Abstract
Purpose :
To make a valid comparison between the effect of patching therapy and dichoptic video gaming in children with amblyopia: preliminary results after 24 weeks of treatment.
Methods :
In this prospective Randomized Clinical Trial all newly diagnosed children with amblyopia were recruited by ten treating orthoptists in four clinics. Exclusion criteria were previous amblyopia treatment, strabismus angle >30PD, neurological disorder, nystagmus and other eye disorders. The research orthoptist examined the child according to the study protocol using the crowded tumbling E-chart to measure visual acuity (VA). If necessary, a refractive adaptation period of 16 weeks was carried out prior to randomization. After informed consent they were randomized to patching therapy: 2 hrs/day; compliance was monitored electronically using the Occlusion Dose Monitor; or dichoptic video game therapy: 1 hr/wk under direct supervision at the outpatient clinic. 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). In addition, quality of life data was collected using the adjusted Child Amblyopia Treatment Questionnaire (CAT-QoL).
Results :
One-hundred children were recruited; 29 subjects refused participation, 2 were excluded. After refractive adaptation period, 27 subjects attained interocular VA <0.2 logMAR. Thirty-five children were included for randomization; 18 were boys (51%). During the study 3 children dropped out of the patching group and 10 out of the gaming group, resulting in 22 (22%) children completing the full study period. Mean age was 6.4±2.8 years. These children had mean VA at start of treatment of 0.43±0.31 logMAR in the amblyopic eye and 0.07±0.15 logMAR in the fellow eye. Mean VA after 24 weeks of treatment improved to 0.20±0.29 logMAR in the amblyopic eye and 0.03±0.13 logMAR in the fellow eye. Nineteen children were interviewed for the CAT-QoL and 18 parents filled out the same questionnaire independently.
Conclusions :
After 24 weeks of patching or gaming treatment mean VA improved with 2.3 logMAR lines in the amblyopic eye. Depending on the results from the CAT-QoL, in-depth interviews will be conducted investigating experiences of parents whose child had either received occlusion therapy or gaming therapy.
This is a 2021 ARVO Annual Meeting abstract.