Randomized Controlled Trial of a Dichoptic Digital Therapeutic for Amblyopia

Abstract

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Randomized clinical trial of streaming dichoptic movies versus patching for treatment of amblyopia in children aged 3 to 7 years

“…After 6 weeks of viewing contrast-rebalanced dichoptic movies at home, 29% of children in the dichoptic movie group had ≤ 0.1 logMAR (≤ 1 line) interocular difference in visual acuity (recovered). These results are similar to those reported in a recent randomized trial of 4- to 7-year-old using a head-mounted display to view dichoptic movie content at-home as a treatment for amblyopia 4 . Additionally, a modest improvement in stereoacuity was observed in the dichoptic movie group at the primary outcome and 4-week visit.…”

“…Additionally, a modest improvement in stereoacuity was observed in the dichoptic movie group at the primary outcome and 4-week visit. Reports of stereoacuity improvements with other dichoptic therapies for amblyopia in children are variable, with some reporting improvement 22 – 25 and others reporting no change 4 , 26 , 27 . The factors that contribute to this variability in stereoacuity outcomes of binocular treatment remain to be determined.…”

“…While these laboratory studies provided proof-of-principle data for the treatment approach, at-home treatment is a more practical alternative. More recently, both a single arm study and a randomized clinical trial allowed children to view cloud-based movie content at home using a head-mounted display (a commercially available smartphone in a virtual reality headset) with reduced fellow eye contrast, reporting a mean visual acuity improvement of 1.5 − 1.8 lines within 12 weeks 3 , 4 . However, head-mounted displays are difficult to use by preschool children because of their size and weight, as well as the visual isolation imposed during wear.…”

The Orientation Selectivity of Dichoptic Masking Suppression is Contrast Dependent in Amblyopia

“…Amblyopia is a neurodevelopmental disorder associated with abnormal visual experience early in life, such as strabismus, anisometropia, high refractive error, and cataract. 1 – 4 It is the most common cause of monocular visual loss in children, 5 , 6 affecting approximately 1% to 5.5% of the population. 2 , 7 Amblyopes suffer from poor monocular visual functions 8 – 10 (e.g.…”

Evaluation of the Efficacy of a New Dichoptic Digital Platform to Treat the Anisometropic and Isometropic Amblyopia

“…There is a great variety of studies confirming the benefit of dichoptic treatment in children with amblyopia after appropriate refractive correction, especially in anisometropic amblyopia [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. However, there are a limited number of trials reporting the opposite, a lack of benefit of a dichoptic approach in amblyopia compared to placebo [ 20 , 21 ].…”