Patch-free streaming contrast-rebalanced dichoptic cartoons versus patching for treatment of amblyopia in children aged 3 to 5 years: a pilot, randomized clinical trial.

Autor: Jost RM; Pediatric Vision Laboratory, Retina Foundation of the Southwest, Dallas, Texas. Electronic address: reedjost@retinafoundation.org., Birch EE; Pediatric Vision Laboratory, Retina Foundation of the Southwest, Dallas, Texas; Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas., Wang YZ; Pediatric Vision Laboratory, Retina Foundation of the Southwest, Dallas, Texas; Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas., Dao LM; ABC Eyes - Pediatric Ophthalmology, Dallas, Texas., Stager D; Pediatric Ophthalmology & Adult Strabismus, Plano, Texas., Luu B; Pediatric Ophthalmology & Adult Strabismus, Plano, Texas., Beauchamp CL; ABC Eyes - Pediatric Ophthalmology, Dallas, Texas., Giridhar P; ABC Eyes - Pediatric Ophthalmology, Dallas, Texas., Brin TA; School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada; Department of Human Sciences, Kanagawa University, Yokohama, Kanagawa, Japan., Baldwin AS; Department of Ophthalmology, McGill University, Montreal, Quebec, Canada., Hess RF; Department of Ophthalmology, McGill University, Montreal, Quebec, Canada., Thompson B; School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada; Centre for Eye and Vision Research, 17W Science Park, Hong Kong; Liggins Institute, University of Auckland, Auckland, New Zealand.
Jazyk: angličtina
Zdroj: Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus [J AAPOS] 2024 Oct; Vol. 28 (5), pp. 103991. Date of Electronic Publication: 2024 Sep 11.
DOI: 10.1016/j.jaapos.2024.103991
Abstrakt: Background: We developed and tested a dichoptic treatment designed for younger children that can be viewed freely and involves a dichoptic manipulation of a popular animation series that enables contrast-rebalancing without disrupting fusion. Our aim was to assess whether this novel amblyopia treatment is superior to patching in children aged 3-5 years.
Methods: A total of 34 children with amblyopia were randomly assigned to contrast-rebalanced dichoptic cartoons (4 hours/week) or patching (14 hours/week) for 2 weeks. Children in the cartoon group continued watching cartoons for an additional 2 weeks. Designed to target the youngest and most treatable children, the dichoptic cartoons presented the entire scene to the amblyopic eye at 100% contrast, while the fellow eye view was presented at reduced contrast with the main character omitted. Best-corrected visual acuity (BCVA), stereoacuity, suppression, and manual dexterity were measured at each visit.
Results: After 2 weeks, improvement in amblyopic eye BCVA was greater for dichoptic treatment than for patching, with a mean improvement of 0.11 ± 0.08 versus 0.06 ± 0.09 logMAR, respectively (P = 0.04). Stereoacuity, suppression, and manual dexterity did not improve significantly more in the dichoptic group than the patching group at 2 weeks. After 4 weeks of dichoptic cartoon treatment, mean visual acuity improvement in the dichoptic group was 0.16 logMAR (95% CI, 0.10-0.21).
Conclusions: In our study cohort, a contrast-rebalanced dichoptic cartoon was more effective than patching in treating childhood amblyopia after 2 weeks. Dichoptic cartoons that rebalance contrast to overcome suppression provide an additional treatment option for amblyopia in young children.
(Copyright © 2024 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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