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Sjoukje E Loudon, Aveen Kadhum, Emily Tan, Huibert Jan Simonsz; The effect of patching and gaming therapy on visual acuity and stereoacuity in children with amblyopia. Invest. Ophthalmol. Vis. Sci. 2020;61(7):508.
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© ARVO (1962-2015); The Authors (2016-present)
To make a valid comparison between the effect of patching therapy and dichoptic video gaming in children with amblyopia: preliminary results after 12 weeks of treatment.
In this ongoing prospective RCT all newly diagnosed amblyopic children with an interocular visual acuity (VA) difference ≥0.2 logMAR were recruited by six treating orthoptists. Exclusion criteria were previous amblyopia treatment, strabismus angle >30PD, neurological disorder, nystagmus, and other eye disorders. To confirm the presence of amblyopia, the recruited children received an additional standard orthoptic examination by the research orthoptist. This included VA measurement with tumbling E-chart, stereo acuity with Randot stereotest and contrast sensitivity with Pelly-Robson or CSV-1000E in younger ones. After informed consent they were randomized to (A) patching therapy: 2 hrs/day; compliance was monitored electronically using the Occlusion Dose Monitor (ODM); or (B) dichoptic video game therapy: 1 hr/wk at the out-patient clinic under direct supervision. If necessary, a refractive adaptation period of 16 weeks was carried out prior to randomization. VA was assessed every 6 weeks by the research orthoptist during the study period of 24 weeks. Main outcome measure was improvement in VA (logMAR units/time period) and stereoacuity in both groups.
So far, 85 children were recruited; 26 refused participation and 2 were excluded. After refractive adaptation period, 23 children attained interocular VA <0.2 logMAR. Thirty-four children were included for randomization; 18 were boys (53%). Mean age was 5.7±2.5 years; 24 had anisometropia, 4 strabismus and 6 a combined cause of amblyopia. Eleven children dropped out. Overall, mean VA at start of treatment was 0.41±0.27 logMAR in the amblyopic eye and 0.07±0.14 logMAR in the fellow eye. Mean compliance with patching was 81%±41%. Mean VA after 12 weeks of treatment improved to 0.23±0.30 logMAR for the amblyopic eye and 0.04±0.13 logMAR in the fellow eye. Stereoacuity improved with 0.12±0.41 log arcsec.
After 12 weeks of treatment children had a mean VA improvement of 2 lines in the amblyopic eye. Improvements were also seen in stereoacuity.
This is a 2020 ARVO Annual Meeting abstract.
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