Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.
Department of Ophthalmology, Goethe University, Frankfurt, Germany.
Ophthalmic Physiol Opt. 2024 Jul;44(5):945-953. doi: 10.1111/opo.13322. Epub 2024 May 17.
The improvement in visual acuity (VA) was determined during optical treatment in children with amblyopia before their participation in a randomised clinical trial comparing the effect of dichoptic video gaming using virtual reality goggles with occlusion therapy.
Children aged 4-12 years with an interocular VA difference ≥0.20 logMAR and an amblyogenic factor: strabismus <30Δ, ≥1.00 D anisometropia, astigmatism ≥1.50 D and/or hypermetropia ≥1.50 D were eligible for 16 weeks of optical treatment. Children with previous amblyopia treatment were excluded. Compliance with spectacle wear was measured electronically over 1 week using the occlusion dose monitor (ODM). The reliability of these measurements was verified. The main outcome was an increase in amblyopic eye VA from baseline to 16 weeks.
Sixty-five children entered the optical treatment period. Mean age was 6.0 ± 2.2 years (range: 4-12 years; IQR 4.5-6.7 years). Amblyopia was caused by anisometropia in 53 (82%) children, strabismus in 6 (9%) and combined mechanism in 6 (9%). After optical treatment, mean VA improved by 0.20 logMAR (SD 0.28; p < 0.001) and 0.07 in the amblyopic and fellow eye, respectively (SD 0.20; p = 0.03). This resulted in 24 children (37%) with an interocular VA difference <0.20 logMAR and in 17% of children with VA at the start of 0.30 logMAR or worse. Poor VA in the amblyopic eye at baseline (p = 0.001) and high anisometropia (p = 0.001) were associated with VA improvement. On average, spectacles were worn 9.7 ± 2.4 h/day (range: 2.3-13.6 h); mean compliance was 73% ± 18% of estimated wake time. Only ambient temperature ≥ 31°C or when spectacles were worn on top of the head prevented a reliable ODM measurement.
VA improved by two lines resulting in more than a third of the children being treated sufficiently with spectacles alone and no longer being classified as amblyopic. The ODM proved to be a reliable method of measuring compliance with spectacle wear.
在参加一项比较使用虚拟现实护目镜的双眼视视频游戏与遮盖治疗弱视效果的随机临床试验之前，对弱视儿童进行光学治疗期间，确定视力（VA）的改善情况。
年龄在 4-12 岁之间、双眼 VA 差异≥0.20 对数视力表（logMAR）且存在弱视成因：斜视<30Δ、≥1.00 D 屈光不正、散光≥1.50 D 和/或远视≥1.50 D 的儿童有资格接受 16 周的光学治疗。排除有既往弱视治疗史的儿童。使用遮盖剂量监测器（ODM）在 1 周内对眼镜佩戴的依从性进行电子测量。验证了这些测量的可靠性。主要结果是弱视眼 VA 从基线到 16 周的增加。
65 名儿童进入光学治疗期。平均年龄为 6.0±2.2 岁（范围：4-12 岁；四分位距 4.5-6.7 岁）。53 名（82%）儿童的弱视是由屈光不正引起的，6 名（9%）儿童是由斜视引起的，6 名（9%）儿童是由混合机制引起的。经过光学治疗，平均 VA 分别提高了 0.20 logMAR（标准差 0.28；p<0.001）和 0.07，在弱视眼和对侧眼中（标准差 0.20；p=0.03）。这导致 24 名（37%）儿童的双眼 VA 差异<0.20 logMAR，17%的儿童的 VA 在开始时为 0.30 logMAR 或更差。基线时弱视眼 VA 较差（p=0.001）和高度屈光不正（p=0.001）与 VA 改善相关。平均而言，眼镜佩戴时间为 9.7±2.4 小时/天（范围：2.3-13.6 小时）；平均依从率为估计清醒时间的 73%±18%。仅环境温度≥31°C 或眼镜戴在头顶上方时，ODM 测量才会受到干扰。
VA 提高了两行，导致三分之一以上的儿童仅通过眼镜治疗即可得到充分治疗，不再被归类为弱视。ODM 被证明是一种可靠的测量眼镜佩戴依从性的方法。
Zotero 插件