The role of Interactive Binocular Treatment system in amblyopia therapy

Abstract

PurposeTo determine the role of Interactive Binocular Treatment (I-BiT™) as a complementary method of patching in amblyopia therapy.MethodsIn this randomized clinical trial study, 50 unilateral amblyopic children (25 male/25 female) between 3 and 10 years with either best corrected visual acuity (BCVA) ≤20/30 in the amblyopic eye or a difference of BCVA ≥ 2 lines between the two eyes were included. They were randomly classified into the case and control groups (25 in each). Patching was recommended in both groups, and cases also received I-BiT™. Cases were asked to play I-BiT™ games through appropriate glasses with conjugate colored filters. Moving and fixed targets were shown to the amblyopic and non-amblyopic eyes, respectively. Playing games was continued 20 min in each session for 5 days a week within one month (total time: 6.6 h). Patching was continued for one month more in both groups to evaluate the continuous effect of I-BiT™. BCVA was measured at baseline, one month after beginning I-BiT™, and one month after cessation of I-BiT™.ResultsBCVA of amblyopic eyes in cases and controls were 0.34 ± 0.14 and 0.33 ± 0.17LogMAR at baseline which improved to 0.17 ± 0.14 and 0.26 ± 0.17 at one month, respectively. The difference was significant in each group (p < 0.001 for cases and p = 0.024 for controls) with more improvement in the case group (p < 0.001). One month after cessation of I-BiT™, BCVA difference between the two groups was not statistically significant. There was no case with recurrence of amblyopia.ConclusionBased on our results, I-BiT™ seems to be effective in amblyopia therapy accompanied with patching. We recommend comparing I-BiT™ alone with patching in further studies.ClinicalTrials.gov Identifier: NCT02740725.

Binocular Treatment of Amblyopia

“…Rajavi et al 24 evaluated the addition of I-BiT to patching, and the 4-week posttreatment cessation period that included patching treatment for both groups revealed further improvement of the patients originally randomized to patching (a mean improvement of À0.08AE0.09 logMAR, P ¼ 0.003) only, but no improvement in the group originally randomized to I-BiT plus patching (a mean improvement of À0.01AE0.07 log-MAR, P > 0.99). 24 At the end of the washout/patching period, there was no significant difference in the VA between the 2 groups (0.16AE0.15 vs. 0.18AE0.19 logMAR for the iBiT and control groups, respectively; P ¼ 0.246).…”

“…The authors of this study acknowledged that the total treatment time may have been too short to see an effect. Also in 2016, Rajavi et al 24 reported the results of another randomized controlled trial (level I) to evaluate the role of I-BiT therapy as an adjunct to patching. In this study, 50 subjects aged 3 to 10 years were randomized to patching for 2 hours per day with or without the addition of I-BiT 5 times per week in 20-minute sessions for a total of 4 weeks.…”

The Role of Binocularity in Anisometropic Amblyopia

“…There is a wide age range both within and between these studies; some recruited only adults 72 , other cohorts were pediatric 74,77 , and some included adult and pediatric subjects 75 . Statisical analysis is therefore being applied or compared to a cohort of subjects that may be at different stages of visual maturity.…”

Videojuegos con un enfoque binocular: una nueva tendencia para el tratamieno de la ambliopía

“…El enfoque binocular pretende obtener, a través de la estimulación de ambos ojos, un efecto secundario sobre la agudeza visual, al eliminar la supresión interocular y permitir la fusión (41). Hess y Thompson describen una serie de tratamientos que permiten la participación del ojo dominante en la terapia (41); es el caso de un tratamiento interactivo binocular (figura 2), también llamado iBit System (42)(43)(44). Otra propuesta es el protocolo de aprendizaje perceptual denominado Push-Pull (45) y un enfoque de juego de acción creado por Noah (46).…”