Twice weekly atropine as a primary treatment for amblyopia: How does this compare with daily atropine?

Abstract

Aim: This paper presents a service review giving results of twice weekly atropine treatment compared with daily treatment for amblyopia in a clinical setting and compares the results with our previous research. Methods: In a retrospective case note review 70 patients treated with twice weekly atropine for amblyopia were compared with a previous cohort treated with daily atropine. Results: Seventy patients were included in the data analysis for twice weekly treatment. Mean (SD) starting visual acuity (VA) of the amblyopic eye was 0.676 (0.337). The mean (SD) VA immediately after treatment improved to 0.368 (0.307). The number of log units' improvement was 0.308. Anisometropic amblyopia responded more positively than strabismic amblyopia and mixed amblyopia (p ¼ 0.021). Those with moderate amblyopia had a better end visual outcome than those with a severely reduced starting acuity (p ¼ 0.0004). Results showed that 49% of patients treated with twice weekly atropine achieved a cure VA, with a further 30% showing a significant improvement. Conclusions: We found no statistical or clinical significance between the two treatment options (p value ¼ 0.962) in terms of visual outcome. Treatment duration, rate of adverse events and failure-to-attend rates were also comparable. The cost of drug treatment for the average 4 month duration of treatment was significantly cheaper for the twice weekly option. Overall, looking at the successful VA outcomes, low incidence of adverse events, excellent parental compliance and reduced treatment costs, twice weekly atropine proves a favourable option as a first-line treatment for all levels and types of amblyopia compared with daily atropine.