Graefe's Arch Clin Exp Ophthalmol (1995) 233:407-413 © Springer-Verlag 1995 Irene Gottlob Sheryl S. Wizov Robert D. Reinecke Visual acuities and scotomas after 3 weeks' levodopa administration in adult amblyopia Received: 22 February 1994 Revised version received: 25 November 1994 Accepted: 16 December 1994 I. Gottlob ~ ([~) - S.S. Wizov R.D. Reinecke Foerderer Eye Movement Center for Children, Wills Eye Hospital, 900 Walnut Street, Philadelphia, PA 19107, USA Fax: + 1-215-5920685 I. Gottlob - S.S. Wizov. R.D. Reinecke Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA 1Affiliated with the First University Eye Clinic, Vienna, Austria Abstract • Background: Previous studies have shown that both a sin- gle dose of levodopa and a 1-week administration of levodopa im- prove visual functions in adult am- blyopic patients. In the present study, we investigated the effect of increased dosage and duration of levodopa on amblyopes' visual functions. • Methods: Visual acu- ity and visual fields were examined before and after 3 weeks of daily administration of levodopa/car- bidopa as well as 1 month and 2 months after completion of drug therapy in a double masked-de- sign. • Results: A significant in- crease in visual acuities and a de- crease in fixation point scotomas were found. Changes were of com- parable dimension to those found after 1 week of levodopa adminis- tration. Improvement of visual functions persisted 2 months after the levodopa/carbidopa adminis- tration was completed. • Conclu- sion: The present study confirms previous findings of improvement in visual function in amblyopia af- ter levodopa/carbidopa administra- tion. However, increasing the dosage and the duration of levodo- pa did not enhance the effect in adults. Introduction We have shown, in two previous studies, that oral levodopa administration improves visual functions in adult amblyopic patients. The first study [1], involving nine adult amblyopic patients, showed that a single dose of orally adminis- tered levodopa had a positive short-term effect on their visual functions. Ninety minutes after administration of levodopa, we found an increase in contrast sensitivity and a reduction in size of the fixation point scotoma. Visual acuity improved one half-line in two of the nine patients tested. In the second study [2], levodopa or placebo was administered in 20 patients for a period of 1 week. This study confirmed the decrease in fixation point scotomas previously found. Improvement of visu- al acuity occurred in 70% of the patients. In three studies, Leguire and coworkers confirmed our results in amblyopic children between 6 and 14 years of age. In the first two studies [4, 5], visual acuity, contrast sensitivity and visual evoked potentials tempo- rarily improved after one single dose of levodopa/car- bidopa. In the third study [6], levodopa/carbidopa was administered during a 3-week period. Significant im- provements in visual acuity and contrast sensitivity were found and were maintained 1 month after termina- tion of treatment. The aim of the study reported here was to investigate visual acuity and fixation point scotomas after an in- creased duration of levodopa/carbidopa administration and a small increase in dosage in amblyopic patients with a mature visual system. In this double-blind study, 29 patients over 16 years of age underwent a 3-week trial of levodopa/carbidopa or placebo. The long-term effect of levodopa was studied by testing visual func- tions 1 and 2 months after termination of treatment.