1. Supervised dichoptic gaming versus monitored occlusion therapy for childhood amblyopia: Effectiveness and efficiency
- Author
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Kadhum, Aveen, Tan, Emily TC, Fronius, Maria, Baart, SJ, Levi, Dennis M, Joosse, Maurits V, Simonsz, Huibert J, and Loudon, Sjoukje E
- Subjects
Clinical Research ,Brain Disorders ,Pediatric ,Neurosciences ,Eye ,amblyopia ,dichoptic treatment ,occlusion therapy ,treatment efficiency ,Clinical Sciences ,Opthalmology and Optometry ,Ophthalmology & Optometry - Abstract
PurposeTo compare the effectiveness and efficiency of supervised dichoptic action-videogame play to occlusion therapy in children with amblyopia.MethodsNewly diagnosed children with amblyopia aged 4-12 years were recruited, excluding strabismus >30PD. After 16 weeks of refractive adaptation children were randomized to gaming 1 h/week supervised by the researcher, or electronically monitored occlusion 2 h/day. The gaming group played a dichoptic action-videogame using virtual reality goggles, which included the task of catching a snowflake presented intermittently to the amblyopic eye. Contrast for the fellow eye was self-adjusted until 2 identical images were perceived. The primary outcome was visual acuity (VA) change from baseline to 24 weeks.ResultsWe recruited 96 children, 29 declined and 2 were excluded for language or legal issues. After refractive adaptation, 24 of the remaining 65 no longer met the inclusion criteria for amblyopia, and 8 dropped out. Of 16 children treated with gaming, 7 (6.7 years) completed treatment, whereas 9 younger children (5.3 years) did not. Of 17 treated with occlusion, 14 (5.1 years) completed treatment and 3 (4.5 years) did not. Of 5 children with small-angle strabismus, 3 treated with occlusion completed treatment and 2 treated with gaming did not. Median VA improved by 0.30 logMAR (IQR 0.20-0.40) after gaming, 0.20 logMAR (0.00-0.30) after occlusion (p = 0.823). Treatment efficiency was 1.25 logMAR/100 h (range 0.42-2.08) with gaming, 0.08 (-0.19-0.68) with occlusion (p
- Published
- 2023