Effect of Levodopa and Carbidopa in Human Amblyopia

Abstract

Background: To assess the role of continuous therapy for 3 weeks with levodopa and carbidopa in the management of human ambiyopia in children and adults. Method: There were 88 amblyopic eyes of 82 subjects included in this double masked randomized prospective clinical trial. Levodopa and carbidopa combination in 2 different dosage schedules were given to both adults and children. The response was monitored of the improvement in visual acuity, contrast sensitivity, and visually evoked potentials. Result: Patients receiving higher dosages of levodopa and carbidopa in both adults and children showed a better response to treatment. However, the effect did not last beyond 9 weeks of stopping treatment. Conclusion: Though levodopa and carbidopa therapy may not be able to ameliorate ambiyopia on its own on a long-term basis, it may be considered nonetheless to be an important adjunct to conventional therapy because it may improve patient compliance for occlusion by improving visual acuity in the amblyopic eye. Thus, it offers promise of improving the functional outcome in these cases. However, longer follow-up trials are needed to substantiate these conclusions. Journal of Pediatric Ophthalmology and Strabismus 2002;39:81-89.

Perceptual Learning Improves Visual Performance in Juvenile Amblyopia

“…However, the use of a neurotransmitter (levodopa) to increase the plasticity of the amblyopic brain is still controversial. 52,53 In a recent study, we demonstrated that perceptual learning may be a useful approach to improving visual performance in adult amblyopia. 46 We asked seven adult observers with amblyopia to practice a repetitive position-discrimination task.…”

Current Recommendations for Amblyopia Treatment

“…Occlusion has been supplemented by near activities 32 and by the administration of neurotransmitters or their analogs, such as levodopa. [33][34][35][36] More mainstream treatment alternatives include optical penalization with over-plus lenses over the dominant eye, 37 occlusion of the spectacle lens using adhesive tape, Bangerter foils, 38 or Min lenses 39 for amblyopic patients who wear glasses, and perhaps most successfully and widespread, atropine penalization of the preferred eye.…”

Visual improvement during psychophysical training in an adult amblyopic eye following visual loss in the contralateral eye

“…This, according to the sparse literature [11], predicted a very unfavorable prognosis. Use of levodopa to ameliorate the amblyopia (see, for example, [7,10]) was considered inadvisable due to the patient's antidepressant medication.…”