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一款用于治疗儿童弱视的动作视频游戏:一项可行性研究。

An action video game for the treatment of amblyopia in children: A feasibility study.

作者信息

Gambacorta Christina, Nahum Mor, Vedamurthy Indu, Bayliss Jessica, Jordan Josh, Bavelier Daphne, Levi Dennis M

机构信息

School of Optometry, Graduate Group in Vision Science and Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA 94720-2020, USA.

School of Optometry, Graduate Group in Vision Science and Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA 94720-2020, USA; School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel.

出版信息

Vision Res. 2018 Jul;148:1-14. doi: 10.1016/j.visres.2018.04.005. Epub 2018 May 12.


DOI:10.1016/j.visres.2018.04.005
PMID:29709618
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5984723/
Abstract

The gold-standard treatment for childhood amblyopia remains patching or penalizing the fellow eye, resulting in an average of about a one line (0.1 logMAR) improvement in visual acuity following ≈120 h of patching in children 3-8 years old. However, compliance with patching and other treatment options is often poor. In contrast, fast-paced action video games can be highly engaging, and have been shown to yield broad-based improvements in vision and attention in adult amblyopia. Here, we pilot-tested a custom-made action video game to treat children with amblyopia. Twenty-one (n = 21) children (mean age 9.95 ± 3.14 [se]) with unilateral amblyopia (n = 12 anisometropic and n = 9 strabismic) completed 20 h of game play either monocularly, with the fellow eye patched (n = 11), or dichoptically, with reduced contrast to the fellow eye (n = 10). Participants were assessed for visual acuity (VA), stereo acuity and reading speed at baseline, and following 10 and 20 h of play. Additional exploratory analyses examined improvements after 6-10 weeks of completion of training (follow-up). Following 20 h of training, VA improved, on average, by 0.14 logMAR (≈38%) for the dichoptic group and by 0.06 logMAR (≈15%) for the monocular group. Similarly, stereoacuity improved by 0.07 log arcsec (≈17%) following dichoptic training, and by 0.06 log arcsec (≈15%) following monocular training. Across both treatment groups, 7 of the 12 individuals with anisometropic amblyopia showed improvement in stereoacuity, whereas only 1 of the 9 strabismic individuals improved. Most improvements were largely retained at follow-up. Our feasibility study therefore suggests that the action video game approach may be used as an effective adjunct treatment for amblyopia in children, achieving results similar to those of the gold-standard treatment in shorter duration.

摘要

儿童弱视的金标准治疗方法仍然是遮盖或抑制健眼,对于3至8岁的儿童,在遮盖约120小时后,视力平均提高约一行(0.1 logMAR)。然而,对遮盖及其他治疗方法的依从性往往较差。相比之下,快节奏动作视频游戏极具吸引力,并且已被证明能使成人弱视患者的视力和注意力得到广泛改善。在此,我们对一款定制的动作视频游戏治疗儿童弱视进行了初步测试。21名(n = 21)单侧弱视儿童(平均年龄9.95 ± 3.14 [标准误])(12名屈光参差性弱视和9名斜视性弱视)完成了20小时的游戏,其中11名单眼游戏,健眼被遮盖,10名双眼游戏,健眼对比度降低。在基线、游戏10小时和20小时后,对参与者的视力(VA)、立体视敏度和阅读速度进行评估。额外的探索性分析在训练完成6至10周后(随访)检查改善情况。经过20小时训练后,双眼游戏组的视力平均提高了0.14 logMAR(约38%),单眼游戏组提高了0.06 logMAR(约15%)。同样,双眼训练后立体视敏度提高了0.07 log弧秒(约17%),单眼训练后提高了0.06 log弧秒(约15%)。在两个治疗组中,12名屈光参差性弱视患者中有7名立体视敏度得到改善,而9名斜视性弱视患者中只有1名得到改善。大多数改善在随访时基本保持。因此,我们的可行性研究表明,动作视频游戏方法可作为儿童弱视的一种有效辅助治疗方法,在更短时间内取得与金标准治疗相似的效果。

相似文献

[1]
An action video game for the treatment of amblyopia in children: A feasibility study.

Vision Res. 2018-7

[2]
A dichoptic custom-made action video game as a treatment for adult amblyopia.

Vision Res. 2015-9

[3]
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J Pediatr Ophthalmol Strabismus. 2020-5-1

[4]
Effect of a Binocular iPad Game vs Part-time Patching in Children Aged 5 to 12 Years With Amblyopia: A Randomized Clinical Trial.

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[5]
Comparison of Dichoptic Therapy Versus Occlusion Therapy in Children With Anisometropic Amblyopia: A Prospective Randomized Study.

J Pediatr Ophthalmol Strabismus. 2023-5

[6]
Binocular iPad Game vs Patching for Treatment of Amblyopia in Children: A Randomized Clinical Trial.

JAMA Ophthalmol. 2016-12-1

[7]
Binocular game versus part-time patching for treatment of anisometropic amblyopia in Chinese children: a randomised clinical trial.

Br J Ophthalmol. 2019-7-4

[8]
Dichoptic Perceptual Training in Children With Amblyopia With or Without Patching History.

Invest Ophthalmol Vis Sci. 2021-5-3

[9]
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[10]
Effectiveness of a Binocular Video Game vs Placebo Video Game for Improving Visual Functions in Older Children, Teenagers, and Adults With Amblyopia: A Randomized Clinical Trial.

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引用本文的文献

[1]
Evolving Strategies in Amblyopia Management: From Traditional Therapies to Cutting-Edge Innovations.

Cureus. 2025-7-15

[2]
Comparative effectiveness of gamified binocular treatment versus conventional patching for amblyopia: a randomized clinical trial.

Front Med (Lausanne). 2025-6-2

[3]
Efficacy of patching combined with action video games in amblyopic children aged 4-10 years: A randomised clinical trial.

Ophthalmic Physiol Opt. 2025-9

[4]
A Systematic Review and Meta-Analysis of Perceptual Learning and Video Game Training for Adults with Monocular Amblyopia.

Ophthalmol Ther. 2025-5

[5]
Transformative Gamified Binocular Therapy for Unilateral Amblyopia in Young Children: Pilot Prospective Efficacy and Safety Study.

JMIR Serious Games. 2025-1-16

[6]
Visual Cortical Function Changes After Perceptual Learning with Dichoptic Attention Tasks in Adults with Amblyopia: A Case Study Evaluated Using fMRI.

Brain Sci. 2024-11-16

[7]
Can viewing a 3D movie improve visual function in children with a history of amblyopia and neurotypical children?: A pilot study.

PLoS One. 2024

[8]
Developing a Novel Pediatric Eye Chart Assessing Visual Acuity by Minimum Separable Threshold.

Children (Basel). 2024-3-27

[9]
Rehabilitation of amblyopia using a digital platform for visual training combined with patching in children: a prospective study.

Graefes Arch Clin Exp Ophthalmol. 2024-9

[10]
Global visual attention SPAN in different video game genres.

Sci Rep. 2023-12-11

本文引用的文献

[1]
Effectiveness of a Binocular Video Game vs Placebo Video Game for Improving Visual Functions in Older Children, Teenagers, and Adults With Amblyopia: A Randomized Clinical Trial.

JAMA Ophthalmol. 2018-2-1

[2]
A Randomized Trial of a Binocular iPad Game Versus Part-Time Patching in Children Aged 13 to 16 Years With Amblyopia.

Am J Ophthalmol. 2017-11-28

[3]
Asymmetric Dichoptic Masking in Visual Cortex of Amblyopic Macaque Monkeys.

J Neurosci. 2017-9-6

[4]
Binocular Therapy for Childhood Amblyopia Improves Vision Without Breaking Interocular Suppression.

Invest Ophthalmol Vis Sci. 2017-6-1

[5]
Binocular iPad Game vs Patching for Treatment of Amblyopia in Children: A Randomized Clinical Trial.

JAMA Ophthalmol. 2016-12-1

[6]
Effect of a Binocular iPad Game vs Part-time Patching in Children Aged 5 to 12 Years With Amblyopia: A Randomized Clinical Trial.

JAMA Ophthalmol. 2016-12-1

[7]
Fine Motor Skills of Children With Amblyopia Improve Following Binocular Treatment.

Invest Ophthalmol Vis Sci. 2016-9-1

[8]
Recovering stereo vision by squashing virtual bugs in a virtual reality environment.

Philos Trans R Soc Lond B Biol Sci. 2016-6-19

[9]
Randomised controlled trial of video clips and interactive games to improve vision in children with amblyopia using the I-BiT system.

Br J Ophthalmol. 2016-11

[10]
Abnormal Fixational Eye Movements in Amblyopia.

PLoS One. 2016-3-1

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