Abstract
Background: In recent years, it has been established that the suppression of the amblyopic eye by the fellow eye is the major cause of amblyopia. New behavioural therapies like dichoptic therapy attempt to reduce suppression in amblyopic adults who have passed the critical stage of visual cortex development. Anisometropic amblyopia has the highest prevalence of amblyopia, and managing this condition in adults may lead to improvement in the quality of life. Aim: The purpose of the review is to assess the impact of this novel treatment of amblyopia, with particular focus on using dichoptic therapy for anisometropic amblyopia in adults. Methods: A literature search was conducted on articles published in the last 20 years, and papers were sourced from databases such as Elsevier, Science Direct and PubMed using the reference manager Mendeley. (The search was performed from December 2017 to December 2018.) Results: Evidence from located studies in adults with anisometropic or mixed amblyopia managed with new behavioural treatments including dichoptic therapy showed some significant improvement in the best-corrected distance visual acuity, stereopsis and contrast sensitivity whilst improving or restoring optimal binocular vision. Conclusion: Adults with anisometropic and/or mixed amblyopia can benefit from dichoptic therapy with a unique approach to improve binocularity concurrently. The therapy represents a viable option for managing amblyopia in adults and can be administered as office-based or home-based treatment in a timely manner that could improve the quality of life for such patients.
Highlights
Dichoptic therapy targets suppression directly, which results in a significant improvement in both monocular and binocular visual functions in adults with anisometropic amblyopia.[1]
This can be explained based on the effect of dichoptic therapy on certain visual functions, including visual acuity, stereo-acuity and contrast sensitivity in anisometropic, strabismic and mixed amblyopia which accounts for a combination of both anisometropic and strabismus amblyopia
From various studies provided in the tables below, it was found that the age groups used for the studies were between 13 and 66 years, who had passed the critical stage of visual development
Summary
Dichoptic therapy targets suppression directly, which results in a significant improvement in both monocular and binocular visual functions in adults with anisometropic amblyopia.[1]. Amblyopic sufferers experience a broad range of low- and high-level visual deficits, including contrast sensitivity reduction,[8] high level of spatial uncertainty,[9] poor monocular fixation,[10] higher sensitivity to contour interaction effect[11,12] and impaired reading abilities.[13] Traditionally, it was believed that the visual deficits in amblyopia could be reversed only if its treatment was administered before the end of the critical period of visual cortex maturation This reversal was usually possible up to 13 years of age, which was often achieved using the standard treatment: monocular occlusion and atropine penalisation.[14] Amblyopia is characterised by a number of visual deficits that influence both monocular and binocular visual functions.[15] These deficits were interpreted as amblyopia which is anatomically monocular without any evidence of binocular function. Anisometropic amblyopia has the highest prevalence of amblyopia, and managing this condition in adults may lead to improvement in the quality of life
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