Fluoxetine improves amblyopia in adult, adolescent patients

Oral fluoxetine confers beneficial effects in the management of adult and adolescent amblyopia, suggests a recent study.

This double-blinded, randomized controlled trial sought to examine the efficacy of oral fluoxetine therapy in improving the visual function of patients with amblyopia aged between 10 and 40 years. A total of 40 eligible participants with anisometropic or mixed amblyopia were randomized to either fluoxetine or placebo groups.

Participants with anisometropia and logMAR best spectacle-corrected visual acuity (BSCVA) worse than 0.2 logMAR in the amblyopic eye or at least a two-line of difference in the BSCVA between the fellow eyes were included, but not those with significant ocular or systemic diseases.

During the study period, the better eye of each patient in both groups was patched for 4–6 hours a day. Oral fluoxetine was administered in participants in the treatment group for 3 months. The primary outcome was change in the Snellen BSCVA after 3 months.

Analysis was conducted using data from 20 participants in the fluoxetine group and 15 from the placebo group (aged 11–37 years). Those in the fluoxetine group had a significantly higher magnitude of improvement in visual acuity from baseline to 3 months after treatment (0.240±0.068 logMAR; 2.4 line-gain) compared with the control group (0.120±0.086 logMAR; 1.2 line-gain).

A development brain disorder, amblyopia is characterized by vision loss due to asymmetric or inadequate visual stimulation early in life. It is responsive to treatment in initiated early, but treatment of older children and adults is usually unsuccessful because of the closure of a window of cortical brain plasticity. [Semin Ophthalmol 2016;31:155-158]