Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.
NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.
Semin Ophthalmol. 2023 Nov;38(8):761-767. doi: 10.1080/08820538.2023.2223275. Epub 2023 Jun 20.
To assess visual acuity (VA) and stereoacuity (SA) improvements in children with amblyopia treated with either binocular dichoptic treatment or patching treatment.
In this pilot prospective coherent study, 34 participants between 4 and 9 years of age with unilateral anisometropic amblyopia and without history of prior amblyopia treatment were enrolled into three groups. Full treatment group (FTG; = 12): participants were prescribed the binocular dichoptic treatment to watch for 90 minutes per day, 5 days a week. Part-time treatment group (PTTG; = 8): participants were prescribed the same binocular treatment as FTG, 90 minutes per day, 3 days per week. Patching treatment group (PTG; = 14): participants wore an adhesive patch over the dominant eye for 2 hours per day, 7 days per week. Amblyopic-eye distance visual acuity (DVA), near visual acuity (NVA) and SA were evaluated at baseline, 4, 8, and 12 weeks.
At 12 weeks, mean amblyopic-eye DVA improved 1.8 lines (95% CI, 1.1-2.5) in FTG, 1.5 lines (95% CI, 0.4-2.7) in PTTG and 3.0 lines (95% CI, 2.0-4.0) in PTG. The amblyopic-eye NVA improved 2.9 lines (95% CI, 2.4-3.5) in FTG, 1.7 lines (95% CI, 0.5-3.0) in PTTG and 2.8 lines (95% CI, 1.8-3.9) in PTG. The SA improved 0.38 log-arcseconds (95% CI, 0.24-0.53) in FTG, 0.59 log-arcseconds (95% CI, 0.36-0.82) in PTTG and 0.40 log-arcseconds (95% CI, 0.13-0.67) in PTG. No significant differences were found in DVA, NVA or SA improvement between FTG and PTG at 12 weeks.
VA and SA after binocular dichoptic treatment produced a similar therapeutic outcome to patching, suggesting a potential value for binocular therapy when treating anisometropic moderate degree of Children's amblyopia.
评估双眼视差治疗或遮盖治疗弱视儿童的视力（VA）和立体视锐度（SA）改善情况。
在这项前瞻性对照研究中，招募了 34 名年龄在 4 至 9 岁之间、有单侧屈光不正性弱视且无弱视治疗史的参与者，将其分为三组。全治疗组（FTG；n=12）：参与者被规定每天观看 90 分钟的双眼视差治疗，每周 5 天。部分治疗组（PTTG；n=8）：参与者接受与 FTG 相同的双眼治疗，每天 90 分钟，每周 3 天。遮盖治疗组（PTG；n=14）：参与者每天戴 2 小时的粘性眼罩，每周 7 天。在基线、4、8 和 12 周时评估弱视眼的远距视力（DVA）、近距视力（NVA）和 SA。
12 周时，FTG 组弱视眼 DVA 平均提高 1.8 行（95%CI，1.1-2.5），PTTG 组提高 1.5 行（95%CI，0.4-2.7），PTG 组提高 3.0 行（95%CI，2.0-4.0）。FTG 组弱视眼 NVA 提高 2.9 行（95%CI，2.4-3.5），PTTG 组提高 1.7 行（95%CI，0.5-3.0），PTG 组提高 2.8 行（95%CI，1.8-3.9）。FTG 组 SA 提高 0.38 对数弧秒（95%CI，0.24-0.53），PTTG 组提高 0.59 对数弧秒（95%CI，0.36-0.82），PTG 组提高 0.40 对数弧秒（95%CI，0.13-0.67）。12 周时，FTG 组和 PTG 组在 DVA、NVA 或 SA 改善方面无显著差异。
双眼视差治疗后的 VA 和 SA 与遮盖治疗产生相似的治疗效果，提示在治疗儿童中度屈光不正性弱视时，双眼治疗具有潜在价值。
