Ophthalmic Technology Assessment: Levodopa/Carbidopa to Augment the Treatment of Amblyopia


Tags Pediatric
Journal Ophthalmology
Status 審查完成
校稿者 蕭靜熹 醫師

Ophthalmology Volume 130, Number 11, November 2023


本研究旨在評估利用左旋多巴/卡比多巴(levodopa/carbidopa)增強弱視療法的臨床效力、有效性和安全性。研究人員通過在PubMed數據庫中進行文獻檢索,最後於2022年10月進行了英語文獻檢索,共檢索到55篇文章,其中有23篇全文被詳細審閱。最終確定了12篇文獻作為評估的適當範圍,並由專家組成小組對其進行了證據等級評級。研究結果顯示,因擔憂長期不良反應(如遲發性運動失調tardive dyskinesia),治療持續時間限制在3至16周。左旋多巴的劑量範圍為每天1.5至8.3mg/kg,通常分為3次每日的劑量。藥物的短期副作用通常報告不一致,但大多數是輕微的,包括頭痛和噁心。最終得出結論,目前最佳證據不足以顯示使用長達16周的左旋多巴/卡比多巴增強弱視療法將導致視力敏銳度的意義性改善。鑑於長期治療帶來的遲發性運動失調等嚴重副作用的潛在風險,左旋多巴/卡比多巴似乎不是弱視療法的可行選擇。未來研究可能專注於改變這些藥物的劑量、研究新的劑型,以增加多巴脂或其他神經傳遞物質功能,並減少副作用。

English Abstract

This article summarizes a review of studies on the use of levodopa/carbidopa to augment amblyopia therapy. The literature search yielded 55 articles, but only 12 were considered appropriate for inclusion. The duration of treatment with levodopa was limited to 3 to 16 weeks due to concerns about long-term adverse effects such as tardive dyskinesia, which were not reported in any of the study participants. The dose of levodopa ranged from 1.5 to 8.3 mg/kg/day, usually divided into 3 daily doses. The carbidopa dose was approximately 25% of the levodopa dose in all treatments. Short-term side effects were generally mild, including headache and nausea. However, the evidence is currently insufficient to show that augmenting amblyopia therapy with levodopa will result in meaningful improvement in visual acuity. The article suggests that pharmacologic augmentation of standard occlusive therapy for amblyopia has not been demonstrated to be effective with current treatment options, and future research may focus on changing medication dosages and studying newer agents to increase neurotransmitter functions and minimize side effects.