Binocular Treatment for Children With Amblyopia Shows Limited Results

Binocular treatment improves amblyopic eye visual acuity (VA) at 4 weeks compared with glasses alone, but the effect was not significant at 8 weeks, researchers found in a study presented at the American Academy of Ophthalmology 2020 conference.

The researchers sought to determine whether binocular treatment can improve amblyopia. They randomly assigned 182 children aged 4 to 6 years with anisometropic strabismic or combined amblyopia (<55 near tropia) to 1 hour/day, 5 days/week binocular treatment on a tablet (Dig Rush dichoptic game, with initially reduced fellow eye contrast) instead of continued glasses wear. The children had previously worn glasses for at least 16 weeks or 8 weeks with no improvement in VA prior to the experiment, the researchers said.

The researchers conducted eye exams of 169 subjects at 4 weeks and 164 subjects at 8 weeks. At the 4-week primary outcome, mean VA was greater with binocular treatment than continued glasses (1.1 vs 0.6 logMAR lines, difference of 0.5 lines; 95.1% confidence interval (CI), 0.1-0.9), and for the 164 subjects completing 8-week exams, the difference was not significant (1.3 vs 1.0 lines, difference of 0.3 lines; 98.4% CI, −0.3 to 0.8), the researchers found.

The researchers said the lack of significant difference at 8 weeks might be attributed to continuing VA improvement with glasses, VA ceiling effect and reduced binocular effect from game design.

Reference

Holmes JM, Manney RE, Kraker R, et al. RCT of Binocular Treatment for Amblyopia in 4-6 Year-Olds. Presented at: American Academy of Ophthalmology 2020 Annual Meeting; November 13-15, 2020. Abstract PO320.