The Measurement and Treatment of Suppression in Amblyopia

Black, Joanna; Hess, Robert F.; Cooperstock, Jeremy R.; To, Long; Thompson, Benjamin

doi:10.3791/3927-v

Cited by 3 publications

(6 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This RCT adds to the long list of studies that have evaluated the e cacy of so-called dichoptic training in amblyopia. [15][16][17][18][19][20][21][22][23][24][25][26] Gabor patches, 8,9,12 even dichoptic Gabor patches, have been used in amblyopia treatment before now. [29][30][31][32] But, to our knowledge, this will be the rst time that gami ed home training using dichoptic Gabor patches has been tested.…”

Section: Discussionmentioning

confidence: 99%

“…22 Initial laboratory studies seemed to con rm this approach. 23,24,25 Later, clinical trials made use of gami cation to improve patient compliance, by inserting dichoptic elements into videogames [26][27][28][29][30][31] or lms. [32][33][34] In terms of VA and stereoacuity, these treatments produced inconsistent results: in some cases, better or similar to those obtained by optical refraction, with 30,26 and without occlusion; 28,35 but worse in others, 29,36,37 for reasons which are unclear.…”

Section: Perceptual Learningmentioning

confidence: 99%

See 1 more Smart Citation

Study protocol for a randomized controlled trial using VISIONARY, a dichoptic Gabor patch video game, to improve visual function in children with amblyopia

Pérez-Benito,

Calderón-González,

Álvarez-Martín

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: Conventional treatment for amblyopia, involving occlusion and penalization of the dominant eye, does not always lead to effective outcomes and is associated with a high risk of recurrence and non-compliance. In this article, we present a protocol for a randomized controlled trial to evaluate the safety and clinical efficacy of Visionary, a novel computer-based therapy that uses dichoptic Gabor patches and band-filtered noise to treat amblyopia in the patient’s home. Methods: Our aim is to recruit a total of 120 children with amblyopia, aged 4–12 years, from the Paediatric Ophthalmology Unit at the Merida Hospital in Badajoz (Spain). The children will be divided into two groups according to whether or not they have previously undergone treatment involving occlusion or penalization of the dominant eye: 60 participants with no history of occlusion or penalization treatment will be assigned to Group A (GA), while Group B (GB) will consist of 60 participants who have previously received treatment with an occlusion dose > 32 weeks in mild or moderate amblyopia or > 48 weeks in severe amblyopia. In GA, the participants will be randomly assigned to either an experimental subgroup (GA-E) or a control subgroup (GA-C). Members of the GA-E group will be prescribed home therapy using computer-based exercises (Visionary); members of the GA-C group will be prescribed occlusion according to Pediatric Eye Disease Investigation Group (PEDIG) protocols. In GB, all participants will receive occlusion according to PEDIG protocols, and all will be prescribed home therapy using Visionary. In the experimental subgroup (GB-E), the computer will adjust the training spatial frequency of the Gabor patch, taking into account the user’s visual acuity (VA); while in the control subgroup (GB-C), the spatial frequency will remain low, irrespective of the patient’s VA. Visual function assessments will be carried out prior to the intervention and every three weeks thereafter; changes in best corrected visual acuity (BCVA) at distance will be the primary outcome measure under consideration. Stereoacuity and patient compliance will also be assessed. Discussion: The Visionary system based on dichoptic Gabor patches was originally conceived as a serious game to provide vision training to amblyopic children by combining the concepts of perceptual learning, dichoptic training, and gamification in the home environment. We hope that this novel approach may lead to greater improvements in vision performance in amblyopic children, as a substitute for occlusion treatment in novel amblyopia or as an adjunct treatment option in persistent amblyopia. Trial registration: This protocol was registered with ClinicalTrials.gov (NCT06150391) on 29th of November 2023.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Perceptual Learningmentioning

confidence: 99%

Study protocol for a randomized controlled trial using VISIONARY, a dichoptic Gabor patch video game, to improve visual function in children with amblyopia

Pérez-Benito,

Calderón-González,

Álvarez-Martín

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Previously, suppression was determined only qualitatively, and it was possible to identify its presence or absence using the 4-point Worth color test or the Bogolini test, etc. To date, new methods are offered for the quantitative measurement of suppression based on the assessment of global information processing [24]. Visual processing is a complex physiological mechanism that includes local and global processes of visual processing.…”

Section: Opinionmentioning

confidence: 99%

“…The results showed that severe suppression was also associated with poor outcomes of occlusive therapy. There is strong evidence that even in adult patients there is a binocular interaction, which is under suppression [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. Suppression may occur to avoid visual confusion caused by conflicting input from the two eyes, and it renders a structurally binocular visual system functionally monocular in individuals with amblyopia [31,35,36].…”

Section: Joj Ophthalmologymentioning

confidence: 99%

See 1 more Smart Citation

Suppression in Amblyopia - Cause or Consequence?

Natalia¹,

Marina

2021

JOJO

View full text Add to dashboard Cite

Amblyopia Treatment through Immersive Virtual Reality: A Preliminary Experience in Anisometropic Children

Molina‐Martín

Leal-Vega

Sáiz

et al. 2023

Vision

View full text Add to dashboard Cite

The use of digital devices provides a wide range of possibilities for measuring and improving visual function, including concepts such as perceptual learning and dichoptic therapy. Different technologies can be used to apply these concepts, including, in recent years, the introduction of virtual reality (VR) systems. A preliminary experience in treating anisometropic amblyopia through an immersive VR device and using prototype software is described. A total of 4 children were treated by performing 18 office-based sessions. Results showed that distance VA in amblyopic eyes remained constant in two subjects, whereas the younger subjects improved after the training. Near VA improved in three subjects. All subjects showed an increase in the stereopsis of at least one step, with three subjects showing a final stereopsis of a 60 s arc. A total of three subjects showed an increase of approximately 0.5 CS units for the spatial frequency of 3 cpd after the training. Results from this pilot study suggest that visual training based on perceptual learning through an immersive VR environment could be a viable treatment for improving CS, VA, and stereopsis in some children with anisometropic amblyopia. Future studies should support these preliminary results.

show abstract

The Measurement and Treatment of Suppression in Amblyopia

Cited by 3 publications

References 7 publications

Study protocol for a randomized controlled trial using VISIONARY, a dichoptic Gabor patch video game, to improve visual function in children with amblyopia

Study protocol for a randomized controlled trial using VISIONARY, a dichoptic Gabor patch video game, to improve visual function in children with amblyopia

Suppression in Amblyopia - Cause or Consequence?

Amblyopia Treatment through Immersive Virtual Reality: A Preliminary Experience in Anisometropic Children

Contact Info

Product

Resources

About