Resultados do tratamento da ambliopia com levodopa combinada à oclusão

Abstract

Purpose: To evaluate visual acuity improvement with levodopa/ benzerazide associated with partial occlusion and followed by total occlusion therapy in patients with amblyopia considered irreversible. Methods: A 9-week experimental open study was performed involving 37 patients, between 7 and 40 years old, with strabismic and/or anisometropic amblyopia. All patients were treated with levodopa (0.70 mg/kg/day) and 25% benzerazide associated with 4-hour/day occlusion of the dominant eye for 5 weeks. In the last 4 weeks, only the total occlusion (24 h) of the dominant eye was performed. Visual acuity was measured by the Early Treatment Diabetic Retinopathy (ETDR) table with the logarithmic minimum angle of resolution (logMAR) scale before the beginning of the treatment and after 1, 3, 5 and 9 weeks of treatment. Adhesions to occlusion therapy and to drug intake were checked through a written questionnaire and capsule counting. Adverse effects were evaluated by clinical examination and questionnaire. Results: After 9 weeks of treatment visual acuity improved from 0.58 ± 0.16 to 0.23 ± 0.16 logMAR (4 lines of improvement in the ETDR table). Conclusion: Levodopa dose of 0.70 mg/ kg/day is well tolerated and, when associated with occlusion therapy, significantly improves visual acuity in patients with amblyopia considered irreversible.