Martín-González Santiago, Portela-Camino Juan, Ruiz-Alcocer Javier, Illarramendi-Mendicute Igor, Garrido-Mercado Rafaela
Department of Construction and Manufacturing Engineering, University of Oviedo;
Department of Optometry, Clinic Begira.
J Vis Exp. 2020 Jan 14(155). doi: 10.3791/60236.
Conventional amblyopia therapy involves occlusion or penalization of the dominant eye, though these methods enhance stereoscopic visual acuity in fewer than 30% of cases. To improve these results, we propose a treatment in the form of a video game, using random-dot stimuli and perceptual learning techniques to stimulate stereoacuity. The protocol is defined for stereo-deficient patients between 7-14 years of age who have already received treatment for amblyopia and have a monocular best corrected distance visual acuity of at least 0.1 logMAR. Patients are required to complete a perceptual learning program at home using the video game. While compliance is stored automatically in the cloud, periodic optometry center visits are used to track patient evolution and adjust the game's stereoscopic demand until the smallest detectable disparity is achieved. The protocol has proved to be successful, and effectiveness is gauged in terms of a two-level gain on a random stereoacuity test (global stereoacuity or cyclopean stereoacuity reference test). Moreover, the random-dot stimuli learning transfers to medial lateral stereoscopic acuity according to a Wirt Circles test, in which success criteria is a final stereoacuity of over 140", and the attained enhancement corresponds to no less than two levels of stereoscopic acuity. Six months later, a random-dot stereoacuity test recorded no reduction in the stereoacuity that was achieved.
传统的弱视治疗方法包括遮盖或抑制优势眼,不过这些方法在不到30%的病例中能提高立体视敏度。为了改善这些结果,我们提出一种以电子游戏形式进行的治疗方法,利用随机点刺激和知觉学习技术来刺激立体视敏度。该方案针对7至14岁的立体视功能不足患者制定,这些患者已经接受过弱视治疗,且单眼最佳矫正远视力至少为0.1 logMAR。患者需在家中使用电子游戏完成一个知觉学习程序。虽然依从性会自动存储在云端,但仍需定期到验光中心就诊,以跟踪患者的进展情况,并调整游戏的立体视要求,直到达到最小可察觉视差。该方案已被证明是成功的,其有效性通过随机立体视敏度测试(全局立体视敏度或独眼立体视敏度参考测试)中的两级增益来衡量。此外,根据维尔特环测试,随机点刺激学习可转移到内外侧立体视敏度,其中成功标准是最终立体视敏度超过140",且获得的提高相当于至少两级立体视敏度。六个月后,随机点立体视敏度测试显示所达到的立体视敏度没有下降。