Active Vision Therapy for Anisometropic Amblyopia in Children: A Systematic Review

Abstract

Purpose. The aim of the study was evaluation of the scientific evidence about the efficacy of vision therapy in children and teenagers with anisometropic amblyopia by performing a systematic literature review. Methods. A search was performed using 3 searching strategies in 4 different databases (PubMed, Web of Science, Scopus, and PruQuest). The quality of the included articles was evaluated using two tools for the risk of bias assessment, ROBINS-I for nonrandomized studies of intervention (NRSI), and ROB 2.0 for randomized clinical trials. Results. The search showed 1274 references, but only 8 of them passed the inclusion criteria after the complete text review. The articles that were finally included comprised 2 randomized control trials and 6 nonrandomized studies of intervention. These articles provided evidence supporting the efficacy of vision therapy for the treatment of anisometropic amblyopia in children and teenagers. Assessment of the risk of bias showed an appropriate risk of bias for the randomized control trials, but a high risk of bias for nonrandomized studies of intervention (NRSI). A main source of risk of bias for NRSI was the domain related to the measurements of the outcomes, due to a lack of double-blind studies. Conclusion. Vision therapy is a promising option for the treatment of anisometropic amblyopia in children and teenagers. However, the level of scientific evidence provided by the studies revised is still limited, and further randomized clinical trials are necessary to confirm the results provided to date and to optimize the vision therapy techniques by knowing the specific neural mechanisms involved.

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

“…Amblyopia research has experienced considerable progress in the last few decades, providing clinicians with more knowledge about the neural basis of the amblyopic visual system and new therapeutic approaches. However, there is a wide heterogeneity in the methodology of vision therapy treatment for amblyopia, according to the scientific literature [ 8 ].…”

“…Over the last few years, vision therapy has been suggested to be an effective option to promote visual rehabilitation and even to accelerate recovery when combined with patching [ 8 ]. New trends in computer-based active vision therapy have been developed for amblyopia treatment, such as the use of perceptual learning environments [ 9 , 10 , 11 ], dichoptic stimulation [ 12 , 13 , 14 ] and binocular training [ 15 , 16 ].…”

Efficacy of vision-based treatments for children and teens with amblyopia: a systematic review and meta-analysis of randomised controlled trials

“…Comparisons of vision-based treatments for patients with amblyopia have been examined in systematic reviews comparing patching against atropine [29][30][31] or binocular treatments against patching. [32][33][34] Only one review 35 included a meta-analysis, which was limited to two studies and two treatments. In general, published systematic reviews and meta-analyses found no significant differences between the various vision-based amblyopia treatments.…”

Structured Visual Learning and Stimulation in School: An Intervention Study

“…But minus and plus lenses connected in flipper glasses have shown good effect as a training tool (Sterner, 2004). Hernández-Rodríguez & Piñero (2020) come to the conclusion that vision therapy looks promising for the treatment of amblyopia in children.…”