Surgery

Ophthalmology

Anesthesia

Pediatrics

Atropine

Internal medicine

Visual acuity

Medicine

Randomized controlled trial

Archives of Ophthalmology

<h3>Objective</h3> To determine the visual acuity outcome at age 10 years for children younger than 7 years when enrolled in a treatment trial for moderate amblyopia. <h3>Methods</h3> In a multicenter clinical trial, 419 children with amblyopia (visual acuity, 20/40-20/100) were randomized to patching or atropine eyedrops for 6 months. Two years after enrollment, a subgroup of 188 children entered long-term follow-up. Treatment after 6 months was at the discretion of the investigator; 89% of children were treated. <h3>Main Outcome Measure</h3> Visual acuity at age 10 years with the electronic Early Treatment Diabetic Retinopathy Study test. <h3>Application to Clinical Practice</h3> Patching and atropine eyedrops produce comparable improvement in visual acuity that is maintained through age 10 years. <h3>Results</h3> The mean amblyopic eye acuity, measured in 169 patients, at age 10 years was 0.17 logMAR (logarithm of the minimum angle of resolution) (approximately 20/32), and 46% of amblyopic eyes had an acuity of 20/25 or better. Age younger than 5 years at entry into the randomized trial was associated with a better visual acuity outcome (<i>P</i> &lt; .001). Mean amblyopic and sound eye visual acuities at age 10 years were similar in the original treatment groups (<i>P</i> = .56 and<i>P</i> = .80, respectively). <h3>Conclusions</h3> At age 10 years, the improvement of the amblyopic eye is maintained, although residual amblyopia is common after treatment initiated at age 3 years to younger than 7 years. The outcome is similar regardless of initial treatment with atropine or patching. <h3>Trial Registration</h3> clinicaltrials.gov Identifier:NCT00000170

A Randomized Trial of Atropine vs Patching for Treatment of Moderate Amblyopia