title: Randomised controlled trial of video clips and interactive games to improve vision in children with amblyopia using the I-BiT system.
abstract: BACKGROUND
  Traditional treatment of amblyopia involves either wearing a patch or atropine penalisation of the better eye. A new treatment is being developed on the basis of virtual reality technology allowing either DVD footage or computer games which present a common background to both eyes and the foreground, containing the imagery of interest, only to the amblyopic eye.
  
  
  METHODS
  A randomised control trial was performed on patients with amblyopia aged 4-8 years with three arms. All three arms had dichoptic stimulation using shutter glass technology. One arm had DVD footage shown to the amblyopic eye and common background to both, the second used a modified shooter game, Nux, with sprite and targets presented to the amblyopic eye (and background to both) while the third arm had both background and foreground presented to both eyes (non-interactive binocular treatment (non-I-BiT) games).
  
  
  RESULTS
  Seventy-five patients were randomised; 67 were residual amblyopes and 70 had an associated strabismus. The visual acuity improved in all three arms by approximately 0.07 logMAR in the amblyopic eye at 6 weeks. There was no difference between I-BiT DVD and non-I-BiT games compared with I-BiT games (stated primary outcome) in terms of gain in vision.
  
  
  CONCLUSIONS
  There was a modest vision improvement in all three arms. Treatment was well tolerated and safe. There was no difference between the three treatments in terms of primary stated outcomes but treatment duration was short and the high proportion of previously treated amblyopia and strabismic amblyopia disadvantaged dichoptic stimulation treatment.
  
  
  BACKGROUND
  NCT01702727, results.
authors.affiliation: Department of Ophthalmology, Nottingham University Hospitals, Nottingham, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Herbison
authors.affiliation: Department of Ophthalmology, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Daisy
authors.initials: D
authors.lastname: MacKeith
authors.affiliation: Department of Ophthalmology, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Anthony
authors.initials: A
authors.lastname: Vivian
authors.affiliation: Department of Computer Science, University of Hull, Hull, UK.
authors.forename: Jon
authors.initials: J
authors.lastname: Purdy
authors.affiliation: Derby Clinical Trials Unit, College of Health and Social Care, University of Derby, Derby, UK.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Fakis
authors.affiliation: Department of Ophthalmology, Nottingham University Hospitals, Nottingham, UK.
authors.forename: Isabel M
authors.initials: IM
authors.lastname: Ash
authors.affiliation: Department of Mechanical, Materials and Manufacturing Engineering, University of Nottingham, Nottingham, UK.
authors.forename: Sue V
authors.initials: SV
authors.lastname: Cobb
authors.affiliation: Department of Mechanical, Materials and Manufacturing Engineering, University of Nottingham, Nottingham, UK.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Eastgate
authors.affiliation: Department of Ophthalmology, Nottingham University Hospitals, Nottingham, UK.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Haworth
authors.affiliation: Department of Ophthalmology, Nottingham University Hospitals, Nottingham, UK.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Gregson
authors.affiliation: Department of Ophthalmology, Nottingham University Hospitals, Nottingham, UK.
authors.forename: Alexander Je
authors.initials: AJ
authors.lastname: Foss
mesh_terms: D000550:Amblyopia / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003196:Computer Graphics / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010775:Photic Stimulation / Q000379:methods; D012683:Sensory Deprivation; D013285:Strabismus / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D018910:Video Games; D014742:Videodisc Recording; D015348:Vision, Binocular / Q000502:physiology*; D014792:Visual Acuity; D014796:Visual Perception / Q000502:physiology
keywords: Child health (paediatrics); Treatment other; Vision