A randomized trial of levodopa as treatment for residual amblyopia in older children

Abstract

Objective: To assess the efficacy and short-term safety of levodopa as adjunctive treatment to patching for amblyopia.

Design: Randomized, placebo-controlled trial.

Participants: One hundred thirty-nine children 7 to 12 years of age with residual amblyopia resulting from strabismus, anisometropia, or both combined (visual acuity [VA], 20/50-20/400) after patching.

Methods: Sixteen weeks of oral levodopa or placebo administered 3 times daily while patching the fellow eye 2 hours daily.

Main outcome measures: Mean change in best-corrected amblyopic-eye VA at 18 weeks.

Results: At 18 weeks, amblyopic-eye VA improved from randomization by an average of 5.2 letters in the levodopa group and by 3.8 letters in the placebo group (difference adjusted for baseline VA, +1.4 letters; 1-sided P=0.06; 2-sided 95% confidence interval, -0.4 to 3.3 letters). No serious adverse effects from levodopa were reported during treatment.

Conclusions: For children 7 to 12 years of age with residual amblyopia after patching therapy, oral levodopa while continuing to patch 2 hours daily does not produce a clinically or statistically meaningful improvement in VA compared with placebo and patching.