The Effect of L-dopa in Amblyopic Children for Whom Occlusion Therapy Failed

ABSTRACT

PURPOSE: This study was undertaken to evaluate the effect of L-dopa in amblyopic children for whom occlusion treatment failed. METHODS: We studied nine amblyopic children (11 eyes) for whom part-time occlusion (4~8 hours/day) treatment for a minimum period of 6 months had failed. The types of amblyopia included anisometropic (1 patient, 1 eye), stimulus deprivation (4 patients, 6 eyes) and mixed (anisometropic and strabismic 2 patients, 2 eyes; anisometropic and organic 2 patients, 2 eyes). Best corrected visual acuity before treatment was between 0.05 and 0.5. They received, with full informed consent of the parent, levodopa (2~4 mg/kg) for 8 weeks combined with part-time occlusion. RESULTS: The children were between 4 and 11 years old (mean 5.8+/-2.05). Of the subjects, 45.5% (4 patients, 5 eyes) had improved visual acuity after 8 weeks of treatment. In one patient with anisometropic, two patients with mixed (anisometropic and strabismic), and one patient with stimulus deprivation (ametropic) amblyopia, visual acuity improved by one to five lines. CONCLUSIONS: In anisometropic, strabismic amblyopes and mild deprivational amblyopes for whom occlusion treatment failed, L-dopa improved visual acuity. L-dopa may be an additional option for treatment of amblyopic patients with a guarded visual prognosis.