June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Binocular outcomes following binocular treatment for childhood amblyopia
Author Affiliations & Notes
  • Krista R Kelly
    Retina Foundation of the Southwest, Dallas, Texas, United States
  • Reed Jost
    Retina Foundation of the Southwest, Dallas, Texas, United States
  • Eileen E Birch
    Retina Foundation of the Southwest, Dallas, Texas, United States
  • Footnotes
    Commercial Relationships   Krista Kelly, None; Reed Jost, None; Eileen Birch, None
  • Footnotes
    Support  Thrasher Research Fund 12954; National Eye Institute EY022313
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3827. doi:
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      Krista R Kelly, Reed Jost, Eileen E Birch; Binocular outcomes following binocular treatment for childhood amblyopia. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3827.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Childhood amblyopia can be treated with binocular games or movies that rebalance contrast between the eyes, which is thought to reduce depth of interocular suppression so the child can experience binocular vision (Birch et al., 2015; Li et al., 2015). We recently found that two weeks of binocular games improved visual acuity more than patching (Kelly et al, 2016). Yet, stereoacuity improvement did not accompany the visual acuity improvement. Here we evaluate additional binocular outcomes.

Methods : 47 amblyopic children (4-12y; ≤4pd) assigned to binocular treatment [movies (n=29) or game (n=18)] were compared to 19 amblyopic children assigned to 2 h/d patching. Amblyopic eye best-corrected visual acuity (BCVA) and binocular outcomes were assessed at baseline and 2 weeks, after 9-10 h binocular or 28 h patching treatment. Binocular outcomes: dichoptic contrast ratio balance point (CR; depth of suppression), Worth-4-Dot (W4D at 7 distances; extent of suppression scotoma), Randot Preschool stereoacuity (RPS).

Results : Mean±SD BCVA improved by 1.4 lines with binocular treatment (0.56±0.29 vs 0.42±0.28 logMAR;t=10.04,p<0.001) and 0.7 lines with patching (0.50±0.15 vs 0.43±0.17 logMAR;t=3.64,p=0.002); i.e., binocular treatment was more successful than patching (t=2.71, p=0.009). Depth of suppression (CR) improved with binocular treatment (baseline: 4.63±3.41 vs 2 week: 3.41±2.66;t=3.81,p<0.001) and patching (4.71±3.08 vs 3.04±.2.07; t=2.85,p=0.012). For binocular treatment, CR improved more for children <7 years than children ≥7 years old (t=2.38, p=0.029). BCVA was correlated with CR at baseline (r=0.39, p=0.007) and at 2 weeks (r=0.38, p=0.008). Extent of suppression improved with binocular treatment (baseline: 0.53±0.41 vs 2 week: 0.41±0.44 log deg;t=2.98,p=0.005), but not with patching (0.36±0.33 vs 0.23±0.45 log deg;t=1.54,p=0.14). Stereoacuity improved with binocular treatment (baseline: 3.56±0.76 vs 2 week: 3.47±0.77 log arcsec;Z=2.00,p=0.045), but not with patching (3.21±0.88 vs 3.30±0.79 log arcsec;Z=1.35,p=0.18).

Conclusions : Contrast-rebalanced binocular treatment was not only successful in ameliorating the visual acuity deficit in childhood amblyopia, but also improved binocular outcomes more than patching, reducing the extent and depth of suppression and improving stereoacuity.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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