Visual acuities after levodopa administration in amblyopia.
PURPOSE: To investigate the effect of the augmentation of levodopa with part-time and full-time occlusion on visual acuity and to determine its late results in amblyopia. METHODS: Seventy-two patients with amblyopia were prospectively studied and randomly distributed into groups A, B, and C consisting of 24 patients each. Group A patients received levodopa alone, group B received levodopa and part-time (3 hours/day) occlusion, and group C received levodopa and full-time (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 administered orally three times a day for 7 weeks. Snellen visual acuity and its 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 completion 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 the 44 patients had a regression in visual acuity. CONCLUSION: The augmentation of levodopa with part-time or full-time occlusion does not enhance the recovery of vision in amblyopia. Improved visual acuity 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 compared to levodopa alone or combined with part-time occlusion.