Gambacorta Christina, Nahum Mor, Vedamurthy Indu, Bayliss Jessica, Jordan Josh, Bavelier Daphne, Levi Dennis M
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.
Vision Res. 2018 Jul;148:1-14. doi: 10.1016/j.visres.2018.04.005. Epub 2018 May 12.
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.
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。
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