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Fluoxetine as a Possible Treatment for Adult Amblyopia
TAKE-HOME MESSAGE
- This study investigated the potential effects of oral fluoxetine on visual acuity and visual-evoked potential in adults with amblyopia. Notably, fluoxetine treatment resulted in a significantly greater improvement in visual acuity compared with placebo.
- Fluoxetine may have a clinically useful therapeutic role in adult amblyopia.
abstract
This abstract is available on the publisher's site.
Access this abstract now Full Text Available for ClinicalKey SubscribersPURPOSE
To evaluate the effects of oral fluoxetine on visual acuity and visual-evoked potential (VEP) parameters in adults patching for amblyopia.
METHODS
In this randomized clinical trial, adults (>18 years of age) with anisometropic or strabismic amblyopia were assigned randomly to a treatment (fluoxetine) group or a placebo group. Standard treatments for amblyopia (glasses prescription and patching) were prescribed for 4 months for all patients beforehand. The first group received fluoxetine (20 mg per day) and the second group received a placebo for 3 months, both continuing patching. Visual acuity evaluation and VEP were performed before and after treatment.
RESULTS
A total of 55 participants were included: 29 in the fluoxetine group and 26 in the placebo group. Mean age was 27.2 ± 8.6 years (18-54). The mean logMAR visual acuity of the amblyopic eye improved by 0.20 ± 0.24 (0-0.8) in the fluoxetine group (P < 0.001) and by 0.08 ± 0.15 (0-0.7) in the placebo group (P = 0.01); mean logMAR improvement was significantly higher in the fluoxetine group than in the placebo group (P = 0.04). At the end of the study, mean visual acuity of the fluoxetine group (0.36 ± 0.21 log MAR) was better than the placebo group (0.43 ± 0.35 log MAR). Among the VEP parameters, N75 amplitude did not change significantly in either group relative to baseline, but the changes were statistically significantly different between the two groups (P = 0.05); N135 latency improved from baseline in the fluoxetine group (P = 0.03).
CONCLUSIONS
In our study cohort, fluoxetine treatment resulted in greater improvement in visual acuity than placebo during patching for adult amblyopia.
Additional Info
Fluoxetine as a possible treatment for adult amblyopia: results of a double-blind, randomized, placebo-controlled trial
J AAPOS 2024 Oct 01;28(5)104009, A Mirmohammadsadeghi, A Mousavi, MR Akbari, H Khojasteh, B Masoomian, M Sadeghi, S Yadegari, H AsadigandomaniFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
An increasing number of studies continue to show that the underlying neuroplasticity necessary for the improvement of amblyopia persists beyond childhood. In this article, the authors used fluoxetine for patients aged 18 to 54 years; this medication had previously shown good results in one study. The theory is that fluoxetine enhances the neuroplasticity effect when combined with 4 hours of daily patching. The strength of this study was that it was a double-blinded, randomized, placebo-controlled trial. There were 55 eligible participants, and the results were encouraging for patients with either refractive or strabismic amblyopia. Gains in visual acuity were significant and persisted during the 18-month follow-up period. The authors acknowledged that, in future studies, more participants, as well as other pre- and post-measures of visual function, should be included.
This is noteworthy since more attention has recently been placed on the importance of binocular integration in amblyopia therapy. One would hope that future studies on pharmacologic intervention will place more emphasis on its coupling with treatments that enhance binocular integration rather than relying on patching.