Binocular amblyopia treatment with contrast-rebalanced movies

Birch, Eileen E.; Jost, Reed M.; Cruz, Angie De La; Kelly, Krista R.; Beauchamp, Cynthia L.; Dao, Lori; Leffler, Joel N.

doi:10.1016/j.jaapos.2019.02.007

Cited by 41 publications

(41 citation statements)

References 39 publications

(50 reference statements)

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“…More effective treatments for amblyopia may target suppression, by requiring integration of information between the two eyes to play dichoptic games or watch dichoptic videos. Like occlusion therapy, binocular treatment results reported to date are generally positive for young children [81][82][83][84][85][86][87] but less effective for older children due to poor compliance and/or intractable residual amblyopia. [88][89][90]…”

Section: Fellow Eye Deficits and Amblyopia Treatmentmentioning

confidence: 99%

Fellow Eye Deficits in Amblyopia

Birch

Kelly

Giaschi

2019

Journal of Binocular Vision and Ocular Motility

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Amblyopia is a neurodevelopmental disorder of the visual system, as a result of discordant visual experience during infancy or early childhood. Because amblyopia is typically defined as monocularly reduced visual acuity accompanied by one or more known amblyogenic factors, it is often assumed that the fellow eye is normal and sufficient for tasks like reading and eye-hand coordination. Recent scientific evidence of ocular motor, visual, and visuomotor deficits that are present with fellow eye monocular viewing and with binocular viewing calls this assumption into question. This clinical update reviews the research that has revealed fellow ocular motor and visual deficits and the effect that these deficits have on an amblyopic child's visuomotor and visuocognitive skills. We need to understand how to prevent and rehabilitate the effects of amblyopia not only on the nonpreferred eye but also on the fellow eye.

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Section: Fellow Eye Deficits and Amblyopia Treatmentmentioning

confidence: 99%

Fellow Eye Deficits in Amblyopia

Birch

Kelly

Giaschi

2019

Journal of Binocular Vision and Ocular Motility

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“…Mean improvement in BCVA with patching was 0.3 ± 0.3 logMAR (three lines). Forty-nine percent of amblyopic children also received 2 to 8 weeks of binocular treatment with contrast rebalanced dichoptic games or movies 6,24–26…”

Section: Resultsmentioning

confidence: 99%

“…*BCVA tested with ATS-HOTV (<7 years old) or E-ETDRS (≥7 years old).†For normal controls, only the right eye was tested.‡Some children were treated only with contrast rebalanced dichoptic games or movies.§Binocular amblyopia treatment with contrast rebalanced dichoptic games6,24 or movies 25,26…”

Section: Resultsmentioning

confidence: 99%

“…During the clinical trials, patching was discontinued. Children played contrast-rebalanced dichoptic games on a tablet 5 h/wk6,24 or watched contrast-rebalanced dichoptic animated videos 4.5 h/wk 25,26. Contrast-rebalancing of dichoptic games and videos (high amblyopic eye contrast and reduced fellow eye contrast) aims to decrease or eliminate suppression, promoting visual acuity recovery by providing binocular visual experience 3,4.…”

Section: Methodsmentioning

confidence: 99%

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Impaired Fellow Eye Motion Perception and Abnormal Binocular Function

Birch

Jost

Wang

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. Binocular discordance due to strabismus, anisometropia, or both may result in not only monocular visual acuity deficits, but also in motion perception deficits. We determined the prevalence of fellow-eye deficits in motion-defined form (MDF) perception, the ability to identify a two-dimensional (2D) shape defined by motion rather than luminance contrast. We also examined the following: the causative role of reduced visual acuity and binocularity, associations with clinical and sensory factors, and effectiveness of binocular amblyopia treatment in alleviating deficits. METHODS. Participants included 91 children with residual amblyopia (strabismic, anisometropic, or both; age, 9.0 6 1.7 years), 79 nonamblyopic children with treated strabismus or anisometropia (age, 8.5 6 2.1 years), and 20 controls (age, 8.6 6 1.5 years). MDF coherence thresholds, visual acuity, stereoacuity, and interocular suppression were measured. RESULTS. MDF deficits, relative to controls, were present in the fellow eye of 23% of children with residual amblyopia and 20% of nonamblyopic children. Stereoacuity and age first patched were correlated with MDF threshold (r ¼ 0.29, 95% CI: 0.09-0.47; r ¼ À0.33, 95% CI : À0.13 to À0.50, respectively). MDF deficits were more common in children treated with patching alone than in those receiving contrast-rebalanced binocular treatment with games or movies (t 89 ¼ 3.46; P ¼ 0.0008). The latter was associated with a reduction in mean fellow eye MDF threshold (t 26 ¼ 6.32, P < 0.0001). CONCLUSIONS. Fellow eye MDF deficits are common and likely reflect abnormalities in binocular cortical mechanisms that result from early discordant visual experience. Binocular amblyopia treatment, which is effective in improving amblyopic eye visual acuity, appears to provide a benefit for the fellow eye.

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“…In amblyopia, even though monocular vision is clinically used to establish its severity and to follow-up effects of treatments, there is a current need for a more accurate measure of the visual improvement in binocular condition. Because modern approaches using binocular stimulation, including dichoptic based, have emerged, [66][67][68][69][70][71][72][73][74] it is now possible to improve monocular BCVA of the amblyopic eye in binocular (dichoptic) condition without penalizing the dominant eye, which in turn brings the possibility of binocular balance restoration. Moreover, monocular discrimination using binocular background is closer to the everyday visual situation than the monocular examination.…”

Section: Discussionmentioning

confidence: 99%

Dichoptic Spatial Contrast Sensitivity Reflects Binocular Balance in Normal and Stereoanomalous Subjects

Barboni

Maneschg

Németh

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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To study binocular balance by comparing dichoptic and standard monocular contrast sensitivity function (CSF) in stereonormal and stereoanomalous/stereoblind amblyopic subjects. METHODS. Sixteen amblyopes and 17 controls participated. Using the capability of the passive three-dimensional display, we measured their CSF both monocularly and dichoptically at spatial frequencies 0.5, 1, 2, 4, and 8 cpds using achromatic Gabor patches on a luminance noise background. During monocular stimulation, the untested eye was covered, while for the dichoptic stimulation the untested eye viewed background noise. Dichoptic CSF of both eyes was acquired within one block. RESULTS. In patients with central fixation, dichoptic viewing had a large negative impact on the CSF of the amblyopic eye, although it hardly affected that of the dominant eye. In contrast, dichoptic viewing had a small but significant effect on both eyes for controls. In addition, all participants lay along a continuum in terms of how much their two eyes were affected by dichoptic stimulation: by using two predefined contrast sensitivity ratios, namely, amblyopic sensitivity decrement and dichoptic sensitivity decrement, not only did we find a significant correlation between these variables among all participants, but also the two groups were identified with minimum error using a cluster analysis. CONCLUSIONS. Dichoptic CSF may be considered to measure visual performance in patients with altered binocular vision, because it better reflects the visual capacity of the amblyopic eye than the standard monocular examinations. It may also be a more reliable parameter to assess the efficacy of modern approaches to treat amblyopia.

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Binocular amblyopia treatment with contrast-rebalanced movies

Cited by 41 publications

References 39 publications

Fellow Eye Deficits in Amblyopia

Fellow Eye Deficits in Amblyopia

Impaired Fellow Eye Motion Perception and Abnormal Binocular Function

Dichoptic Spatial Contrast Sensitivity Reflects Binocular Balance in Normal and Stereoanomalous Subjects

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