Effectiveness of a Novel Video Game Platform in the Treatment of Pediatric Amblyopia

Abstract

Purpose: To test the non-inferiority of a novel game platform for the treatment of pediatric amblyopia compared to standard eye patching. Methods: Forty participants (ages 4 to 18 years) across seven optometric clinics in the United States diagnosed as having amblyopia associated with anisometropia were randomly assigned to either 12 weeks of eye patching therapy (n = 19) or Barron Vision (Barron Associates, Inc) video game treatment (n = 21). Participants in the eye patching group with best corrected visual acuity (BCVA) worse than 20/200 in their amblyopic eye were prescribed 6 hours of patching daily, whereas those whose BCVA was 20/200 (1.00 logarithm of the minimum angle of resolution [logMAR]) or better were instructed to patch for 2 hours daily. Participants in the video game group, irrespective of the severity of their amblyopia, were instructed to play four different 5-minute mini-games five times a week for a total of 20 minutes a day. Results: A mixed linear modeling analysis of before and after BCVA differences after 12 weeks showed the non-inferiority of video game treatment to eye patching using a 0.10 logMAR threshold while adjusting for the participant's age, sex, and baseline BCVA. Conclusions: The results of the study suggest that a 12-week home-based video game vision therapy intervention can provide equivalent treatment outcomes to eye patching for amblyopia in children ages 5 to 18 years. Video game–based vision therapy may be a more acceptable and time-efficient alternative to existing approaches. By incorporating elements of perceptual learning, approaches such as Barron Vision video game treatment may have additional long-term therapeutic benefits and may improve treatment compliance. [ J Pediatr Ophthalmol Strabismus . 20XX;X(X):XX–XX.]

Non-Surgical Strabismus Treatment

“…Virtual reality is a relatively new intervention that can be used to treat eye and vision problems [21,31]. Home video therapy can provide patch-equivalent treatment results [32][33][34][35].…”

Current Developments in the Management of Amblyopia with the Use of Perceptual Learning Techniques

“…Addresses multiple amblyopia impairments: A great number of studies support that the various PL treatments are effective in improving VA of the amblyopic eye, with superior, or at least equal results compared to patching [27,37,40,54,57,58,61,67]. Furthermore, the PL approaches have a definite advantage in restoring other visual deficits, like stereoacuity, CS, and crowding effect, as well as visuomotor deficits, while patching has no impact on them [13,27,28,31,34,37,40,44,46,49,54,57,59,61].…”

“…-Activity log: PL software applications include a built-in log that records playing hours plus patient's performance data, stored either in the app or on a server/cloud, therefore providing an objective track of compliance to the training program [28,29,34,45,54,65]. -Faster treatment effects: Many studies have pointed out that PL programs generate equivalent visual outcomes in a shorter time (at least 5-fold faster) compared to patching [13,27,30,34,47,50,58,61]. Thus, this improves adherence and brings optimal results [49,52].…”