Ophthalmology Unit, Azienda Ospedaliero-Universitaria di Bologna IRCCS, Bologna, Italy.
University Eye Clinic, DINOGMI, Polyclinic Hospital San Martino IRCCS, Genoa, Italy.
PLoS One. 2021 Oct 8;16(10):e0257999. doi: 10.1371/journal.pone.0257999. eCollection 2021.
To date, there is still no consensus regarding the effect of binocular treatment for amblyopia. The purpose of this systematic review and meta-analysis was to summarize the available evidence to determine whether binocular treatment is more effective than patching in children with amblyopia.
Four electronic databases (PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials) were searched for studies that compared binocular treatment and patching in children with amblyopia. The outcome measures were visual acuity and stereopsis. Pooled effects sizes were calculated with a random-effect model. The standardized difference in means (SDM) with 95% confidence intervals (CI) was calculated. Sensitivity analysis and assessment of publication bias were performed.
Five randomized clinical trials were included. No significant difference in visual acuity between patients treated with binocular treatment and patching was observed (SDM = -0.12; 95% CI: -0.45-0.20; P = 0.464). No significant difference in stereopsis between patients treated with binocular treatment and patching was observed (SDM = -0.07; 95% CI: -0.61-0.48; P = 0.809). For both variables, the between-study heterogeneity was high (respectively, I2 = 61% and I2 = 57%).
This meta-analysis found no convincing evidence supporting the efficacy of binocular treatment as an alternative to conventional patching. Therefore, the binocular treatment cannot fully replace traditional treatment but, to date, it can be considered a valid complementary therapy in peculiar cases. Further studies are required to determine whether more engaging therapies and new treatment protocols are more effective.
迄今为止，对于弱视的双眼治疗效果仍无定论。本系统评价和荟萃分析旨在总结现有证据，以确定双眼治疗是否比遮盖治疗更有效。
检索了四个电子数据库（PubMed、Scopus、Web of Science 和 Cochrane 对照试验中心注册库），以比较弱视儿童的双眼治疗和遮盖治疗。主要结局指标为视力和立体视。采用随机效应模型计算汇总效应量。计算了具有 95%置信区间（CI）的均数差值（SDM）。进行敏感性分析和发表偏倚评估。
纳入了 5 项随机临床试验。接受双眼治疗和遮盖治疗的患者在视力方面无显著差异（SDM = -0.12；95%CI：-0.45-0.20；P = 0.464）。接受双眼治疗和遮盖治疗的患者在立体视方面也无显著差异（SDM = -0.07；95%CI：-0.61-0.48；P = 0.809）。对于这两个变量，研究间异质性均较高（分别为 I2 = 61%和 I2 = 57%）。
本荟萃分析未发现令人信服的证据支持双眼治疗作为传统遮盖治疗的替代方法的疗效。因此，双眼治疗不能完全替代传统治疗，但迄今为止，它可以被认为是在特殊情况下的一种有效的补充治疗方法。需要进一步研究以确定是否更具吸引力的治疗方法和新的治疗方案更有效。
