A randomized trial of levodopa as treatment for residual amblyopia in older children

Michael X. Repka, Raymond T. Kraker, Trevano W. Dean, Roy W. Beck, R. Michael Siatkowski, Jonathan M. Holmes, Cynthia L. Beauchamp, Richard P. Golden, Aaron M. Miller, Lisa C. Verderber, David K. Wallace

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objective To assess the efficacy and short-term safety of levodopa as adjunctive treatment to patching for amblyopia. Design Randomized, placebo-controlled trial. Participants One hundred thirty-nine children 7 to 12 years of age with residual amblyopia resulting from strabismus, anisometropia, or both combined (visual acuity [VA], 20/50-20/400) after patching. Methods Sixteen weeks of oral levodopa or placebo administered 3 times daily while patching the fellow eye 2 hours daily. Main Outcome Measures Mean change in best-corrected amblyopic-eye VA at 18 weeks. Results At 18 weeks, amblyopic-eye VA improved from randomization by an average of 5.2 letters in the levodopa group and by 3.8 letters in the placebo group (difference adjusted for baseline VA, +1.4 letters; 1-sided P = 0.06; 2-sided 95% confidence interval, -0.4 to 3.3 letters). No serious adverse effects from levodopa were reported during treatment. Conclusions For children 7 to 12 years of age with residual amblyopia after patching therapy, oral levodopa while continuing to patch 2 hours daily does not produce a clinically or statistically meaningful improvement in VA compared with placebo and patching.

Original languageEnglish (US)
Pages (from-to)874-881
Number of pages8
JournalOphthalmology
Volume122
Issue number5
DOIs
StatePublished - May 1 2015
Externally publishedYes

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Amblyopia
Levodopa
Visual Acuity
Placebos
Anisometropia
Therapeutics
Strabismus
Random Allocation
Randomized Controlled Trials
Outcome Assessment (Health Care)
Confidence Intervals
Safety

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Repka, M. X., Kraker, R. T., Dean, T. W., Beck, R. W., Siatkowski, R. M., Holmes, J. M., ... Wallace, D. K. (2015). A randomized trial of levodopa as treatment for residual amblyopia in older children. Ophthalmology, 122(5), 874-881. https://doi.org/10.1016/j.ophtha.2015.01.002

A randomized trial of levodopa as treatment for residual amblyopia in older children. / Repka, Michael X.; Kraker, Raymond T.; Dean, Trevano W.; Beck, Roy W.; Siatkowski, R. Michael; Holmes, Jonathan M.; Beauchamp, Cynthia L.; Golden, Richard P.; Miller, Aaron M.; Verderber, Lisa C.; Wallace, David K.

In: Ophthalmology, Vol. 122, No. 5, 01.05.2015, p. 874-881.

Research output: Contribution to journalArticle

Repka, MX, Kraker, RT, Dean, TW, Beck, RW, Siatkowski, RM, Holmes, JM, Beauchamp, CL, Golden, RP, Miller, AM, Verderber, LC & Wallace, DK 2015, 'A randomized trial of levodopa as treatment for residual amblyopia in older children', Ophthalmology, vol. 122, no. 5, pp. 874-881. https://doi.org/10.1016/j.ophtha.2015.01.002
Repka MX, Kraker RT, Dean TW, Beck RW, Siatkowski RM, Holmes JM et al. A randomized trial of levodopa as treatment for residual amblyopia in older children. Ophthalmology. 2015 May 1;122(5):874-881. https://doi.org/10.1016/j.ophtha.2015.01.002
Repka, Michael X. ; Kraker, Raymond T. ; Dean, Trevano W. ; Beck, Roy W. ; Siatkowski, R. Michael ; Holmes, Jonathan M. ; Beauchamp, Cynthia L. ; Golden, Richard P. ; Miller, Aaron M. ; Verderber, Lisa C. ; Wallace, David K. / A randomized trial of levodopa as treatment for residual amblyopia in older children. In: Ophthalmology. 2015 ; Vol. 122, No. 5. pp. 874-881.
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AU - Beauchamp, Cynthia L.

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AB - Objective To assess the efficacy and short-term safety of levodopa as adjunctive treatment to patching for amblyopia. Design Randomized, placebo-controlled trial. Participants One hundred thirty-nine children 7 to 12 years of age with residual amblyopia resulting from strabismus, anisometropia, or both combined (visual acuity [VA], 20/50-20/400) after patching. Methods Sixteen weeks of oral levodopa or placebo administered 3 times daily while patching the fellow eye 2 hours daily. Main Outcome Measures Mean change in best-corrected amblyopic-eye VA at 18 weeks. Results At 18 weeks, amblyopic-eye VA improved from randomization by an average of 5.2 letters in the levodopa group and by 3.8 letters in the placebo group (difference adjusted for baseline VA, +1.4 letters; 1-sided P = 0.06; 2-sided 95% confidence interval, -0.4 to 3.3 letters). No serious adverse effects from levodopa were reported during treatment. Conclusions For children 7 to 12 years of age with residual amblyopia after patching therapy, oral levodopa while continuing to patch 2 hours daily does not produce a clinically or statistically meaningful improvement in VA compared with placebo and patching.

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