Randomised trial of three treatments for amblyopia: Vision therapy and patching, perceptual learning and patching alone.

Autor: Hernández-Andrés R; Department of Optics, Optometry and Science of Vision, University of Valencia, Valencia, Spain., Serrano MÁ; Department of Psychobiology, University of Valencia, Valencia, Spain., Alacreu-Crespo A; Department of Psychology and Sociology, Area of Personality, Assessment and Psychological Treatment, University of Zaragoza, Zaragoza, Spain., Luque MJ; Department of Optics, Optometry and Science of Vision, University of Valencia, Valencia, Spain.
Jazyk: angličtina
Zdroj: Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) [Ophthalmic Physiol Opt] 2025 Jan; Vol. 45 (1), pp. 31-42. Date of Electronic Publication: 2024 Oct 12.
DOI: 10.1111/opo.13395
Abstrakt: Background: Active vision therapy for amblyopia shows good results, but there is no standard vision therapy protocol. This study compared the results of three treatments, two combining patching with active therapy and one with patching alone, in a sample of children with amblyopia.
Methods: Two protocols have been developed: (a) perceptual learning with a computer game designed to favour the medium-to-high spatial frequency-tuned achromatic mechanisms of parvocellular origin and (b) vision therapy with a specific protocol and 2-h patching. The third treatment group used patching only. Fifty-two amblyopic children (aged 4-12 years), were randomly assigned to three monocular treatment groups: 2-h patching (n = 18), monocular perceptual learning (n = 17) and 2-h patching plus vision therapy (n = 17). Visual outcomes were analysed after 3 months and compared with a control group (n = 36) of subjects with normal vision.
Results: Visual acuity (VA) and stereoacuity (STA) improved significantly after treatment for the three groups with the best results for patching plus vision therapy, followed by monocular perceptual learning, with patching only least effective. Change in the interocular difference in VA was significant for monocular perceptual learning, followed by patching. Differences in STA between groups were not significant. For VA and interocular differences, the final outcomes were influenced by the baseline VA and interocular difference, respectively, with greater improvements in subjects with poorer initial values.
Conclusions: Visual acuity and STA improved with the two most active treatments, that is, vision therapy followed by perceptual learning. Patching alone showed the worst outcome. These results suggest that vision therapy should include monocular accommodative exercises, ocular motility and central fixation exercises where the fovea is more active.
(© 2024 The Author(s). Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.)
Databáze: MEDLINE
Externí odkaz: