Chen Chun-Wen, Zhu Qin, Duan Yu-Bing, Yao Jing-Yan
Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
BMJ Open Ophthalmol. 2021 Feb 24;6(1):e000625. doi: 10.1136/bmjophth-2020-000625. eCollection 2021.
Several studies have compared binocular therapy and patching for the treatment of amblyopia. However, most of them involved a small number of cases and reported controversial results. Thus, the benefit of binocular therapy remains to be confirmed. We conducted a meta-analysis to evaluate the efficacy of binocular therapy versus patching and to testify whether binocular therapy could become supplementary method in children with amblyopia. Randomised controlled trials that evaluated the efficacy of binocular therapy for amblyopia versus patching were identified using PubMed, Embase, Cochrane Library, Ovid, Web of Science, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform. Data screening, extraction and quality assessment were performed independently by two researchers. Six trials were identified and analysed to compare binocular therapy (708 eyes) with patching (664 eyes) for change in best-corrected visual acuity and stereoacuity. Efficacy estimates were evaluated by standard mean difference (SMD) and 95% CI. The best-corrected visual acuity in binocular group was better than that of in patching group (SMD=-0.21 logarithm of the minimum angle of resolution (log MAR), 95% CI of -0.50 to 0.08 log MAR, p=0.003). The results showed statistically significant difference in the change of best-corrected visual acuity between the groups, but not in stereoacuity. Binocular therapy may be a promising treatment of conditions affecting visual acuity, and could be applied as a supplementary method to patching for amblyopia in clinical practice. The present analysis showed that some children with amblyopia may benefit from binocular therapy. Nevertheless, larger randomised controlled clinical trials are required to confirm these findings.
多项研究比较了双眼疗法和遮盖疗法治疗弱视的效果。然而，其中大多数研究病例数量较少，且报告的结果存在争议。因此，双眼疗法的益处仍有待证实。我们进行了一项荟萃分析，以评估双眼疗法与遮盖疗法的疗效，并验证双眼疗法是否可成为弱视儿童的辅助治疗方法。通过PubMed、Embase、Cochrane图书馆、Ovid、科学网、ClinicalTrials.gov和世界卫生组织国际临床试验注册平台，检索评估双眼疗法与遮盖疗法治疗弱视疗效的随机对照试验。由两名研究人员独立进行数据筛选、提取和质量评估。共纳入并分析了6项试验，比较双眼疗法组（708只眼）和遮盖疗法组（664只眼）在最佳矫正视力和立体视锐度方面的变化。疗效评估采用标准化均数差（SMD）和95%可信区间（CI）。双眼疗法组的最佳矫正视力优于遮盖疗法组（SMD=-0.21最小分辨角对数（log MAR），95%CI为-0.50至0.08 log MAR，p=0.003）。结果显示，两组间最佳矫正视力变化有统计学显著差异，但立体视锐度无差异。双眼疗法可能是一种治疗影响视力疾病的有前景的方法，在临床实践中可作为遮盖疗法治疗弱视的辅助方法应用。目前的分析表明，一些弱视儿童可能从双眼疗法中获益。然而，需要更大规模的随机对照临床试验来证实这些发现。
