Combined atropine and patching therapy vs patching alone for amblyopia: Is one superior?

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Although amblyopic eye visual acuity (VA) improvement in children with severe amblyopia treated with combined atropine and patching therapy (CAPT) was greater than in children treated with patching alone, the differences were relatively small, according to a study.

In this randomized clinical trial, 108 children between the ages of 3 and 12 years with severe amblyopia (20/100 to 20/500) cause by strabismus, anisometropia, or both were randomly assigned to CAPT (n = 52) or patching therapy (n = 55) and followed for 6 months.

From baseline to 6 months the mean (SD) amblyopic eye VA improved from 0.95 (0.22) logMAR to 0.72 logMAR (7.2 lines) in the CAPT group and 0.58 logMAR (5.8 lines) in the patching alone group.

At 3 months, amblyopic eye VA improvement in the CAPT group was greater than that in the patching alone the CAPT group.

Despite the superior mean improvement of amblyopic eye VA with CAPT, the authors included the clinical relevance could not be determined due to the relatively small difference.

Wang S, Wen W, Zhu W, et al. Effect of combined atropine and patching vs patching alone for treatment of severe amblyopia in children aged 3 to 12 yearsA randomized clinical trial. JAMA Ophthalmol.  2021;doi:10.1001/jamaophthalmol.2021.2413

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