가림치료에 반응하지 않는 난치성 약시에서 도파민 약물투여 후 장기간 관찰 결과

Long-Term Study of Levodopa/Carbidopa for Refractory Childhood Amblyopia

Purpose: To evaluate the long-term (12 to 30 months) effect of L-dopa with part-time occlusion in patients in which occlusion therapy failed. Methods: Seventeen eyes of 12 amblyopic children who failed with part-time occlusion (4 to 8 hours/day) treatment for a minimum period of 6 months were studied. The follow-up period was 12 to 30 months. The average best corrected visual acuity (BCVA) before treatment was 0.28±0.20 (0.05-0.5). After full informed consent was obtained from their parents, the children received levodopa (2 to 4 mg/kg) for 8 weeks combined with part-time occlusion and spectacles. Results: The average age of the subjects was 7.0±2.7 years and the mean follow-up period was 23.7±7.7 (12 to 30) months. After the administration of levodopa for 8 weeks, 9 eyes (53%) showed improvement in BCVA, and only 4 eyes showing a mean regression of 0.20±0.11 logMAR visual acuities. The BCVA reached the maximum value after a mean of 8.47 months. After 8 weeks from baseline, 13 eyes (76%) reached the maximum BCVA. After 12 to 30 months of follow-up, 12 out of 17 eyes (70.6%) showed a BCVA improvement of 0.14±0.19 logMAR. Conclusions: After the long-term (12 to 30 months) follow-up, L-dopa with part-time occlusion in patients in which occlusion therapy failed showed improved visual acuities in 76% of the cases. J Korean Ophthalmol Soc 2009;50(11):1692-1697