LEVODOPA CARBIDOPA TREATMENT FOR AMBLYOPIA IN OLDER CHILDREN

The purpose of the present study is to determine how long visual funct ion improves during levodopa/carbidopa with part-time occlusion treatm ent in older amblyopic children. A 7-week open clinical trial of levod opa (0.55 mg/kg, three times daily) with 25% carbidopa combined with p art-time occlusion (3 hours/day), was undertaken in 15 older (mean age , 8.87 years) amblyopic children. Visual acuity, fusion, and stereo ac uity were measured at baseline, at weeks 1, 3, 5, and 7 during treatme nt, and 6 weeks following the end of all treatment. Health status was assessed by physical examination, questionnaire, and standard laborato ry tests (CHEM 20, complete blood cell count [CBC], and differential). The results revealed that visual acuity in the amblyopic eye improved for 5 weeks, from 20/170 at baseline to 20/107, then stabilized for t he last 2 weeks. Visual acuity also improved in the dominant eye by 0. 6 lines, from 20/19 to 20/16. At the 6-week follow up, visual acuity i n the amblyopic eye remained at 20/107 (paired t = 4.78, df = 14, P < .001), a 37% improvement. Thirty-three percent of the subjects demonst rated improved fusion from baseline to the 7-week trial that was maint ained at follow up (chi2 = 3.97, P < .05). Stereo acuity did not signi ficantly change. Physical exam (blood pressure, body temperature, resp iration, heart rate) and standard laboratory tests remained normal and side effects were minimal. It is concluded that levodopa/carbidopa co mbined with part-time occlusion in older amblyopic children improves v isual acuity for 5 weeks then stabilizes, and can lead to improvements in visual acuity and in fusion over a period of at least 6 weeks foll owing cessation of treatment, with minimal side effects.