The effect on refractive error of unilateral atropine as compared with patching for the treatment of amblyopia

Michael X Repka, Michele Melia, Maya Eibschitz-Tsimhoni, Richard London, Elbert Magoon

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Abstract

Our objective was to determine whether the use of unilateral atropine as amblyopia therapy leads to an asymmetric change in refractive error compared with patching. Patients were enrolled in a clinical trial in which atropine 1% solution or occlusion with an adhesive patch was administered daily to the sound eye of children 3 to less than 7 years of age for a period of at least 6 months to a maximum of 2 years. Refractive error at entry and at 2 years was determined with cycloplegic retinoscopy for 282 of 419 patients enrolled. The baseline mean refractive error was + 3.13 diopters (D) in patients assigned randomly to receive atropine and + 2.58D in patients assigned randomly to wear the patch. The mean change in refractive error of the sound eye was + 0.10 D in the atropine group (N = 134) and + 0.08 D in the patch group (N = 148). Patients also were subdivided into those treated with atropine only (n = 41) and patching only (n = 64) because some children changed treatments during their study participation. The mean change for the sound eyes was -0.21 D for the patients receiving only atropine and -0.06 D for the patients receiving only patching. Unilateral atropine applied to the sound eye compared with occlusion was not associated with any adverse effect on refractive error following up to 2 years of treatment.

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Amblyopia
Refractive Errors
Atropine
Therapeutics
Retinoscopy
Mydriatics
Adhesives
Clinical Trials

ASJC Scopus subject areas

  • Ophthalmology

Cite this

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title = "The effect on refractive error of unilateral atropine as compared with patching for the treatment of amblyopia",
abstract = "Our objective was to determine whether the use of unilateral atropine as amblyopia therapy leads to an asymmetric change in refractive error compared with patching. Patients were enrolled in a clinical trial in which atropine 1{\%} solution or occlusion with an adhesive patch was administered daily to the sound eye of children 3 to less than 7 years of age for a period of at least 6 months to a maximum of 2 years. Refractive error at entry and at 2 years was determined with cycloplegic retinoscopy for 282 of 419 patients enrolled. The baseline mean refractive error was + 3.13 diopters (D) in patients assigned randomly to receive atropine and + 2.58D in patients assigned randomly to wear the patch. The mean change in refractive error of the sound eye was + 0.10 D in the atropine group (N = 134) and + 0.08 D in the patch group (N = 148). Patients also were subdivided into those treated with atropine only (n = 41) and patching only (n = 64) because some children changed treatments during their study participation. The mean change for the sound eyes was -0.21 D for the patients receiving only atropine and -0.06 D for the patients receiving only patching. Unilateral atropine applied to the sound eye compared with occlusion was not associated with any adverse effect on refractive error following up to 2 years of treatment.",
author = "Repka, {Michael X} and Michele Melia and Maya Eibschitz-Tsimhoni and Richard London and Elbert Magoon",
year = "2007",
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AU - London, Richard

AU - Magoon, Elbert

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AB - Our objective was to determine whether the use of unilateral atropine as amblyopia therapy leads to an asymmetric change in refractive error compared with patching. Patients were enrolled in a clinical trial in which atropine 1% solution or occlusion with an adhesive patch was administered daily to the sound eye of children 3 to less than 7 years of age for a period of at least 6 months to a maximum of 2 years. Refractive error at entry and at 2 years was determined with cycloplegic retinoscopy for 282 of 419 patients enrolled. The baseline mean refractive error was + 3.13 diopters (D) in patients assigned randomly to receive atropine and + 2.58D in patients assigned randomly to wear the patch. The mean change in refractive error of the sound eye was + 0.10 D in the atropine group (N = 134) and + 0.08 D in the patch group (N = 148). Patients also were subdivided into those treated with atropine only (n = 41) and patching only (n = 64) because some children changed treatments during their study participation. The mean change for the sound eyes was -0.21 D for the patients receiving only atropine and -0.06 D for the patients receiving only patching. Unilateral atropine applied to the sound eye compared with occlusion was not associated with any adverse effect on refractive error following up to 2 years of treatment.

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