Selective serotonin reuptake inhibitors for amblyopia treatment: a systematic review and meta-analysis of randomized controlled trials
Abstract
Introduction: Amblyopia is a neurodevelopmental visual disorder treated with occlusion or pharmacological penalization of the dominant, non-amblyopic eye in early childhood. After early childhood, efficacy of occlusion therapy is limited due to a reduction in neuronal plasticity, and no mainstay clinical treatment is available. Selective serotonin reuptake inhibitors (SSRIs) have been hypothesized to enhance neuroplasticity in the adult brain, thereby facilitating improvements in amblyopia. We aimed to perform a systematic review and meta-analysis evaluating the effect of SSRIs on patients with amblyopia.
Methods: We systematically searched Pubmed, EMBASE, and Cochrane Central for randomized controlled trials (RCTs) and controlled observational studies comparing an SSRI with placebo in patients with amblyopia. Outcomes of interest were visual acuity (VA) change and visual evoked potential (VEP) change (P100 amplitude and latency). Statistical analysis was performed using the web version of RevMan by calculating the mean difference between groups (MD). Heterogeneity was assessed with Cochrane Q test and I2 statistics.
Results: Four RCTs and 139 patients were included. 55% patients received SSRIs. Three studies used fluoxetine and one study used citalopram as the intervention. While SSRIs use statistically improved VA (MD 0.09 logMAR, 95% CI 0.04-0.14, p = 0.0004), the extent of improvement was not clinically significant. SSRIs did not have any effect on VEPs.
Conclusion:…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 139 participants or records.
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