Cited by 182Ophthalmology and Visual Impairment StudiesOphthalmology and Eye DisordersRetinal Diseases and Treatments

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Patching vs Atropine to Treat Amblyopia in Children Aged 7 to 12 Years: A Randomized Trial

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Pediatric Eye Disease Investigator Group·2008·Archives of Ophthalmology

DOI 10.1001/archophthalmol.2008.107PMC PMC2846774

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Abstract

OBJECTIVE: To compare patching with atropine eyedrops in the treatment of moderate amblyopia (visual acuity, 20/40-20/100) in children aged 7 to 12 years. METHODS: In a randomized, multicenter clinical trial, 193 children with amblyopia were assigned to receive weekend atropine or patching of the sound eye 2 hours per day. Main Outcome Measure Masked assessment of visual acuity in the amblyopic eye using the electronic Early Treatment Diabetic Retinopathy Study testing protocol at 17 weeks. RESULTS: At 17 weeks, visual acuity had improved from baseline by an average of 7.6 letters in the atropine group and 8.6 letters in the patching group. The mean difference between groups (patching - atropine) adjusted for baseline acuity was 1.2 letters (ends of complementary 1-sided 95% confidence intervals for noninferiority, -0.7, 3.1 letters). This difference met the prespecified definition for equivalence (confidence interval <5 letters). Visual acuity in the amblyopic eye was 20/25 or better in 15 participants in the atropine group (17%) and 20 in the patching group (24%; difference, 7%; 95% confidence interval, -3% to 17%). CONCLUSIONS: Treatment with atropine or patching led to similar degrees of improvement among 7- to 12-year-olds with moderate amblyopia. About 1 in 5 achieved visual acuity of 20/25 or better in the amblyopic eye. CLINICAL RELEVANCE: Atropine and patching achieve similar results among older children with unilateral amblyopia. TRIAL REGISTRATION: (clinicaltrials.gov) Identifier: NCT00315328.

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Background
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Piano, M. E. F., & Simmers, A. J. (2019) · Therapeutic Advances in Ophthalmology · doi:10.1177/2515841419857379 · Cited by 15
Calibrating vision: Concepts and questions
Bosten, J. M., Coen-Cagli, R., Franklin, A., Solomon, S. G., & Webster, M. A. (2022) · Vision Research · doi:10.1016/j.visres.2022.108131 · Cited by 13
Amblyopia and Strabismus
Granet, D. B., & Khayali, S. (2011) · Pediatric Annals · doi:10.3928/00904481-20110117-08 · Cited by 14
Short-term effects of vision trainer rehabilitation in patients affected by anisometropic amblyopia: electrofunctional evaluation
Veneruso, P. E., Ziccardi, L., Magli, G., Falsini, B., & Magli, A. (2014) · Documenta Ophthalmologica · doi:10.1007/s10633-014-9462-x · Cited by 14
Vision Therapy and Virtual Reality Applications
Fortenbacher, D. L., Bartolini, A., Dornbos, B., & Tran, T. A. (2018) · Advances in Ophthalmology and Optometry · doi:10.1016/j.yaoo.2018.04.002 · Cited by 14
Longitudinal Impact on Quality of Life for School-aged Children with Amblyopia Treatment: Perspective from Children
Chen, Y., Chen, X., Chen, J., Zheng, J., Xu, J., & Yu, X. (2015) · Current Eye Research · doi:10.3109/02713683.2015.1011280 · Cited by 14
Outcomes of 3 hours part-time occlusion treatment combined with near activities among children with unilateral amblyopia.
Alotaibi, A. G., Fawazi, S. M., Alenazi, B. R., & Abu‐Amero, K. K. (2012) · Saudi Medical Journal · doi:10.15537/1658-3175.5527 · Cited by 13
Designing clinical trials for amblyopia
Holmes, J. M. (2015) · Vision Research · doi:10.1016/j.visres.2015.01.029 · Cited by 13
Impact of Visual Cues on the Magnitude and Variability of the Accommodative Response in Children With Emmetropia and Uncorrected Hyperopia and Adults
Roberts, T. L., Manny, R. E., & Anderson, H. A. (2019) · Investigative Ophthalmology & Visual Science · doi:10.1167/iovs.18-25256 · Cited by 12
Childhood amblyopia: A systematic review of recent management options
Alrasheed, S. H., & Aldakhil, S. (2024) · Saudi Journal of Ophthalmology · doi:10.4103/sjopt.sjopt_212_23 · Cited by 12
“[63] compared the effectiveness of 2 h of patching versus weekend atropine treatment for children (ages 7–12) with anisometropic and/ or strabismic amblyopia over 17 weeks.”
Background
Evaluation of the Aniseikonia Inspector Version 3 in School‐Aged Children
Kehler, L. A. F., Fraine, L. A., & Lu, P. (2014) · Optometry and Vision Science · doi:10.1097/opx.0000000000000245 · Cited by 12
Practical use and prescription of ocular medications in children and infants
Webber, A. L., & Sharwood, P. L. (2021) · Clinical and Experimental Optometry · doi:10.1080/08164622.2021.1877533 · Cited by 12
Factors predicting regression of visual acuity following successful treatment of anisometropic amblyopia
Jia, Y., Liu, J., Ye, Q., Zhang, S., Feng, L., Xu, Z., Zhuang, Y., He, Y., Zhou, Y., Chen, X., et al. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.1013136 · Cited by 12
A computer-based anaglyphic system for the treatment of amblyopia
Rastegarpour, A., & Rastegarpour, A. (2011) · Clinical ophthalmology · doi:10.2147/opth.s25074 · Cited by 12
Home-based screening tools for amblyopia: a systematic review
Sii, S. S. Z., Chean, C. S., Kuht, H. J., Bunce, C., Thomas, M. G., & Rufai, S. R. (2023) · Eye · doi:10.1038/s41433-023-02412-3 · Cited by 14
Occlusion therapy improves phase-alignment of the cortical response in amblyopia
Kelly, J. P., Tarczy‐Hornoch, K., Herlihy, E. P., & Weiss, A. H. (2014) · Vision Research · doi:10.1016/j.visres.2014.11.014 · Cited by 11
NEIVATECH pilot study: immersive virtual reality training in older amblyopic children with non-compliance or non-response to patching
Vega, L. L., Coco-Martín, M. B., Molina‐Martín, A., Cuadrado-Asensio, R., Vallelado-Álvarez, A. I., Sánchez-Tocino, H., Mayo-Íscar, A., Hernández-Rodríguez, C. J., Arenillas, J. F., & Pinero, D. P. (2024) · Scientific Reports · doi:10.1038/s41598-024-79565-y · Cited by 10
Long-Term Efficacy of the Combination of Active Vision Therapy and Occlusion in Children with Strabismic and Anisometropic Amblyopia
Milla, M., Molina‐Martín, A., & Pinero, D. P. (2022) · Children · doi:10.3390/children9071012 · Cited by 10
Clinicians’ perspectives of health-related quality of life (HRQoL) implications of amblyopia: a qualitative study
Carlton, J. (2011) · British and Irish Orthoptic Journal · doi:10.22599/bioj.35 · Cited by 10
Associations between the cause of amblyopia and pre-treatment contrast sensitivity, stereoacuity, fixation, and nystagmus
Jia, Y., Ye, Q., Liu, J., Feng, L., Xu, Z., He, Y., Zhou, Y., Chen, X., Yao, Y. X., Thompson, B. S., et al. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e28857 · Cited by 9
“Amblyopia subtype differences that have been reported previously may have been influenced by smaller sample sizes or an interaction between amblyopia subtype and amblyopia treatment response, an effect that has been reported by some studies [50] but not others [51 – 54].”
Result
Clinical Aniseikonia in Anisometropia and Amblyopia
South, J., Gao, T. Y., Collins, A., Lee, A. C.-L., Turuwhenua, J., & Black, J. M. (2020) · British and Irish Orthoptic Journal · doi:10.22599/bioj.154 · Cited by 9
Proportion of Refractive Errors in a Polish Immigrant Population in Chicago
Allison, C. L. (2010) · Optometry and Vision Science · doi:10.1097/opx.0b013e3181e61beb · Cited by 8
Paediatric Eye Services: How Much of the Workload Is Amblyopia-Related?
Stewart, C. E., Shah, S. P., Wren, S. M. E., & Roberts, C. J. (2016) · Strabismus · doi:10.1080/09273972.2016.1205102 · Cited by 8
L’amblyopie
Orssaud, C. (2014) · Journal Français d Ophtalmologie · doi:10.1016/j.jfo.2014.01.004 · Cited by 8

Authors: Pediatric Eye Disease Investigator Group
Affiliations: University of Ottawa (CA)
Corresponding author: Pediatric Eye Disease Investigator Group
Venue: Archives of Ophthalmology
Publisher: American Medical Association (AMA)
Published: 2008-12-08
Volume: 126
Issue: 12
Pages: 1634
ISSN: 0003-9950 (ISSN-L)
DOI: 10.1001/archophthalmol.2008.107
PMC: PMC2846774
OpenAlex: W97765374
Cited by: 182
References: 7
Citations by year: 2026: 9 · 2025: 6 · 2024: 7 · 2023: 9 · 2022: 16 · 2021: 12 · 2020: 10 · 2019: 10 · 2018: 13 · 2017: 7 · 2016: 11 · 2015: 11 · 2014: 9 · 2013: 10 · 2012: 6
FWCI: 8.66
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Archives of Ophthalmology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Eye Institute (EY011751, U10EY011751, UG1EY011751)
Topics: Health Sciences › Medicine › Ophthalmology › Ophthalmology and Visual Impairment Studies
Health Sciences › Medicine › Ophthalmology › Ophthalmology and Eye Disorders
Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
Keywords: amblyopia, occlusion therapy, patching, atropine, atropine eye drops, visual acuity, children, unilateral amblyopia, non-inferiority, treatment equivalence
MeSH terms: Amblyopia, Atropine, Child, Female, Humans, Male, Mydriatics, Ophthalmic Solutions, Sensory Deprivation, Visual Acuity, Vision, Binocular, Treatment Outcome

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Patching vs Atropine to Treat Amblyopia in Children Aged 7 to 12 Years: A Randomized Trial

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