Successful persistent strabismic amblyopia treatment using active therapy as an adjuvant to occlusion

Area of Science:

• Ophthalmology
• Neuroscience
• Vision Science

Background:

• Amblyopia, or 'lazy eye', affects visual development and can persist into adulthood.
• Conventional treatments like patching have limitations, especially for persistent or 'patch-resistant' amblyopia.
• Novel therapeutic approaches are needed to improve long-term outcomes for amblyopia patients.

Purpose of the Study:

• To evaluate a novel treatment protocol for persistent strabismic and combined-mechanism amblyopia.
• The protocol integrates home-based perceptual learning (PL) with traditional in-clinic visual therapy.
• This approach aims to enhance outcomes beyond standard patching for patch-resistant amblyopia.

Main Methods:

• A cohort of 53 patients with persistent amblyopia (strabismic or combined-mechanism) were treated between 2018-2022.
• The protocol involved in-clinic orthoptics and visual therapy.
• Home-based therapy utilized gamified perceptual learning software (Gabor patch, dichoptic stimulation, random dot stereograms).

Main Results:

• 87% of patients achieved a best-corrected visual acuity (BCVA) of logMAR 0.1 or better.
• Mean BCVA improved significantly from logMAR 0.30±0.23 to logMAR 0.07±0.12 (p < 0.01).
• Stereoacuity improved significantly, with 81% achieving measurable stereoacuity post-treatment (p < 0.01).
• Central fixation was achieved in 65% of patients with initial eccentric fixation.

Conclusions:

• The novel protocol effectively improved BCVA and stereoacuity in patients with persistent amblyopia.
• Reduced angle of deviation was also observed as an outcome.
• Treatment gains remained stable six months post-therapy, indicating long-term efficacy.