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    Levodopa for amblyopia explored as novel modality

    Despite findings, patients still seemed to experience subtle-but-slow improvement over time

     

    Take home:

    A study of children with residual amblyopia did not find an advantage with the use of levodopa compared with a placebo group.

     

     

    Baltimore—In children ages 7 to 12 with residual amblyopia use of the medication, levodopa, did not lead to a meaningful improvement in visual acuity compared with placebo, said Michael X. Repka, MD, MBA.

    There are a few medical therapies currently tried for amblyopia—including atropine, oral levodopa, and oral and intramuscular citicholine—although results with levodopa and citicholine have been mixed, said Dr. Repka, the David L. Guyton, M.D., and Feduniak Family Professor of Ophthalmology, and professor of pediatric medicine, Johns Hopkins University School of Medicine, Wilmer Eye Institute, Baltimore.

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    All three agents are not currently approved by the FDA for the treatment of amblyopia, he added.

    There are six trials that have analyzed the use of levodopa for amblyopia against placebo, but they have had varied results, Dr. Repka said.

    One 2012 meta-analysis found that the drug compared with placebo was favorable by about 1 line.1 However, the results are hard to follow from the various trials because of various treatment durations and treatment times that differed with respect to amblyopia.

    About the PEDIG Study

    The Pediatric Eye Disease Investigator Group (PEDIG) that Dr. Repka participated in had the primary objective of comparing oral levodopa plus patching with oral placebo plus patching for residual amblyopia for older children. The 139 children who participated over more than 3 years came from 27 different centers; all were between the ages of 7 and 12. Patients had strabismus and/or amblyopia; they had patching for at least 2 hours daily for at least 3 months prior to enrollment.

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