Assessment of a computer-based treatment for older amblyopes: the Glasgow Pilot Study.
OBJECTIVE
There have been few viable alternatives to patching the better eye as a treatment of amblyopia for more than two centuries. The success of patching depends on compliance, which is problematic for up to 59% of children and their families.


METHODS
This pilot study trialled the interactive binocular treatment (I-BiT) system as an alternative amblyopia treatment in 12 older amblyopes (6.1-11.4 years, median 8.2), who had not complied with or responded to occlusion. Virtual reality images were projected to each eye simultaneously via a headset during eight treatment sessions of 25-min duration. Outcome measures were changes in high- (HCVA) and low-contrast log MAR acuity (LCVA) at 1 week, 4 weeks and a final follow-up (3-18 months) after the final treatment.


RESULTS
Sustained improvements in HCVA were observed in seven children (58%) and in LCVA in eight children (67%), including two for whom amblyopia was eliminated. Five children had visual acuities equivalent to 6/12 or better at least 6 months after stopping treatment, compared with one child prior to treatment. Significant improvements in HCVA occurred up to the fourth treatment; in LCVA to the seventh treatment.


CONCLUSIONS
Sustained improvements in visual acuity were observed for 58% of this small group of children using the I-BiT system, despite prior failure with conventional treatment. This offers hope for a potential time-saving alternative to patching, in which compliance can easily be monitored, but the results need to be validated by means of a randomised controlled trial.
Cleary
M
M
Orthoptic Department, Gartnavel General Hospital, Glasgow, Scotland. marie.cleary@northglasgow.scot.nhs.uk
Moody
A D
AD
Buchanan
A
A
Stewart
H
H
Dutton
G N
GN
D000550:Amblyopia / Q000628:therapy*; D002648:Child; D015350:Contrast Sensitivity / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D009885:Ophthalmology / Q000295:instrumentation; D010865:Pilot Projects; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology