Islam Torikul, Roy Amit Dutta
Department of Biomedical Engineering (BME), Khulna University of Engineering & Technology, Khulna, 9230, Bangladesh; Department of Biomedical Engineering (BME), New Jersey Institute of Technology, Newark, NJ, USA.
Department of Biomedical Engineering (BME), Khulna University of Engineering & Technology, Khulna, 9230, Bangladesh.
J Optom. 2025 Apr-Jun;18(2):100540. doi: 10.1016/j.optom.2025.100540. Epub 2025 Mar 24.
Convergence insufficiency (CI) is a common binocular vision disorder that significantly impacts visual comfort and quality of life. It has been hypothesized that CI therapy can also be provided effectively with Virtual reality (VR). Recently, a few studies were conducted on virtual reality-based CI therapy. However, to the best of the authors' knowledge, no systematic review and meta-analysis has been performed on the effectiveness of VR-based CI therapy. Therefore, this study aims to fill this critical gap and investigate the effectiveness of VR-based CI therapy. Consequently, it may be helpful to the clinicians, patients, and researchers to choose therapy, and develop future research studies. A systematic search was conducted on Google scholar, Scopus, PubMed and Science Direct until October 1, 2024. A total of 649 studies were screened, of which 3 studies were eligible to be included. We evaluated the quality and risk of bias for the included studies. Using the random-effects model, we found an overall mean difference of 3.38 (95% CI: 1.61, 5.16) before and after VR-based therapy. I² was 54.82% in our study, which indicates moderate heterogeneity. Then, we performed a Q test and found Q (df = 2) = 4.3593 and p-value = 0.1131, which indicates that albeit some heterogeneity observed in our analysis, it was not statistically significant. We also performed Leave-One-Out sensitivity analysis, which indicates that the overall findings of our analysis were relatively stable and not excessively dependent on any single selected study. No significant evidence of publication bias was found by using a funnel plot, Begg's test (Kendall's Tau = 1, p-value = 0.33), and Egger's test (intercept = 2.45, p-value = 0.40). Although we found VR based CI therapy has a positive effect, small sample size and variability in study methodologies make the current evidence insufficient to draw definitive conclusions regarding its effectiveness. Further studies are required to have more robust and reliable data.
集合不足（CI）是一种常见的双眼视觉障碍，会显著影响视觉舒适度和生活质量。据推测，虚拟现实（VR）也可以有效地提供CI治疗。最近，进行了一些基于虚拟现实的CI治疗研究。然而，据作者所知，尚未对基于VR的CI治疗的有效性进行系统评价和荟萃分析。因此，本研究旨在填补这一关键空白，调查基于VR的CI治疗的有效性。因此，这可能有助于临床医生、患者和研究人员选择治疗方法，并开展未来的研究。在谷歌学术、Scopus、PubMed和科学Direct上进行了系统检索，直至2024年10月1日。共筛选了649项研究，其中3项研究符合纳入标准。我们评估了纳入研究的质量和偏倚风险。使用随机效应模型，我们发现基于VR的治疗前后的总体平均差异为3.38（95%CI：1.61，5.16）。在我们的研究中，I²为54.82%，这表明存在中度异质性。然后，我们进行了Q检验，发现Q（自由度=2）=4.3593，p值=0.1131，这表明尽管在我们分析中观察到一些异质性，但在统计学上并不显著。我们还进行了留一法敏感性分析，这表明我们分析的总体结果相对稳定，并且不过度依赖于任何单一选定的研究。通过漏斗图、Begg检验（肯德尔tau=1，p值=0.33）和Egger检验（截距=2.45，p值=0.40）未发现明显的发表偏倚证据。尽管我们发现基于VR的CI治疗有积极效果，但样本量小和研究方法的变异性使得目前的证据不足以就其有效性得出明确结论。需要进一步的研究来获得更有力和可靠的数据。
