A Prospective Trial to Assess the Efficacy of Eye-Tracking-Based Binocular Treatment versus Patching for Children’s Amblyopia: A Pilot Study

Abstract

ABSTRACT Purpose To assess visual acuity (VA) and stereoacuity (SA) improvements in children with amblyopia treated with either binocular dichoptic treatment or patching treatment. Methods In this pilot prospective coherent study, 34 participants between 4 and 9 years of age with unilateral anisometropic amblyopia and without history of prior amblyopia treatment were enrolled into three groups. Full treatment group (FTG; n = 12): participants were prescribed the binocular dichoptic treatment to watch for 90 minutes per day, 5 days a week. Part-time treatment group (PTTG; n = 8): participants were prescribed the same binocular treatment as FTG, 90 minutes per day, 3 days per week. Patching treatment group (PTG; n = 14): participants wore an adhesive patch over the dominant eye for 2 hours per day, 7 days per week. Amblyopic-eye distance visual acuity (DVA), near visual acuity (NVA) and SA were evaluated at baseline, 4, 8, and 12 weeks. Results At 12 weeks, mean amblyopic-eye DVA improved 1.8 lines (95% CI, 1.1–2.5) in FTG, 1.5 lines (95% CI, 0.4–2.7) in PTTG and 3.0 lines (95% CI, 2.0–4.0) in PTG. The amblyopic-eye NVA improved 2.9 lines (95% CI, 2.4–3.5) in FTG, 1.7 lines (95% CI, 0.5–3.0) in PTTG and 2.8 lines (95% CI, 1.8–3.9) in PTG. The SA improved 0.38 log-arcseconds (95% CI, 0.24–0.53) in FTG, 0.59 log-arcseconds (95% CI, 0.36–0.82) in PTTG and 0.40 log-arcseconds (95% CI, 0.13–0.67) in PTG. No significant differences were found in DVA, NVA or SA improvement between FTG and PTG at 12 weeks. Conclusions VA and SA after binocular dichoptic treatment produced a similar therapeutic outcome to patching, suggesting a potential value for binocular therapy when treating anisometropic moderate degree of Children’s amblyopia.