PEDIG: Patching, atropine both effective against amblyopia

Both patching and atropine provide benefit for pediatric patients with amblyopia, regardless of variables including age, depth of amblyopia and the number of patching hours prescribed, a large study has found.

Early in the trial, patients in the study with visual acuities of 20/80 to 20/100 showed more rapid improvement when prescribed longer periods of patching, but this difference disappeared by 6-month follow-up, the study authors said.

Members of the Pediatric Eye Disease Investigator Group randomized 419 children under the age of 7 who had amblyopia and visual acuity ranging from 20/40 to 20/100 to receive either patching or atropine. All participants were followed for up to 6 months.

Visual acuity was slightly better in the patching group than in the atropine group, the authors said. The relative treatment effect did not vary with age, cause of amblyopia or baseline amblyopic eye acuity. Patients whose initial VA was 20/80 to 20/100 and who had been prescribed 10 or more hours a day of patching showed a more rapid improvement in acuity than did patients prescribed a lesser amount of patching (P = .01) or than patients in the atropine group (P < .001). However, by 6 months the differences were no longer significant, the authors reported in the August issue of Ophthalmology.

“For the clinician weighing the pros and cons of patching vs. atropine as an initial therapy for a child with amblyopia who is within this age and acuity range, our results indicate that age, depth of amblyopia and cause of amblyopia are not important factors to consider,” the authors stated.