A randomized trial of adding a plano lens to atropine for amblyopia

Pediatric Eye Disease Investigator Group

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Some children have residual amblyopia after treatment with atropine eyedrops for amblyopia due to strabismus and/or anisometropia. We conducted a randomized clinical trial to evaluate the effectiveness of augmenting the effect of atropine by changing the lens over the fellow eye to plano in children with residual amblyopia. METHODS: A total of 73 children 3 to +1) were enrolled after at least 12 weeks of atropine treatment of the fellow eye. Participants were randomly assigned to continuing weekend atropine alone or wearing a plano lens over the fellow eye (while continuing atropine). The primary outcome was assessed at 10 weeks, and participants were followed until improvement ceased. RESULTS: At the 10-week primary outcome visit, amblyopic-eye visual acuity had improved an average of 1.1 lines with the plano lens and 0.6 lines with atropine only (difference adjusted for baseline visual acuity = + 0.5 line; 95% CI, -0.1 to 11.2). At the primary outcome or later visit when the best-measured visual acuity was observed, the mean amblyopic-eye improvement from baseline was 1.9 lines with the plano lens and 0.8 lines with atropine only. CONCLUSIONS: When amblyopic-eye visual acuity stops improving with atropine treatment, there may be a small benefit to augmenting atropine therapy with a plano lens over the fellow eye. However, the effect was not statistically significant, and the large confidence interval raises the possibility of no benefit or a benefit larger than we observed. A larger study would be necessary to get a more precise estimate of the treatment effect.

Fingerprint

Amblyopia
Atropine
Lenses
Visual Acuity
Anisometropia
Therapeutics
Ophthalmic Solutions
Strabismus
Randomized Controlled Trials
Confidence Intervals

ASJC Scopus subject areas

  • Ophthalmology
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

Cite this

@article{20b084dd43bc4a099192ad354a2c41c2,
title = "A randomized trial of adding a plano lens to atropine for amblyopia",
abstract = "BACKGROUND: Some children have residual amblyopia after treatment with atropine eyedrops for amblyopia due to strabismus and/or anisometropia. We conducted a randomized clinical trial to evaluate the effectiveness of augmenting the effect of atropine by changing the lens over the fellow eye to plano in children with residual amblyopia. METHODS: A total of 73 children 3 to +1) were enrolled after at least 12 weeks of atropine treatment of the fellow eye. Participants were randomly assigned to continuing weekend atropine alone or wearing a plano lens over the fellow eye (while continuing atropine). The primary outcome was assessed at 10 weeks, and participants were followed until improvement ceased. RESULTS: At the 10-week primary outcome visit, amblyopic-eye visual acuity had improved an average of 1.1 lines with the plano lens and 0.6 lines with atropine only (difference adjusted for baseline visual acuity = + 0.5 line; 95{\%} CI, -0.1 to 11.2). At the primary outcome or later visit when the best-measured visual acuity was observed, the mean amblyopic-eye improvement from baseline was 1.9 lines with the plano lens and 0.8 lines with atropine only. CONCLUSIONS: When amblyopic-eye visual acuity stops improving with atropine treatment, there may be a small benefit to augmenting atropine therapy with a plano lens over the fellow eye. However, the effect was not statistically significant, and the large confidence interval raises the possibility of no benefit or a benefit larger than we observed. A larger study would be necessary to get a more precise estimate of the treatment effect.",
author = "{Pediatric Eye Disease Investigator Group} and Wallace, {David K.} and Lazar, {Elizabeth L.} and Repka, {Michael X} and Holmes, {Jonathan M.} and Kraker, {Raymond T.} and Hoover, {Darren L.} and Weise, {Katherine K.} and Waters, {Amy L.} and Rice, {Melissa L.} and Peters, {Robert J.}",
year = "2015",
doi = "10.1016/j.jaapos.2014.10.022",
language = "English (US)",
volume = "19",
pages = "42--48",
journal = "Journal of AAPOS",
issn = "1091-8531",
publisher = "Mosby Inc.",
number = "1",

}

TY - JOUR

T1 - A randomized trial of adding a plano lens to atropine for amblyopia

AU - Pediatric Eye Disease Investigator Group

AU - Wallace, David K.

AU - Lazar, Elizabeth L.

AU - Repka, Michael X

AU - Holmes, Jonathan M.

AU - Kraker, Raymond T.

AU - Hoover, Darren L.

AU - Weise, Katherine K.

AU - Waters, Amy L.

AU - Rice, Melissa L.

AU - Peters, Robert J.

PY - 2015

Y1 - 2015

N2 - BACKGROUND: Some children have residual amblyopia after treatment with atropine eyedrops for amblyopia due to strabismus and/or anisometropia. We conducted a randomized clinical trial to evaluate the effectiveness of augmenting the effect of atropine by changing the lens over the fellow eye to plano in children with residual amblyopia. METHODS: A total of 73 children 3 to +1) were enrolled after at least 12 weeks of atropine treatment of the fellow eye. Participants were randomly assigned to continuing weekend atropine alone or wearing a plano lens over the fellow eye (while continuing atropine). The primary outcome was assessed at 10 weeks, and participants were followed until improvement ceased. RESULTS: At the 10-week primary outcome visit, amblyopic-eye visual acuity had improved an average of 1.1 lines with the plano lens and 0.6 lines with atropine only (difference adjusted for baseline visual acuity = + 0.5 line; 95% CI, -0.1 to 11.2). At the primary outcome or later visit when the best-measured visual acuity was observed, the mean amblyopic-eye improvement from baseline was 1.9 lines with the plano lens and 0.8 lines with atropine only. CONCLUSIONS: When amblyopic-eye visual acuity stops improving with atropine treatment, there may be a small benefit to augmenting atropine therapy with a plano lens over the fellow eye. However, the effect was not statistically significant, and the large confidence interval raises the possibility of no benefit or a benefit larger than we observed. A larger study would be necessary to get a more precise estimate of the treatment effect.

AB - BACKGROUND: Some children have residual amblyopia after treatment with atropine eyedrops for amblyopia due to strabismus and/or anisometropia. We conducted a randomized clinical trial to evaluate the effectiveness of augmenting the effect of atropine by changing the lens over the fellow eye to plano in children with residual amblyopia. METHODS: A total of 73 children 3 to +1) were enrolled after at least 12 weeks of atropine treatment of the fellow eye. Participants were randomly assigned to continuing weekend atropine alone or wearing a plano lens over the fellow eye (while continuing atropine). The primary outcome was assessed at 10 weeks, and participants were followed until improvement ceased. RESULTS: At the 10-week primary outcome visit, amblyopic-eye visual acuity had improved an average of 1.1 lines with the plano lens and 0.6 lines with atropine only (difference adjusted for baseline visual acuity = + 0.5 line; 95% CI, -0.1 to 11.2). At the primary outcome or later visit when the best-measured visual acuity was observed, the mean amblyopic-eye improvement from baseline was 1.9 lines with the plano lens and 0.8 lines with atropine only. CONCLUSIONS: When amblyopic-eye visual acuity stops improving with atropine treatment, there may be a small benefit to augmenting atropine therapy with a plano lens over the fellow eye. However, the effect was not statistically significant, and the large confidence interval raises the possibility of no benefit or a benefit larger than we observed. A larger study would be necessary to get a more precise estimate of the treatment effect.

UR - http://www.scopus.com/inward/record.url?scp=84933048408&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84933048408&partnerID=8YFLogxK

U2 - 10.1016/j.jaapos.2014.10.022

DO - 10.1016/j.jaapos.2014.10.022

M3 - Article

VL - 19

SP - 42

EP - 48

JO - Journal of AAPOS

JF - Journal of AAPOS

SN - 1091-8531

IS - 1

ER -