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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)
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.
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).
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.
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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