Effectiveness of binocular therapy as a complementary treatment of part-time patching in older amblyopic children: a
Qing Zhu1, Qi Zhao2, Ran Liang1
1Department of Ophthalmology, the Second Hospital of Dalian Medical University, Dalian, 116027, China.
Insights
Combined 3D movie therapy and patching significantly improved vision in older amblyopic children. This binocular treatment enhanced visual function and stereoacuity more effectively than patching alone.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Vision Science
Background:
- Amblyopia, or 'lazy eye,' affects visual development in children.
- Traditional patching therapy can have poor compliance and response rates in older children.
- Novel treatment strategies are needed to improve visual outcomes for this population.
Purpose of the Study:
- To evaluate the efficacy of combining stereoscopic 3D movies with part-time patching for treating amblyopia in older children.
- To compare this novel binocular treatment approach against traditional patching alone.
- To assess treatment effectiveness in children with poor response or compliance to conventional methods.
Main Methods:
- A randomized clinical trial included 32 children aged 5-12 years with amblyopia.
- Participants were assigned to either a combined treatment group (3D movies + patching) or a patching-only group.
- The combined treatment involved blurring the fellow eye with a Bangerter filter and watching 3D movies; primary outcome was visual acuity at 6 weeks.
Main Results:
- The combined treatment group showed a significantly greater improvement in amblyopic eye visual acuity (0.17 logMAR) compared to the patching-only group (0.05 logMAR) at 6 weeks.
- This difference was statistically significant, indicating a 1.3-line gain on the logMAR chart for the combined group.
- Only the combined group demonstrated significant improvement in stereoacuity, with a mean gain of 0.47 log arcsec.
Conclusions:
- Laboratory-based binocular treatment using 3D movies and patching achieved high compliance and substantial visual gains in older amblyopic children.
- This combined approach is more effective than patching alone, particularly for children with prior poor treatment response.
- The significant improvement in stereoacuity highlights a key advantage of the combined binocular treatment strategy.
Purpose:
To assess the effectiveness of combined use of stereoscopic 3D video movies and part-time patching in treating older amblyopic children with poor response or compliance to traditional patching treatments and comparing this combined treatment with patching alone.
Methods:
Thirty-two children aged 5-12 years with amblyopia associated with anisometropia, strabismus, or both were recruited in a randomized clinical trial. Eligible participants were assigned randomly to the combined and patching groups. Here, binocular treatment refers to using the Bangerter filter to blur the fellow eye and subsequently watching a close-up 3D movie with large parallax. The primary outcome was amblyopic eye (AE) best-corrected visual acuity (BCVA) improvement at six weeks. In addition, secondary outcomes included BCVA of AE improvement at three weeks and change of stereoacuity.
Results:
Of 32 participants, mean (SD) age was 6.63 (1.46) years, and 19 (59%) were female. At 6 weeks, mean (SD) amblyopic eye VA improved by 0.17 ± 0.08 logMAR (2-sided 95% CI, 0.13 to 0.22; F = 57.2, p < 0.01) and 0.05 ± 0.04 logMAR (2-sided 95% CI, 0.05 to 0.09; F = 8.73, p = 0.01) in the combined and patching groups, respectively. The difference was statistically significant (mean difference, 0.13 logMAR [1.3 line]; 95% CI, 0.08-0.17 logMAR [0.8-1.7 lines]; t25 = 5.65, p < 0 .01). After treatment, only the combined group had significantly improved stereoacuity, such as binocular function score (median [interquartile range], 2.30 [2.23 to 2.68] vs. 1.69 [1.60 to 2.30] log arcsec; paired, z = -3.53, p < 0.01), and mean stereoacuity gain was 0.47 log arcsec (± 0.22). Changes in other types of stereoacuity were similar.
Conclusion:
Our laboratory-based binocular treatment strategy engaged a high level of compliance that led to a substantial gain in visual function after a short period of treatment for older amblyopic children having poor response or compliance to traditional patching treatments. Notably, the improving stereoacuity showed a greater advantage.
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