June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
The effect of patching and gaming therapy on visual acuity in children with amblyopia and influence on quality of life
Author Affiliations & Notes
  • Aveen Kadhum
    Erasmus MC, Rotterdam, Zuid-Holland, Netherlands
  • Emily Tan
    Erasmus MC, Rotterdam, Zuid-Holland, Netherlands
  • Janna Bruijning
    Optometry & Orthoptics, Hogeschool Utrecht, Utrecht, Utrecht, Netherlands
  • Maurits V Joosse
    Ophthalmology, Haaglanden Medical Center Westeinde Hospital, The Hague, Netherlands
  • Huibert Jan Simonsz
    Erasmus MC, Rotterdam, Zuid-Holland, Netherlands
  • Sjoukje E Loudon
    Erasmus MC, Rotterdam, Zuid-Holland, Netherlands
  • Footnotes
    Commercial Relationships   Aveen Kadhum, None; Emily Tan, None; Janna Bruijning, None; Maurits Joosse, None; Huibert Simonsz, None; Sjoukje Loudon, None
  • Footnotes
    Support  Lijf & Leven, ODAS, Uitzicht
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 159. doi:
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      Aveen Kadhum, Emily Tan, Janna Bruijning, Maurits V Joosse, Huibert Jan Simonsz, Sjoukje E Loudon; The effect of patching and gaming therapy on visual acuity in children with amblyopia and influence on quality of life. Invest. Ophthalmol. Vis. Sci. 2021;62(8):159.

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

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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.


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