To evaluate the effect of fluoxetine on improving visual acuity and visual-evoked potential (VEP) parameters in adult amblyopia

In a randomized clinical trial, adult cases (>18 years old) with anisometropic or strabismic amblyopia included in the study. Usual treatments of amblyopia (glasses prescription and patching) were prescribed for 4 months before receiving drugs. The cases were assigned randomly to the fluoxetine or placebo group. The cases in the fluoxetine group received 20 mg fluoxetine/day and the cases in the placebo group received placebo for 3 months. The cases in the placebo group received placebo for 3 months. Visual acuity testing and VEP were performed before and after treatment. The changes in logarithm of the minimum angle of resolution (logMAR) and the changes in latency and amplitude of VEP waves were compared between fluoxetine and placebo groups.

55 patients (29 cases in the fluoxetine and 26 cases in the placebo group) with a mean age of 27.2 ± 8.6 (18–54) years participated in this study. The mean pre-treatment logMAR was 0.55 ± 0.29 (0.20 - 1.3) in the fluoxetine group and 0.51 ± 0.31 (0.1–1.3) in the placebo group. The mean post-treatment logMAR was 0.35 ± 0.20 (0-0.7) in the fluoxetine group and 0.43 ± 0.35 (0–1.3) in the placebo group. The mean logMAR change was 0.20 ± 0.24 (0–0.8) in the fluoxetine group and 0.08 ± 0.15 (0 - 0.7) in the placebo group (p=0.04). In 8 patients in the fluoxetine group, the VA improved more than 0.2 logMAR. Among VEP parameters, only N75 amplitude change was greater in the fluoxetine group than placebo group (p=0.05).

Fluoxetine can be a valuable treatment for adult anisometropic and strabismic amblyopia and increase visual acuity in some cases.