PURPOSE: There have been few viable alternatives to patching the better eye as a treatment of amblyopia for more than two centuries. The success of patching depends on compliance, which is problematic for up to 59% of children and their families. METHODS: This pilot study trialled the interactive binocular treatment (I-BiT) system as an alternative amblyopia treatment in 12 older amblyopes (6.1-11.4 years, median 8.2), who had not complied with or responded to occlusion. Virtual reality images were projected to each eye simultaneously via a headset during eight treatment sessions of 25-min duration. Outcome measures were changes in high- (HCVA) and low-contrast log MAR acuity (LCVA) at 1 week, 4 weeks and a final follow-up (3-18 months) after the final treatment. RESULTS: Sustained improvements in HCVA were observed in seven children (58%) and in LCVA in eight children (67%), including two for whom amblyopia was eliminated. Five children had visual acuities equivalent to 6/12 or better at least 6 months after stopping treatment, compared with one child prior to treatment. Significant improvements in HCVA occurred up to the fourth treatment; in LCVA to the seventh treatment. CONCLUSION: Sustained improvements in visual acuity were observed for 58% of this small group of children using the I-BiT system, despite prior failure with conventional treatment. This offers hope for a potential time-saving alternative to patching, in which compliance can easily be monitored, but the results need to be validated by means of a randomised controlled trial.
RCT Entities:
PURPOSE: There have been few viable alternatives to patching the better eye as a treatment of amblyopia for more than two centuries. The success of patching depends on compliance, which is problematic for up to 59% of children and their families. METHODS: This pilot study trialled the interactive binocular treatment (I-BiT) system as an alternative amblyopia treatment in 12 older amblyopes (6.1-11.4 years, median 8.2), who had not complied with or responded to occlusion. Virtual reality images were projected to each eye simultaneously via a headset during eight treatment sessions of 25-min duration. Outcome measures were changes in high- (HCVA) and low-contrast log MAR acuity (LCVA) at 1 week, 4 weeks and a final follow-up (3-18 months) after the final treatment. RESULTS: Sustained improvements in HCVA were observed in seven children (58%) and in LCVA in eight children (67%), including two for whom amblyopia was eliminated. Five children had visual acuities equivalent to 6/12 or better at least 6 months after stopping treatment, compared with one child prior to treatment. Significant improvements in HCVA occurred up to the fourth treatment; in LCVA to the seventh treatment. CONCLUSION: Sustained improvements in visual acuity were observed for 58% of this small group of children using the I-BiT system, despite prior failure with conventional treatment. This offers hope for a potential time-saving alternative to patching, in which compliance can easily be monitored, but the results need to be validated by means of a randomised controlled trial.
Authors: Christina Gambacorta; Mor Nahum; Indu Vedamurthy; Jessica Bayliss; Josh Jordan; Daphne Bavelier; Dennis M Levi Journal: Vision Res Date: 2018-05-12 Impact factor: 1.886
Authors: N Herbison; S Cobb; R Gregson; I Ash; R Eastgate; J Purdy; T Hepburn; D MacKeith; A Foss Journal: Eye (Lond) Date: 2013-06-28 Impact factor: 3.775
Authors: Luke E Hallum; Christopher Shooner; Romesh D Kumbhani; Jenna G Kelly; Virginia García-Marín; Najib J Majaj; J Anthony Movshon; Lynne Kiorpes Journal: J Neurosci Date: 2017-07-25 Impact factor: 6.167