, Donna J.

AU - Galli, Jay

AU - Whitaker, Michele E.

AU - Tamkins, Susanna M.

AU - Gonzalez, Michele

AU - Jacobs, Siby

AU - Collins, Mary Louise Z

AU - McCarus, Cheryl L.

AU - Brown, Jaime N.

AU - Conlan, Dorothy B.

AU - Lambert, Scott R.

AU - Yang, Lucy

AU - Elliott, Alexander T.

AU - Fallaha, Nicole

AU - Cruz, Oscar A.

AU - Davitt, Bradley V.

AU - Havertape, Susan A.

AU - Miyazaki, Emily A.

AU - Bosch, Molly B.

AU - Levada, Andrew J.

AU - Beck, Roy W.

PY - 2002

Y1 - 2002

N2 - 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.

AB - 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.

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UR - http://www.scopus.com/inward/citedby.url?scp=0036130883&partnerID=8YFLogxK

M3 - Article

C2 - 11879129

AN - SCOPUS:0036130883

VL - 120

SP - 268

EP - 278

JO - JAMA Ophthalmology

JF - JAMA Ophthalmology

SN - 2168-6165

IS - 3

ER -