Amblyopia Training Research Articles

Longitudinal follow-up and outcome analysis in patching resistant/patching noncompliant amblyopic subjects treated with dichoptic amblyopia training

Purpose: The purpose of the study was to estimate the efficacy of dichoptic amblyopia training (DAT) in patching resistant/patching noncompliant amblyopic subjects on best-corrected distance visual acuity and stereoacuity with 12-month follow-up. Methodology: In this study, 113 participants with anisometropic, isometropic, strabismic, and accommodative esotropia with amblyopia, with a mean age of 8 years (interquartile range [IQR] 7–10), using full-time spectacle correction and not improving with prescribed patching protocol in 2 subsequent visits 3 months apart were included in the study. Subjects with deprivational amblyopia, ocular comorbidity, or neuronal defects were excluded. Subjects were given 30 min of dichoptic gameplay with Bynocs DAT for 5 days a week for at least 6 weeks. Best-corrected distance visual acuity and stereoacuity of subjects were recorded before treatment, immediately after Bynocs DAT, 6 months, and at 12-month follow-up. Results: The age group of the participants was divided into three groups – (1) <9 years (64.6%), (2) 10–17 years (33.6%), and (3) >18 years (1.8%). The median (IQR) age of 113 participants was 8 years (7–10). The diagnosis of the participants was anisometropic amblyopia in 18 (15.9%), isometropic amblyopia in 72 (63.7%), accommodative esotropia with amblyopia in 18 (15.9%), and strabismic amblyopia in 5 (4.4%). Post dichoptic therapy, the best-corrected distance visual acuity improvement was statistically significant using the McNemar test and remained stable till the 12-month follow-up (P < 0.001). Post Bynocs DAT, stereoacuity improvement was statistically significant using the McNemar test and maintained till the 12-month follow-up (P < 0.001). Conclusion: Best-corrected distance visual acuity and stereoacuity improved after Bynocs DAT and remained stable in patching resistant/patching noncompliant subjects with anisometropic and isometropic amblyopia 12 months after cessation of treatment.

Special clinical features with a novel mutation site of CHN1 gene in a Chinese family with Duane retraction syndrome

ABSTRACT Purpose This study is to describe the special clinical and genotypic features of a Chinese family with variant types of Duane retraction syndrome and to present our experience on managing these cases. Methods Four individuals from one family were reviewed by ophthalmologic examinations, in which two affected and two unaffected individuals were revealed. MRI scans were performed on the two patients. Relevant gene mutations were screened by the next-generation sequencing technology and confirmed by Sanger sequencing technology. Results The six-year-old proband presented with special clinical features of severe horizontal gaze dysfunction, exotropia and mild scoliosis. His mother showed significantly limited binocular abductions, with retraction of eyeballs in adduction. From MRI scans, abducens nerves were not observed in both patients and the oculomotor nerve was slightly thin in the proband. The proband and his mother shared the same CHN1 gene mutation site (c. 62A>G; p.Y21C). Strabismus surgery was performed on the proband to correct the primary gaze exotropia. (NM_001822: exon3 or NM_001025201: exon4: c. 62A>G; p.Y21C) Conclusions A novel CHN1 gene mutation was revealed from a Chinese family with Duane retraction syndrome. Remarkably, the proband and his mother presented different clinical features of ocular motility disorder. Strabismus correction surgery and amblyopia training helped to improve the appearance and visual function of the proband.

Comparison of the effectiveness of amblyopia treatment with eye-patch and binocular Occlu-tab for the same treatment duration.

Purpose:This study aimed to compare the conventional eye patch with Occlu-tab—a binocular open-type amblyopia training device—and evaluate their effectiveness in amblyopia treatment.Methods:In this prospective, multi-center study, 40 patients between ages 3 to 12 years, diagnosed with anisometropic amblyopia (refraction difference of both eyes ≥ 2 D, best-corrected visual acuity [BCVA] of the amblyopic eye ≤ 0.1 [logMAR]) were treated with Occlu-tab or conventional eye patch for 1 h per day thrice a week. We compared the visual acuity of both groups before and after 6, 7, and 8 weeks of amblyopia treatment. One-way repeated-measures analysis of variance and Tukey’s test were used to compare the visual acuity of both groups pre- and post-treatment.Results:Both groups had significantly improved visual acuity at 6, 7, and 8 weeks compared to that before treatment (all P < 0.001). The improvement in BCVA of the Occlu-tab group (0.33 ± 0.25) was significantly greater than that of the eye patch group (0.16 ± 0.17) after 8 weeks of treatment (P = 0.02).Conclusion:Amblyopia treatment using binocular open game training with Occlu-tab led to greater improvement in visual acuity than that with a conventional eye patch for the same treatment duration.

Stimuli Characteristics and Psychophysical Requirements for Visual Training in Amblyopia: A Narrative Review.

Active vision therapy using perceptual learning and/or dichoptic or binocular environments has shown its potential effectiveness in amblyopia, but some doubts remain about the type of stimuli and the mode and sequence of presentation that should be used. A search was performed in PubMed, obtaining 143 articles with information related to the stimuli used in amblyopia rehabilitation, as well as to the neural mechanisms implied in such therapeutic process. Visual deficits in amblyopia and their neural mechanisms associated are revised, including visual acuity loss, contrast sensitivity reduction and stereopsis impairment. Likewise, the most appropriate stimuli according to the literature that should be used for an efficient rehabilitation of the amblyopic eye are described in detail, including optotypes, Gabor’s patches, random-dot stimuli and Vernier’s stimuli. Finally, the properties of these stimuli that can be modified during the visual training are discussed, as well as the psychophysical method of their presentation and the type of environment used (perceptual learning, dichoptic stimulation or virtual reality). Vision therapy using all these revised concepts can be an effective option for treating amblyopia or accelerating the treatment period when combining with patching. It is essential to adapt the stimuli to the patient’s individual features in both monocular and binocular training.

Survey on the Cooperation System of Daycares and Kindergartens Regarding Amblyopia Training

Survey on the Cooperation System of Daycares and Kindergartens Regarding Amblyopia Training

Stochastic Resonance Applied to Amblyopia Training and the Plasticity of Brain

Stochastic Resonance Applied to Amblyopia Training and the Plasticity of Brain

Improvement of Adherence with Occlu-Pad Therapy for Pediatric Patients with Amblyopia.

We aimed to examine visual acuity improvement effect and adherence in amblyopia training using tablet type vision training equipment (Occlu-pad). The subjects were 138 patients with amblyopia (average age of 5.5 ± 1.6 years old); their amblyopic visual acuity at the start of training was logMAR 0.15 to 1.3. Occlu-pad is a device that processes images such that amblyopic eyes can only view the image as it passes through polarized glasses; this is achieved by peeling off the polarizing film layer in the liquid crystal display of an iPad (Apple). Amblyopia training comprised either the instructional training with Occlu-pad or the eye patch (Patching) as a family training, after wearing perfectly corrected glasses. Visual acuity improvement following amblyopia training by Occlu-pad and Patching was significantly different after 6 months in patients with anisometropic amblyopia (p <0.05). In patients with strabismic amblyopia, a significant difference between training methods was observed after 9 months (p <0.05). Use of the Occlu-pad resulted in better adherence for patients with either anisometropic amblyopia or strabismic amblyopia; a significant difference in adherence was observed after 3 months, compared with Patching (p <0.05). Amblyopia training with Occlu-pad supports greater visual acuity improvement and adherence than Patching.

Clinical analysis of traumatic endophthalmitis in children

Objective To analyze the clinical manifestation, treatment and its efficacy of traumatic endophthalmitis in children. Methods The data of 45 eyes of 45 cases of traumatic endophthalmitis in children aged 1-11 years from Jan. 2014 to Apr. 2016 were collected and retrospectively analyzed. Twenty-seven patients underwent debridement combined with vitrectomy. Eighteen patients underwent debridement and intravitreal injection of vancomycin, but the infection aggravated after injection in 14 cases, they underwent vitrectomy. Results The hypopyon occurred in 16 cases (35.5%), the anterior chamber exudation occurred in 29 cases (64.5%). After intravitreal injection the infection was controlled in 4 eyes. Forty-one cases underwent vitrectomy. During surgery silicone was tamponaded in 39 cases and C3F8 tamponade in 2 cases. All patients were followed up for 1 year after surgery. Silicone oil was removed in 27 cases and wasn’t removed in 7 cases, 1 case underwent evisceroneurotomy due to the uncontrollable infection. Atrophy of eyeball was happened in 4 cases. In the second stage treatment, IOL were implanted in 8 cases, 2 cases wore RGP. After treatment the visual acuity was improved in 22 cases, 10 cases unchanged and decreased in 7 cases, the vision wasn’t tested in 6 cases due to the age and other reasons. Conclusion The clinical feature of children with endophthalmitis is exudation of anterior chamber and hypopyon. Vitrectomy is the most effective method for the treatment of infectious endophthalmitis in children. Secondary implantation of intraocular lens and glasses, and corresponding amblyopia training can further improve visual function of children. Key words: Endophthalmitis, children, traumatic; Clinical manifestation; Treatment; Efficacy

Android application for ocular training in amblyopia

Android application for ocular training in amblyopia

Android application for ocular training in amblyopia

This paper propose a mobile application that runs on the Android system, an app that aims to help persons with amblyopia by running recovery exercises in a very simple and convenient way, right on their own phone. It is very important to know that training the amblyopic eye even five minutes a day can result in vision acuity recovery, so it is recommended to use this application every day. Moreover, it is very easy to use, with an intriguing and intuitive menu with very simple commands. The subject with amblyopia can do the exercises anywhere, anytime. Another advantage is the accessibility of the application, which is used by the phone, can be used at any time of the day; the user has to give only five minutes of his daily activities.

Modified iPad for treatment of amblyopia: a preliminary study

We report the results of a new amblyopia treatment device used in 7 children with anisometropic amblyopia. The Occlu-pad was created by removing the polarizing film layer from the liquid crystal display screen of an iPad Air (Apple Inc, Cupertino, CA). Patients were asked to wear special glasses that contained a polarizing filter for their amblyopic eye and a light reduction filter for their normal eye and instructed to play an amblyopia training game displayed only to the amblyopic eye. In 5 patients corrected distance visual acuities in the amblyopic eyes improved after 2 months' treatment on average by 0.38 (logarithm of the minimum angle of resolution).

Parallels between use of constraint‐induced movement therapy to treat neurological motor disorders and amblyopia training

There are striking similarities between the visual defect of amblyopia and the motor deficit of the extremities produced by such types of damage to the central nervous system (CNS) as stroke and traumatic brain injury, both after and before maturity. Part of the motor deficit of the extremities following CNS injury can be attributed to a learning phenomenon termed "learned nonuse" or if present from birth, "developmental disregard." The same mechanism is hypothesized to be involved in the development of amblyopia. Treatments that are efficacious in the remediation of these defects, Constraint-Induced Movement therapy and amblyopia training, also share a number of strong similarities. In addition, plastic brain changes are produced by CI therapy and are hypothesized to occur during amblyopia training.

21 cases of eye trauma because of amblyopia training in children

目的 探讨弱视儿童训练致眼外伤的原因及预防.方法 对近6年中所接诊的弱视儿童在进行弱视治疗训练过程中所致眼外伤的情况进行分析及治疗.结果 21例(22眼)弱视儿童经对症治疗后,矫正视力:0.3～0.6者21眼,0.8者1眼,伤口愈合,出血吸收.结论 21例虽无严重眼外伤,但也应引起家长及社会各界的重视,更加完善弱视训练方法,做好防范工作。

The non‐amblyopic eye of a unilateral amblyope: a unique entity

The non-amblyopic eye of a unilateral amblyope is generally thought of as a ‘normal’ eye. Recently differences in sensitivity, visual acuity, fixation and eye movements, between a ‘normal’ eye and the non-amblyopic eye of unilateral amblyopes were reported in the literature. Two separate studies were conducted fifteen years apart, with two distinctly different samples in which both gave similar results regarding the distribution of ametropia within the sample populations. This distribution was found to be significantly different for amblyopic eyes, non-amblyopic eyes of unilateral amblyopes and ‘normal’ eyes. Amblyopia training, whether employing the CAM vision stimulator or occlusion therapy, appears to have a positive effect on the contrast sensitivity function of both the amblyopic and non-amblyopic eyes of the unilateral amblyope, although there may be no improvement in the visual acuity. On the other hand, age-matched normal undergoing identical treatment programs show no change in their contrast sensitivity function.

Amblyopia therapy by the Campbell-Hess technique.

Campbell and Hess developed a new technique for treating amblyopia. This technique involves stimulation of the amblyopic eye for precise time intervals with a graded series of contrast frequency gratings. Partial occlusion is used only during the treatment. Treating strabismic and anisometropic amblyopes by the Campbell-Hess amblyopia training technique produced an improvement of two lines on the acuity chart in six of 14 patients.

Training in Amblyopia

Training in Amblyopia