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Simone Lan Li, Reed Jost, Sarah Morale, David Stager, Lori Dao, David Stager, Jr, Eileen Birch; Binocular iPad treatment of amblyopia leads to lasting improvement of visual acuity. Invest. Ophthalmol. Vis. Sci. 2014;55(13):816.
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© ARVO (1962-2015); The Authors (2016-present)
Traditional amblyopia treatments (patching/penalization) do not always restore 20/20 vision and the recurrence rate is high within 6 months after the cessation of traditional treatment. We and others recently demonstrated the benefit of binocular treatment for amblyopia in children (Li et al ARVO 2013) and adults (Hess et al 2012, 2013). However, no data to date have determined the durability of the visual acuity improvements as a result of binocular treatment. In this study, we examined whether visual acuity improvements obtained with 4-8 weeks of binocular amblyopia treatment were maintained at 3 and 6 months after the cessation of treatment.
We assigned 11 amblyopic children to binocular iPad treatment (5-12y). All children had been wearing glasses (if applicable) for at least 3 months and had stable best-corrected visual acuity (BCVA) prior to baseline. All were instructed to play the dichoptic iPad game apps for 4 h/week for 4 weeks and 8 children continued to play the games for an additional 4 weeks. BCVA was measured at baseline, at the 4- and 8-week outcome visits, and at 3 and 6 months after the cessation of treatment. None of the 11 children patched after the cessation of treatment.
At baseline, mean BCVA ±se was 0.45±0.07 logMAR (N=11; range: 0.20-0.80 logMAR). With intent-to-treat analysis, BCVA improved significantly with 4-8 weeks of binocular treatment to 0.35±0.07 logMAR (N=11; p<0.01; range: 0.00 to 0.70 logMAR). BCVA improvement gained during the binocular iPad treatment was maintained at 3 months post-treatment (0.37± 0.08 logMAR; N=9) and at 6 months post-treatment (0.38±0.08 logMAR; N=9). Among all children who returned for the 3- and/or 6-month post-treatment visits, only one experienced a BCVA regression (≥0.2 logMAR), likely due to measurement error because her BCVA improved by 0.1 logMAR at the 6-month post-treatment visit.
Binocular iPad treatment for amblyopia yielded a significant improvement in BCVA after 4-8 weeks. The obtained improvements in BCVA were maintained. Therefore, binocular iPad treatment is a promising new approach for the treatment of amblyopia.
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