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Comment & Response |

Atropine vs Patching

Philip Lempert, MD1
[+] Author Affiliations
1Arleo Eye Associates, Ithaca, New York
JAMA Ophthalmol. 2015;133(5):619. doi:10.1001/jamaophthalmol.2014.6111.
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To the Editor The recent article by Repka et al1 concerning maintenance of visual acuity (VA) after treatment for amblyopia contains incongruities between the data and conclusions.

Only 147 of the 419 children (35%) completed the study. The participants with poorer vision (mean VA, 0.13 logMAR) may have been more likely to drop out than the group with better VA (mean VA, 0.19 logMAR). The poorer vision may have reduced their incentive to continue, but in any case it could have enhanced the final result slightly toward better vision in the treated group. It is also interesting that there was a dramatic increase in the percentage of fellow eyes with VA of 20/20 or better from 9.5% initially to 95.9% after 15 years (Table 1 in the article by Repka et al1). This is particularly surprising in view of reports of visual function deficits in the presumably nonamblyopic normal eyes.2 Did the inclusion of fellow eyes with VA better than 20/20 skew the results toward greater mean intraocular differences and increase the number of participants with intraocular differences in VA?

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May 1, 2015
Michael X. Repka, MD, MBA; Raymond T. Kraker, MSPH; Jonathan M. Holmes, BM, BCh; for the Pediatric Eye Disease Investigator Group
1Wilmer Ophthalmological Institute, Johns Hopkins University, Baltimore, Maryland
2Jaeb Center for Health Research, Tampa, Florida
3Mayo Clinic, Rochester, Minnesota
JAMA Ophthalmol. 2015;133(5):619-620. doi:10.1001/jamaophthalmol.2014.6131.
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