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Daniel Spiegel, Jinrong LI, Robert Hess, Winston Byblow, Long To, Jeremy Cooperstock, Minbin Yu, Benjamin Thompson; Anodal tDCS Enhances the Effect of Binocular Therapy on Stereopsis in Adults with Amblyopia. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4983.
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Both binocular therapy and anodal transcranial direct current stimulation (tDCS) of the visual cortex have been found to improve visual function in small groups of adults with amblyopia, possibly by reducing suppression within the visual cortex. The aim of this study was to assess whether the combination of anodal tDCS and binocular therapy would result in greater improvements in visual function than binocular therapy alone.
Sixteen young adults with amblyopia (eight per group) participated in a sham-controlled, cross-over, double-blind study. Both groups received identical in-office binocular therapy which consisted of a dichoptic videogame presented on an iPod touch device equipped with a lenticular overlay screen. Higher contrast images were presented to the amblyopic eye to overcome suppression and successful game play required binocular combination. Participants completed 10 treatment sessions, each lasting 65 minutes and tDCS was administered during the first 15 minutes of therapy. Group 1 received anodal tDCS of the visual cortex during the first five treatment sessions and sham tDCS during the second five sessions. In group 2, the order was reversed. Stereopsis and visual acuity were measured before treatment, after five treatment sessions and after ten treatment sessions.
In agreement with previous studies, binocular therapy resulted in significant improvements in amblyopic eye visual acuity (F(2, 28) = 52.095, p < 0.0001) and stereopsis (F(2, 28) = 10.222, p = 0.004). The mean improvement in acuity was 0.34 logMAR ± 0.04 SEM (t(15) = 8.342, p < 0.001). In addition, anodal tDCS reliably enhanced the improvement in stereoacuity induced by binocular therapy (F(1, 14) = 10.5, p = 0.006).
These preliminary results indicate that in adults with amblyopia the combination of anodal tDCS and binocular therapy accelerate improvements in stereopsis compared with binocular therapy alone.
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