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一项基于网络的感知学习治疗弱视儿童的随机研究。

A randomized study of network-based perception learning in the treatment of amblyopia children.

作者信息

Zheng Chang-Yue, Xu Wei, Wu Shun-Qiang, Han Dong-Xu

机构信息

Department of Ophthalmology, Eye and ENT Hospital Affiliated to Fudan University, Shanghai 200031, China.

NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences (Fudan University), Shanghai 200031, China.

出版信息

Int J Ophthalmol. 2022 May 18;15(5):800-806. doi: 10.18240/ijo.2022.05.17. eCollection 2022.

Abstract

AIM

To compare the effectiveness of network-based perception learning (NBPL) and traditional training in the treatment of amblyopia children.

METHODS

This randomized controlled clinical trial recruited 56 participants aged 4-12y with anisometropic and/or strabismic amblyopia. Participants were randomly divided into two groups: the NBPL group (=28) who received patching and NBPL for 3mo, and the control group (=28) who got 3mo of patching and traditional training. Best-corrected visual acuity (BCVA) in the amblyopic eye and stereoacuity were measured and compared at baseline, 1, 2, and 3mo post-randomization.

RESULTS

There were no significant differences in age, gender ratio, and BCVA between the two groups at baseline. At 3mo, most patients gained lines (2 logMAR lines on average) of BCVA in both groups except one 11-year-old girl in the control group (<0.05). But no significant difference in BCVA improvement of the amblyopic eye between the two groups was found (=0.725), and amblyopia resolved (BCVA of 0.1 logMAR or better or within 1 logMAR line of the fellow eye) for 13 (46.4%) participants in both groups. The number of patients with improvement of stereoacuity was 25 and 13 in the NBPL group and control group (=0.041), respectively, and a significant difference exists in the distribution of stereopsis at 3mo between the two groups (=0.015). Besides, in patients with measurable stereopsis improvement degree and space for improvement in the two groups, the NBPL group also achieved better stereoscopic improvement than the control group (10/11 4/11, <0.05).

CONCLUSION

The NBPL system has a significant effect on the improvement of BCVA and stereoacuity of amblyopia children and is better than traditional training in terms of stereoacuity improvement. Perceptual learning visual training may play a more important role in the treatment of amblyopia in the future.

摘要

目的

比较基于网络的感知学习(NBPL)与传统训练方法治疗弱视儿童的效果。

方法

这项随机对照临床试验招募了56名年龄在4至12岁之间、患有屈光参差性和/或斜视性弱视的参与者。参与者被随机分为两组:NBPL组(n = 28)接受3个月的遮盖治疗和NBPL训练,对照组(n = 28)接受3个月的遮盖治疗和传统训练。在随机分组后的基线、1个月、2个月和3个月时,测量并比较弱视眼的最佳矫正视力(BCVA)和立体视锐度。

结果

两组在基线时的年龄、性别比例和BCVA方面无显著差异。3个月时,除对照组一名11岁女孩外,两组大多数患者的BCVA均提高了行数(平均2个logMAR行)(P<0.05)。但两组弱视眼BCVA改善情况无显著差异(P = 0.725),两组均有13名(46.4%)参与者的弱视得到治愈(BCVA达到0.1 logMAR或更好,或与对侧眼相差在1个logMAR行以内)。NBPL组和对照组立体视锐度改善的患者人数分别为25例和13例(P = 0.041),两组在3个月时立体视分布存在显著差异(P = 0.015)。此外,在两组中可测量立体视改善程度且有改善空间的患者中,NBPL组的立体视改善也优于对照组(10/11比4/11,P<0.05)。

结论

NBPL系统对改善弱视儿童的BCVA和立体视锐度有显著效果,在立体视锐度改善方面优于传统训练。感知学习视觉训练在未来弱视治疗中可能发挥更重要的作用。

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Rethinking amblyopia 2020.重新思考弱视 2020.
Vision Res. 2020 Nov;176:118-129. doi: 10.1016/j.visres.2020.07.014. Epub 2020 Aug 28.
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Amblyopia: Detection and Treatment.弱视:检测与治疗。
Am Fam Physician. 2019 Dec 15;100(12):745-750.
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Causal topography of visual cortex in perceptual learning.视觉皮层在知觉学习中的因果拓扑结构。
Neuroimage. 2020 Jan 1;204:116257. doi: 10.1016/j.neuroimage.2019.116257. Epub 2019 Oct 9.

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