Der Effekt der Levodopatherapie auf das visuell evozierte Potential und die Sehschärfe in der Amblyopie

Başmak, Hikmet; Yildirim, Nilgün; Erdinç, Oğuz Osman; Yurdakul, Sumru; Özdemir, Gazi

doi:10.1159/000027402

Cited by 22 publications

(8 citation statements)

References 11 publications

(13 reference statements)

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“…4, 5 Levodopa is converted to dopamine, which appears to play an important role in retinal function and in central visual processing. 6 Improvements in VA and/or visual evoked potential amplitudes have been reported immediately following a single dose, 7 a 1-week course, 8 or a 7-week course 4, 9, 10 of levodopa, but much of the improvement regressed after discontinuation of the drug. Studies investigating the use of levodopa as amblyopia treatment have also shown improvement in VA. 4,5,7,8, 10–16 However, some participants experience partial regression after stopping the medication.…”

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confidence: 99%

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A Randomized Trial of Levodopa as Treatment for Residual Amblyopia in Older Children

et al. 2015

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Objective To assess the efficacy and short-term safety of levodopa as adjunctive treatment to patching for amblyopia. Design Randomized, placebo-controlled trial. Participants One hundred thirty-nine children 7 to 12 years of age with residual amblyopia resulting from strabismus, anisometropia or both combined (20/50 to 20/400) following patching. Methods Sixteen weeks of oral levodopa or placebo administered 3 times a day while patching the fellow eye 2 hours per day. Main Outcome Measures Mean change in best-corrected amblyopic-eye visual acuity at 18 weeks. Results At 18 weeks, amblyopic-eye visual acuity improved from randomization by an average of 5.2 letters in the levodopa group and 3.8 letters in the placebo group (difference adjusted for baseline visual acuity = +1.4 letters, 1-sided P=0.06; 2-sided 95% confidence interval = −0.4 to +3.3 letters). No serious adverse effects from levodopa were reported during treatment. Conclusions For children 7 to 12 years of age with residual amblyopia following patching therapy, oral levodopa while continuing to patch 2 hours per day does not produce a clinically or statistically meaningful improvement in visual acuity compared with placebo and patching.

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“…Studies investigating the use of levodopa as amblyopia treatment have also shown improvement in VA. 4,5,7,8, 10–16 However, some participants experience partial regression after stopping the medication. 4,7,8,10–12,14 …”

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confidence: 99%

A Randomized Trial of Levodopa as Treatment for Residual Amblyopia in Older Children

et al. 2015

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“…One such ancillary treatment is oral levodopa, which is used to supplement dopamine deficiency in brains of adults with Parkinson's disease and children with dopamine-responsive dystonia [2,3]. Levodopa improves visual acuity and neuroplasticity of the brain in treatment of amblyopic eyes, both for children and adults patients [15][16][17][18][19]. Levodopa-Carbidopa is used for treatment of amblyopia, administered orally in a dose ranging from 4.1 to 6.6 mg/kg/day in 2-3 divided doses (1-3 tablets per day) [20].…”

Section: Progress Of Visionmentioning

confidence: 99%

Levodopa as Treatment for Adults with Amblyopia

Bogdănici¹,

Bogdanici²,

Moraru³

et al. 2017

Rev. Chim.

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Levodopa is a medication used in treatment for Parkinson�s disease, which is associated with low levels of a chemical called dopamine in the brain. Levodopa is turned into dopamine in the body and therefore increases levels of this chemical. Levodopa was used as a treatment of amblyopia alone or in combination with classical treatment of occlusion. Visual acuity is improved after treatment with oral Levodopa. When is used as an adjunct to the occlusion therapy, Levodopa can be associated with long-term improvement in the vision, and may have also better compliance for patching. Levodopa stimulates the brain plasticity in adult age and can be used in treatment for amblyopia. Patients have also an increase of the visual acuity after orthoptic treatment for amblyopia and when Levodopa is administered, the vision increases much more. Contrary to the classical conception, according to which amblyopia cannot be treated after 10-12 years of age and it is untreatable in adults, studies about treatment with Levodopa in amblyopic eyes, may allow the improvement of the visual acuity in adults, as well.

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“…Many studies have been performed to evaluate the role of levodopa in the treatment of amblyopia. Some of these studies used levodopa at a relatively high dose (6 mg/kg/day7,8 to 13 mg/kg/day9), but for short durations (1 day9 to 1 week7). Other studies used much lower doses of 1.5 mg/kg/day10–14 for a longer duration (7 weeks), and one as yet unpublished randomized trial of levodopa as treatment for residual amblyopia used two doses (0.51 mg/kg versus 0.76 mg/kg, each given three times daily) for 8 weeks 15.…”

Section: Introductionmentioning

confidence: 99%

“…In severe amblyopia (visual acuity 0.2 or worse), occlusion for 6 hours has been found to be as effective as full-time occlusion 21. Some of the previous studies of levodopa used the drug without occlusion8,11 in some patients. Some studies used only 2–3 hours of occlusion7,11,15 and other studies used full-time occlusion 14,17…”

Section: Introductionmentioning

confidence: 99%

Pharmacological enhancement of treatment for amblyopia

Rashad¹

2012

OPTH

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BackgroundThe purpose of this study was to compare a weight-adjusted dose of carbidopa- levodopa as treatment adjunctive to occlusion therapy with occlusion therapy alone in children and adults with different types of amblyopia.MethodsThis prospective study included 63 patients with amblyopia classified into two groups, ie, an occlusion group which included 35 patients who received occlusion therapy only and a pharmacological enhancement group which included 28 patients who received oral carbidopa-levodopa together with occlusion therapy for 6 weeks.ResultsThe mean logarithm of the minimal angle of resolution (logMAR) of the eyes with amblyopia was not significantly different in the occlusion group (0.52, 0.52, and 0.51) than in the pharmacological enhancement group (0.58, 0.49, and 0.56) at three follow-up visits (at months 1, 3, and 12, respectively). There was a highly significant improvement in mean logMAR of amblyopic eyes compared with baseline in both occlusion groups (from 0.68 to 0.52, from 0.68 to 0.52, and from 0.68 to 0.51) and in the pharmacological enhancement group (from 0.81 to 0.58, from 0.81 to 0.49, and from 0.81 to 0.56) at the month 1, 3, and 12 visits (P = 0.01, P = 0.01, and P = 0.001, respectively). The improvement of mean logMAR in the subgroup of patients older than 12 years was greater in the pharmacological enhancement group (42.5%) than in the occlusion group (30%). The improvement of mean logMAR in the subgroup of patients with severe amblyopia was greater in the pharmacological enhancement group (34.3%) than in the occlusion group (22%).ConclusionSignificant improvement was reported in both groups at all follow-up visits over 1 year. Regardless of the etiology of amblyopia, levodopa-carbidopa may be added to part-time occlusion in older patients as a means of increasing the plasticity of the visual cortex. Levodopa may add to the effect of occlusion in severe amblyopia and bilateral amblyopia.

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Der Effekt der Levodopatherapie auf das visuell evozierte Potential und die Sehschärfe in der Amblyopie

Cited by 22 publications

References 11 publications

A Randomized Trial of Levodopa as Treatment for Residual Amblyopia in Older Children

A Randomized Trial of Levodopa as Treatment for Residual Amblyopia in Older Children

Levodopa as Treatment for Adults with Amblyopia

Pharmacological enhancement of treatment for amblyopia

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