Levodopa Plus Occlusion Therapy versus Occlusion Therapy Alone for Children with Anisometropic Amblyopia

Purpose: This study aimed to compare the effects of short-term administration of levodopa plus occlusion therapy versus occlusion therapy alone in preschool children with hyperopic anisometropic amblyopia. Methods: This comparative interventional study included 40 eligible preschool children aged 6 to 7 years with hyperopic anisometropic amblyopia. The primary outcome measure was the logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity recorded at baseline, 3 weeks after the treatment initiation and 12 weeks after the treatment termination. The results were compared between the two groups. Results: No statistically significant intergroup difference was observed in baseline logMAR visual acuities (P = 0.92). The mean logMAR visual acuities of the amblyopic eyes were significantly better in both groups three weeks after the treatment initiation than the baseline (P < 0.01 in both groups). At 12 weeks after treatment termination, the logMAR visual acuities of the amblyopic eyes were significantly better than the baseline values (P < 0.001 in the placebo group and P = 0.09 in the levodopa group). Intergroup comparisons revealed no statistically significant difference in visual acuities 3 weeks after the treatment initiation (P = 0.11) and 12 weeks after the treatment termination (P=0.10). Twelve weeks after the treatment termination, visual acuities regressed 0.037 logMAR in the placebo group and 0.042 logMAR in the levodopa group. These regression rates were not significantly different (P = 0.89). Conclusion: The results of this study provide evidence that adding short-term administration of levodopa to occlusion therapy in hyperopic anisometropic amblyopia offers no additional benefit in visual outcomes and provides no advantage in terms of the regression rate.