Aveen Kadhum1, Emily T C Tan1, Dennis M Levi2, Linda Colpa3, Maria Fronius4, Huibert J Simonsz1, Sjoukje E Loudon5. 1. Department of Ophthalmology, Erasmus Medical Center, Room Ee 1663, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. 2. School of Optometry, Graduate Group in Vision Science and Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, USA. 3. Program in Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, Canada. 4. Department of Ophthalmology, Child Vision Research Unit, Goethe University, Frankfurt am Main, Germany. 5. Department of Ophthalmology, Erasmus Medical Center, Room Ee 1663, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. s.loudon@erasmusmc.nl.
Abstract
PURPOSE: In an ongoing randomised clinical trial comparing dichoptic VR video games with patching for amblyopia, we evaluated any potential barriers to successful use of this novel amblyopia treatment method. METHODS:From December 2017, all newly diagnosed amblyopic children were recruited. Excluded were children under age 4 and patients with strabismus exceeding 30PD. The video game was played for 1 h per week at the outpatient clinic under direct supervision. Records were kept of difficulties encountered during treatment and categorised into domains. Factors influencing the successful completion of this treatment were identified and related to patient characteristics. RESULTS:Ninety-one children were recruited for the trial, 20 parents refused participation before randomisation, because of the logistical challenges the outpatient dichoptic treatment would cause them. Of the 17 children who commenced dichoptic treatment (median age 6.2 years; IQR 4.9-8.4 years), 10 did not complete treatment. Children under age 5.5 years were unable to comprehend the game settings or the game itself. Older children (N = 7; 41%) were less willing to comply with the video game. Loss of interest in the game (N = 8; 47%) was found to be a limiting factor at all ages. CONCLUSION: Half of the children failed to complete VR dichoptic treatment, mainly due to young age. In countries with nationwide screening where amblyopia is detected before age 6, the applicability of such dichoptic treatment is limited.
RCT Entities:
PURPOSE: In an ongoing randomised clinical trial comparing dichoptic VR video games with patching for amblyopia, we evaluated any potential barriers to successful use of this novel amblyopia treatment method. METHODS: From December 2017, all newly diagnosed amblyopic children were recruited. Excluded were children under age 4 and patients with strabismus exceeding 30PD. The video game was played for 1 h per week at the outpatient clinic under direct supervision. Records were kept of difficulties encountered during treatment and categorised into domains. Factors influencing the successful completion of this treatment were identified and related to patient characteristics. RESULTS: Ninety-one children were recruited for the trial, 20 parents refused participation before randomisation, because of the logistical challenges the outpatient dichoptic treatment would cause them. Of the 17 children who commenced dichoptic treatment (median age 6.2 years; IQR 4.9-8.4 years), 10 did not complete treatment. Children under age 5.5 years were unable to comprehend the game settings or the game itself. Older children (N = 7; 41%) were less willing to comply with the video game. Loss of interest in the game (N = 8; 47%) was found to be a limiting factor at all ages. CONCLUSION: Half of the children failed to complete VR dichoptic treatment, mainly due to young age. In countries with nationwide screening where amblyopia is detected before age 6, the applicability of such dichoptic treatment is limited.
Entities:
Keywords:
Amblyopia; Barriers to successful treatment; Dichoptic treatment
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