Dichoptic movie viewing treats childhood amblyopia.
BACKGROUND
Contrast-balanced dichoptic experience with perceptual-learning tasks or simple games has been shown to improve visual acuity significantly in amblyopia. However, these tasks are intensive and repetitive, and up to 40% of unsupervised patients are noncompliant. We investigated the efficacy of a potentially more engaging movie method to provide contrast-balanced binocular experience via complementary dichoptic stimulation.


METHODS
Eight amblyopic children 4-10 years of age were enrolled in a prospective cohort study to watch 3 dichoptic movies per week for 2 weeks on a passive 3D display. Dichoptic versions of 18 popular animated feature films were created. A patterned image mask of irregularly shaped blobs was multiplied with the movie images seen by the amblyopic eye and an inverse mask was multiplied with the images seen by the fellow eye. Fellow-eye contrast was initially set at a reduced level that allowed binocular vision and was then incremented by 10% at each visit. Best-corrected visual acuity, random dot stereoacuity, and interocular suppression were measured at baseline and 2 weeks.


RESULTS
Mean amblyopic eye visual acuity (with standard error of the mean) improved from a logarithm of minimum angle of resolution of 0.72 ± 0.08 at baseline to 0.52 ± 0.09 (P = 0.003); that is, 2.0 lines of improvement at the 2-week outcome visit. No significant change in interocular suppression or stereoacuity was found.


CONCLUSIONS
Passive viewing of dichoptic feature films is feasible and could be a promising new treatment for childhood amblyopia. The maximum improvement that may be achieved by watching dichoptic movies remains to be determined. No known side effects are associated with this new treatment.
Retina Foundation of the Southwest, Dallas, Texas.
Simone L
SL
Li
McGill Vision Research, Department of Ophthalmology, McGill University, Montréal, Québec, Canada.
Alexandre
A
Reynaud
McGill Vision Research, Department of Ophthalmology, McGill University, Montréal, Québec, Canada.
Robert F
RF
Hess
Retina Foundation of the Southwest, Dallas, Texas; Ophthalmology, UT Southwestern Medical Center, Dallas, Texas.
Yi-Zhong
YZ
Wang
Retina Foundation of the Southwest, Dallas, Texas.
Reed M
RM
Jost
Retina Foundation of the Southwest, Dallas, Texas.
Sarah E
SE
Morale
Retina Foundation of the Southwest, Dallas, Texas.
Angie
A
De La Cruz
Pediatric Ophthalmology & Adult Strabismus, Plano, Texas.
Lori
L
Dao
Pediatric Ophthalmology & Adult Strabismus, Plano, Texas.
David
D
Stager
Retina Foundation of the Southwest, Dallas, Texas; Ophthalmology, UT Southwestern Medical Center, Dallas, Texas. Electronic address: ebirch@retinafoundation.org.
Eileen E
EE
Birch
D000550:Amblyopia / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D009040:Motion Pictures; D010469:Perceptual Distortion / Q000502:physiology*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology