Patch-free streaming contrast-rebalanced dichoptic cartoons versus patching for treatment of amblyopia in children aged 3 to 5 years: a pilot, randomized clinical trial

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-10-01 DOI:10.1016/j.jaapos.2024.103991

Reed M. Jost MS , Eileen E. Birch PhD , Yi-Zhong Wang PhD , Lori M. Dao MD , David Stager MD , Becky Luu OD , Cynthia L. Beauchamp MD , Prashanthi Giridhar MD , Taylor A. Brin PhD , Alex S. Baldwin PhD , Robert F. Hess PhD , Benjamin Thompson PhD

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Abstract

Background

We developed and tested a dichoptic treatment designed for younger children that can be viewed freely and involves a dichoptic manipulation of a popular animation series that enables contrast-rebalancing without disrupting fusion. Our aim was to assess whether this novel amblyopia treatment is superior to patching in children aged 3-5 years.

Methods

A total of 34 children with amblyopia were randomly assigned to contrast-rebalanced dichoptic cartoons (4 hours/week) or patching (14 hours/week) for 2 weeks. Children in the cartoon group continued watching cartoons for an additional 2 weeks. Designed to target the youngest and most treatable children, the dichoptic cartoons presented the entire scene to the amblyopic eye at 100% contrast, while the fellow eye view was presented at reduced contrast with the main character omitted. Best-corrected visual acuity (BCVA), stereoacuity, suppression, and manual dexterity were measured at each visit.

Results

After 2 weeks, improvement in amblyopic eye BCVA was greater for dichoptic treatment than for patching, with a mean improvement of 0.11 ± 0.08 versus 0.06 ± 0.09 logMAR, respectively (P = 0.04). Stereoacuity, suppression, and manual dexterity did not improve significantly more in the dichoptic group than the patching group at 2 weeks. After 4 weeks of dichoptic cartoon treatment, mean visual acuity improvement in the dichoptic group was 0.16 logMAR (95% CI, 0.10-0.21).

Conclusions

In our study cohort, a contrast-rebalanced dichoptic cartoon was more effective than patching in treating childhood amblyopia after 2 weeks. Dichoptic cartoons that rebalance contrast to overcome suppression provide an additional treatment option for amblyopia in young children.

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治疗 3-5 岁儿童弱视的无贴片流对比平衡二分法动画片与贴片疗法：一项试验性随机临床试验。

背景：我们开发并测试了一种专为低龄儿童设计的二分法治疗方法，这种方法可以自由观看流行的动画片系列，在不破坏融合的情况下实现对比度平衡。我们的目的是评估这种新型弱视治疗方法在 3-5 岁儿童中是否优于贴片治疗：共有 34 名弱视儿童被随机分配到对比度平衡的二分法动画片组（每周 4 小时）或贴片组（每周 14 小时），为期 2 周。动画片组的儿童继续观看动画片 2 周。针对年龄最小、最容易治疗的儿童，二向性动画片以 100% 的对比度向弱视眼呈现整个场景，而同视眼的视图则以较低的对比度呈现，并省略主要角色。每次就诊都会测量最佳矫正视力（BCVA）、立体视敏锐度、抑制和手的灵活性：2 周后，弱视眼 BCVA 的改善幅度在二分法治疗中大于贴片治疗，平均改善幅度分别为 0.11 ± 0.08 对 0.06 ± 0.09 logMAR（P = 0.04）。在 2 周时，二向分色组的立体视敏锐度、抑制和手部灵活性的改善并没有明显高于贴片组。经过 4 周的二分卡通治疗后，二分卡通组的平均视力提高了 0.16 logMAR（95% CI，0.10-0.21）：在我们的研究队列中，对比度平衡的二向色动画片在治疗两周后的儿童弱视方面比贴片更有效。重新平衡对比度以克服抑制的二向色动画片为治疗幼儿弱视提供了另一种选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.