Purpose: To investigate the effect of the augmentation of levodopa with par
t-time and full-time occlusion on visual acuity and to determine its late r
esults in amblyopia.
Methods: Seventy-two patients with amblyopia were prospectively studied and
randomly distributed into groups A, B, and C consisting of 24 patients eac
h. Group A patients received levodopa alone, group B received levodopa and
part-time (3 hours/day) occlusion, and group C received levodopa and full-t
ime (during all waking hours) occlusion of the dominant eye. Levodopa 0.50
mg/kg body weight, with a 25% fixed dose combination of carbidopa, was admi
nistered orally three times a day for 7 weeks. Snellen visual acuity and it
s logMAR equivalent were recorded before treatment, at weeks 1, 3, 5, and 7
after starting treatment, and every 6 weeks for 1 year after the completio
n of treatment.
Results: Fifty-three (74%) of the 72 patients had an improvement in visual
acuity after treatment. Forty-four of the 53 patients with improved visual
acuities completed 1-year post-treatment follow-up. Twenty-three (52%) of t
he 44 patients had a regression in visual acuity.
Conclusion: The augmentation of levodopa with part-time or full-time occlus
ion does not enhance the recovery of vision in amblyopia. Improved visual a
cuity after levodopa administration persists at least 1 year in almost half
of patients after cessation of treatment. Addition of full-time occlusion
to levodopa helps maintain improved visual acuity for a longer duration com
pared to levodopa alone or combined with part-time occlusion.