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PEDIATRICS Vol. 113 No. 6 June 2004, pp. 1800-1802

COMMENTARY

Recent Advances in the Treatment of Amblyopia

Graham E. Quinn, MD, MSCE, Roy W. Beck, MD, PhD, Jonathan M. Holmes, BM, BCh and Michael X. Repka, MD

Children’s Hospital of Philadelphia
University of Pennsylvania School of Medicine
Philadelphia, PA 19104
Jaeb Center for Health Research
Tampa, FL 33647
Department of Ophthalmology
Mayo Clinic College of Medicine
Rochester MN 55905
Wilmer Institute
Johns Hopkins University School of Medicine
Baltimore, MD 21287

Abbreviations: PEDIG, Pediatric Eye Disease Investigator Group • logMAR, logarithm of the minimal angle of resolution

The first 300 words of the full text of this article appear below.

In 1997, the Pediatric Eye Disease Investigator Group (PEDIG) was formed to conduct clinical research in eye disorders that affect children.1,2 The primary focus of PEDIG involves studies that can be conducted through simple protocols with limited data collection and implemented by both university-based and community-based pediatric eye care practitioners as part of their routine practice. As of October 1, 2003, 135 investigators at 97 sites in North America have participated in at least 1 PEDIG study.

A major focus of PEDIG has been the evaluation of different treatment modalities for amblyopia (the Amblyopia Treatment Study). Amblyopia was selected for study because it is the most common cause of monocular visual impairment in children and young and middle-aged adults,3,4 and opinions vary on the appropriate treatment regimens. Three randomized trials have been completed thus far, and 3 trials and 2 observational studies are currently in progress.


   ATROPINE VERSUS PATCHING FOR MODERATE AMBLYOPIA
 
The first PEDIG amblyopia trial compared patching of the sound eye versus instillation of atropine drops in the sound eye as treatments for moderate amblyopia (20/40 to 20/100) in children 3 to 7 years old.5–9 Amblyopia was due to unequal refractive error, strabismus, or both. Atropine blurs the vision in the sound eye through its cycloplegic effect that can last, at least partially, for up to 14 days. The group of children randomized to atropine treatment received 1 drop of 1% atropine in the sound eye daily; if by 4 months acuity had not reached 20/30 or improved from baseline by ≥3 lines, then any far-sighted correction in the spectacle lens of the sound eye was removed to augment the effect of the atropine. The patching group was initially prescribed daily patching for a minimum of 6 hours up to all waking hours at investigator discretion; if by 4 months acuity had not reached . . . [Full Text of this Article]

Address correspondence to Graham E. Quinn, MD, MSCE, Division of Pediatric Ophthalmology, Children’s Hospital of Philadelphia, One Children’s Center, Philadelphia, PA 19104. E-mail: quinn@email.chop.edu




This article has been cited by other articles:


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The Pediatric Eye Disease Investigator Group Report May Be Too Optimistic About Efficacy of Treatment
Pediatrics, November 1, 2004; 114(5): 1366 - 1366.
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 PediatricsHome page
G. E. Quinn, R. W. Beck, M. X. Repka, J. M. Holmes, and on Behalf of Pediatric Eye Disease Investigator Gr
The Pediatric Eye Disease Investigator Group Report May Be Too Optimistic About Efficacy of Treatment: In Reply
Pediatrics, November 1, 2004; 114(5): 1366 - 1367.
[Full Text] [PDF]