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Patching vs Atropine to Treat Amblyopia in Children Aged 7 to 12 Years: A Randomized Trial
Open accessAbstract
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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“In typically developing individuals, effectiveness of treatment diminishes after the age of 7 years, although there are substantial individual differences in response to treatment after that period (Scheiman et al., 2008).”
From Brain adaptation and alternative developmental trajectories (2015) · cites this paper as Scheiman et al., 2008
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Metadata
- 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)
- 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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