Abstract
BackgroundThe gold standard treatments in amblyopia are penalizing therapies, such as patching or blurring vision with atropine that are aimed at forcing the use of the amblyopic eye. However, in the last years, new therapies are being developed and validated, such as dichoptic visual training, aimed at stimulating the amblyopic eye and eliminating the interocular supression.PurposeTo evaluate the effect of dichoptic visual training using a virtual reality head mounted display in a sample of anisometropic amblyopic adults and to evaluate the potential usefulness of this option of treatment.MethodsA total of 17 subjects (10 men, 7 women) with a mean age of 31.2 years (range, 17–69 year) and anisometropic amblyopia were enrolled. Best corrected visual acuity (BCVA) and stereoacuity (Stereo Randot graded circle test) changes were evaluated after 8 sessions (40 min per session) of dichoptic training with the computer game Diplopia Game (Vivid Vision) run in the Oculus Rift OC DK2 virtual reality head mounted display (Oculus VR).ResultsMean BCVA in amblyopic eye improved significantly from a logMAR value of 0.58 ± 0.35 before training to a post-training value of 0.43 ± 0.38 (p < 0.01). Forty-seven percent of the participants achieved BCVA of 20/40 or better after the training as compared to 30% before the training. Mean stereoacuity changed from a value of 263.3 ± 135.1 before dichoptic training to a value of 176.7 ± 152.4 s of arc after training (p < 0.01). A total of 8 patients (47.1%) before dichoptic treatment had unmeasurable stereoacuity while this only occurred in 2 patients (11.8%) after training.ConclusionsDichoptic training using a virtual reality head mounted display seems to be an effective option of treatment in adults with anisometropic amblyopia. Future clinical trials are needed to confirm this preliminary evidence.Trial registrationTrial ID: ISRCTN62086471. Date registered: 13/06/2017. Retrospectively registered
Highlights
The gold standard treatments in amblyopia are penalizing therapies, such as patching or blurring vision with atropine that are aimed at forcing the use of the amblyopic eye
Dichoptic training using a virtual reality head mounted display seems to be an effective option of treatment in adults with anisometropic amblyopia
We have conducted a preliminary study evaluating the effect of dichoptic visual training using a virtual reality head mounted display in a sample of amblyopic adults in order to evaluate the potential usefulness of this option of treatment
Summary
The gold standard treatments in amblyopia are penalizing therapies, such as patching or blurring vision with atropine that are aimed at forcing the use of the amblyopic eye. Amblyopia is a reduction of the best corrected visual acuity of the eye without organic cause [1] In this condition, there is an abnormal binocular experience due to a mismatch between the images perceived with each eye [1]. Žiak et al BMC Ophthalmology (2017) 17:105 blurring vision with atropine that are aimed at forcing the use of the amblyopic eye [5] This type of amblyopia treatment can be effective for up to 7 years of age [6]. We have conducted a preliminary study evaluating the effect of dichoptic visual training using a virtual reality head mounted display in a sample of amblyopic adults in order to evaluate the potential usefulness of this option of treatment
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