Binocular versus standard occlusion or blurring treatment for unilateral amblyopia in children aged three to eight years

Tailor, Vijay; Bossi, Manuela; Bunce, Catey; Greenwood, John A.; Dahlmann‐Noor, Annegret

doi:10.1002/14651858.cd011347.pub2

Cited by 23 publications

(24 citation statements)

References 122 publications

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“…These facts are the main strengths of this review because most of the previous articles (see Table 5 ) do not differentiate results by type of amblyopia when vision therapy is applied. Tailor et al [ 40 ] still mentioned this issue when only 1 of 9 NRSI of their systematic review about vision therapy in amblyopia used anisometropic amblyopes. And second, the aforementioned lack of standardized protocols of vision therapy and well-performed RCTs entail an important limitation in evidence-based clinical practice, which should be resolved with further research.…”

Section: Discussionmentioning

confidence: 99%

Active Vision Therapy for Anisometropic Amblyopia in Children: A Systematic Review

Hernández-Rodríguez

Piñero

2020

Journal of Ophthalmology

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Purpose. The aim of the study was evaluation of the scientific evidence about the efficacy of vision therapy in children and teenagers with anisometropic amblyopia by performing a systematic literature review. Methods. A search was performed using 3 searching strategies in 4 different databases (PubMed, Web of Science, Scopus, and PruQuest). The quality of the included articles was evaluated using two tools for the risk of bias assessment, ROBINS-I for nonrandomized studies of intervention (NRSI), and ROB 2.0 for randomized clinical trials. Results. The search showed 1274 references, but only 8 of them passed the inclusion criteria after the complete text review. The articles that were finally included comprised 2 randomized control trials and 6 nonrandomized studies of intervention. These articles provided evidence supporting the efficacy of vision therapy for the treatment of anisometropic amblyopia in children and teenagers. Assessment of the risk of bias showed an appropriate risk of bias for the randomized control trials, but a high risk of bias for nonrandomized studies of intervention (NRSI). A main source of risk of bias for NRSI was the domain related to the measurements of the outcomes, due to a lack of double-blind studies. Conclusion. Vision therapy is a promising option for the treatment of anisometropic amblyopia in children and teenagers. However, the level of scientific evidence provided by the studies revised is still limited, and further randomized clinical trials are necessary to confirm the results provided to date and to optimize the vision therapy techniques by knowing the specific neural mechanisms involved.

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Section: Discussionmentioning

confidence: 99%

Active Vision Therapy for Anisometropic Amblyopia in Children: A Systematic Review

Hernández-Rodríguez

Piñero

2020

Journal of Ophthalmology

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“…Although stereopsis improved in the case ( P < 0.001) and control ( P < 0.001), there was no significant difference between them pre- and post-therapy. Up to April 2015 on Cochrane review by Tailor et al., 11 there was no clinical trial offering standardized evidence of the safety and effectiveness of binocular treatments, but the results of non-controlled cohorts were encouraging.…”

Section: Discussionmentioning

confidence: 99%

Comparison between patching and interactive binocular treatment in amblyopia: A randomized clinical trial

Rajavi

Sabbaghi

Sharifi

et al. 2019

Journal of Current Ophthalmology

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PurposeTo compare the effect of amblyopia therapy on cases who received interactive binocular treatment (I-BiT™) with those who received standard patching of the dominant eye with placebo I-BiT™.MethodsIn this randomized clinical trial, 38 unilateral amblyopic children (3–10 years old) were studied. All unilateral amblyopic children who had best corrected visual acuity (BCVA) worse than 0.30 logMAR or a difference of two Snellen lines of BCVA between their two eyes were included, and children who did not complete at least 75% of amblyopia treatment were excluded from this study. Eventually, a total of 19 and 21 subjects were included in case and control groups, respectively. Cases played I-BiT™ games, while controls had standard patch therapy and played with placebo I-BiT™ games, both for one month. All subjects were examined at baseline and after one-month therapy.ResultsBCVA improved significantly in both groups after one-month treatment (case: P = 0.003, control: P < 0.001), while in comparison with each other, there was not any difference between them (P = 0.52). Although stereopsis improved in the case (P < 0.001) and control (P < 0.001), there was no significant difference between them pre and post-therapy. Our children played games for about 6 h total during one month in both groups, and their compliance was 87.5% and 76% in cases and controls, respectively. Two children were excluded due to their lower compliance of playing I-BiT™ games (n = 38).ConclusionsI-BiT™ game and patching with placebo game had similar BCVA improvement in amblyopic children after one-month treatment. It is suggested to conduct further randomized clinical trials with a larger sample size and longer duration of study and assessment of its recurrence.

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“…Classical patching therapy might be counterproductive for the development of coordinated vergence eye movements because it forces the two eyes to work independently and does not favor the correct development of binocular oculomotor control. Dichoptic therapies that attempt to balance the input to the two eyes and favor conjugate eye movements might be better suited to ensure binocular cooperation (Hess et al 2010; To et al 2011; Knox et al 2012; Li et al 2013; Tailor et al 2015, 2016; Maiello et al 2016; Bossi et al 2017). Here, we have shown that the link between the oculomotor and hand motor system is unaffected by simulated visual impairment.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional binocular eye–hand coordination in normal vision and with simulated visual impairment

2018

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Sensorimotor coupling in healthy humans is demonstrated by the higher accuracy of visually tracking intrinsically-rather than extrinsically-generated hand movements in the fronto-parallel plane. It is unknown whether this coupling also facilitates vergence eye movements for tracking objects in depth, or can overcome symmetric or asymmetric binocular visual impairments. Human observers were therefore asked to track with their gaze a target moving horizontally or in depth. The movement of the target was either directly controlled by the observer's hand or followed hand movements executed by the observer in a previous trial. Visual impairments were simulated by blurring stimuli independently in each eye. Accuracy was higher for self-generated movements in all conditions, demonstrating that motor signals are employed by the oculomotor system to improve the accuracy of vergence as well as horizontal eye movements. Asymmetric monocular blur affected horizontal tracking less than symmetric binocular blur, but impaired tracking in depth as much as binocular blur. There was a critical blur level up to which pursuit and vergence eye movements maintained tracking accuracy independent of blur level. Hand-eye coordination may therefore help compensate for functional deficits associated with eye disease and may be employed to augment visual impairment rehabilitation.

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Binocular versus standard occlusion or blurring treatment for unilateral amblyopia in children aged three to eight years

Cited by 23 publications

References 122 publications

Active Vision Therapy for Anisometropic Amblyopia in Children: A Systematic Review

Active Vision Therapy for Anisometropic Amblyopia in Children: A Systematic Review

Comparison between patching and interactive binocular treatment in amblyopia: A randomized clinical trial

Three-dimensional binocular eye–hand coordination in normal vision and with simulated visual impairment

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