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Published on: September 27, 2024
Focal ambient visual acuity stimulation improves vision in amblyopic children with stagnating BCVA-A retrospective
Kai Januschowski1,2,3, Abdullah Salim1, Anna Thonet1,3
1Mount St. Peter Eye Clinic, Trier, Germany.
Insights
Focal ambient visual acuity stimulation (FAVAS) combined with occlusion therapy significantly improved visual acuity in amblyopic children. This digital therapy offers a superior alternative to occlusion alone for stagnant cases.
Area of Science:
- Ophthalmology
- Pediatric medicine
- Vision science
Background:
- Amblyopia, or "lazy eye," affects visual development in children.
- Conventional treatment often involves occlusion therapy.
- Stagnating visual acuity despite treatment presents a therapeutic challenge.
Purpose of the Study:
- To evaluate the efficacy of focal ambient visual acuity stimulation (FAVAS) integrated into a computer game as an adjunct to occlusion therapy.
- To compare outcomes of combined therapy versus occlusion therapy alone in children with amblyopia and stagnating visual acuity.
Main Methods:
- Retrospective, multicentre analysis of 227 children with amblyopia and stagnating visual acuity.
- Comparison between eyes receiving occlusion therapy plus FAVAS and eyes receiving occlusion therapy alone.
- Propensity score matching used to create comparable groups (57 eyes per group).
Main Results:
- The FAVAS group demonstrated a significant mean BCVA gain of 0.15 logMAR (p < 0.001).
- The control group (occlusion alone) showed a non-significant BCVA improvement of 0.01 logMAR (p = 0.356).
- No significant changes in stereo vision were observed in either group.
Conclusions:
- Combining occlusion therapy with FAVAS is more effective than occlusion alone for improving visual acuity in amblyopic children with stagnating vision.
- Digital stimulation therapy, like FAVAS, shows promise as an effective addition to standard amblyopia treatments.
- FAVAS offers a clinically relevant improvement in visual acuity for challenging amblyopia cases.
Purpose:
The aim of this study was to investigate whether amblyopic children with stagnating best-corrected visual acuity (BCVA) would benefit from an additional stimulation therapy-specifically focal ambient visual acuity stimulation (FAVAS) integrated into a computer game-compared to occlusion therapy alone.
Methods:
This retrospective, multicentre study analysed clinical records of 227 children with amblyopia showing stagnation of visual acuity despite at least 90 days of occlusion therapy. Analyses were performed on an eye-based level. Eyes that had received FAVAS (Caterna Vision GmbH, Potsdam, Germany) alongside occlusion therapy were assigned to the FAVAS group, while eyes treated with occlusion therapy alone served as controls. Post hoc propensity score matching was applied. After matching, 105 patients (114 eyes; 57 eyes per group) remained for analysis. The primary endpoint was improvement in best corrected visual acuity (BCVA, logMAR); the secondary endpoint was change in stereo vision.
Results:
The FAVAS group showed a significant improvement in BCVA, with a mean gain of 0.15 logMAR (95% CI [0.11;0.18], p < 0.001), compared to a non-significant improvement of 0.01 logMAR (95% CI [-0.02;0.04], p = 0.356) in the control group. No significant changes were observed in stereo vision in either group.
Conclusion:
The combination of occlusion therapy and FAVAS was superior to occlusion alone in amblyopic children with stagnating BCVA, yielding significant and clinically relevant improvements in visual acuity. These findings support the integration of digital stimulation therapy as an effective adjunct to conventional amblyopia treatment.
Trial Registration:
German Clinical Trials Register (DRKS): DRKS00030216.
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