Li Simone L, Reynaud Alexandre, Hess Robert F, Wang Yi-Zhong, Jost Reed M, Morale Sarah E, De La Cruz Angie, Dao Lori, Stager David, Birch Eileen E
Retina Foundation of the Southwest, Dallas, Texas.
McGill Vision Research, Department of Ophthalmology, McGill University, Montréal, Québec, Canada.
J AAPOS. 2015 Oct;19(5):401-5. doi: 10.1016/j.jaapos.2015.08.003.
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.
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.
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.
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.
在弱视患者中，通过知觉学习任务或简单游戏进行对比平衡的双眼视体验已被证明能显著提高视力。然而，这些任务强度大且重复，高达40%的无监督患者不依从。我们研究了一种可能更具吸引力的电影方法的疗效，该方法通过互补的双眼视刺激提供对比平衡的双眼视体验。
八名4至10岁的弱视儿童参加了一项前瞻性队列研究，在被动3D显示器上每周观看3部双眼视电影，共2周。制作了18部流行动画电影的双眼视版本。将不规则形状斑点的图案图像蒙版与弱视眼看到的电影图像相乘，将反向蒙版与对侧眼看到的图像相乘。对侧眼的对比度最初设置在允许双眼视觉的降低水平，然后每次就诊时增加10%。在基线和2周时测量最佳矫正视力、随机点立体视和双眼抑制。
弱视眼的平均视力（平均标准误差）从基线时的最小分辨角对数0.72±0.08提高到0.52±0.09（P = 0.003）；即在2周的随访结果中提高了2.0行。未发现双眼抑制或立体视有显著变化。
被动观看双眼视故事片是可行的，可能是一种有前景的儿童弱视新治疗方法。观看双眼视电影可能实现的最大改善仍有待确定。这种新治疗方法尚无已知的副作用。
