Ming Xiaolu, Huang Gantian, Chen Xiaohang, Liao Meng, Liu Longqian
Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, 610041, China.
Ophthalmol Ther. 2025 May;14(5):857-881. doi: 10.1007/s40123-025-01128-9. Epub 2025 Mar 27.
Amblyopia is a neurodevelopmental disorder characterized by a reduction in best-corrected visual acuity (BCVA). This meta-analysis aimed to analyze the effectiveness of perceptual learning and video game training for adults with amblyopia.
Following Cochrane guidelines (PROSPERO CRD42024504502), we conducted a systematic search across multiple databases. Randomized controlled trials (RCTs) on adults with amblyopia receiving behavioral therapies were included. Data on interventions, sample size, and logMAR visual acuity were extracted and analyzed using Review Manager 5.4 and Stata 17.0.
A total of 6439 studies were identified, with 22 meeting the inclusion criteria after screening. The meta-analysis included 422 adult patients with amblyopia across these studies. Quality assessment revealed that 78% of studies had a low risk of bias. The analysis showed a statistically significant standardized mean difference (SMD) of -0.68 in the experimental group compared with controls, indicating an improvement in visual acuity (P < 0.05). Subgroup analyses indicated that perceptual learning and video game training also resulted in visual improvement (P < 0.05). In addition, the results indicated a significant improvement in visual acuity with dichoptic training or monocular training, reaching visual acuity improvement (P < 0.05).
These findings indicate that targeted visual training facilitates neural plasticity, reduces interocular suppression, and reinforces neural pathways associated with visual processing. While video game-based interventions represent a viable and engaging rehabilitation strategy, a combined approach may be most effective in enhancing monocular and binocular functions. Future research should focus on refining training protocols to enhance both monocular and binocular visual function more effectively.
弱视是一种以最佳矫正视力（BCVA）下降为特征的神经发育障碍。本荟萃分析旨在分析感知学习和视频游戏训练对成人弱视患者的有效性。
按照Cochrane指南（PROSPERO CRD42024504502），我们在多个数据库中进行了系统检索。纳入了关于成人弱视患者接受行为疗法的随机对照试验（RCT）。使用Review Manager 5.4和Stata 17.0提取并分析了干预措施、样本量和对数最小分辨角视力的数据。
共识别出6439项研究，筛选后有22项符合纳入标准。这些研究的荟萃分析纳入了422例成人弱视患者。质量评估显示，78%的研究偏倚风险较低。分析表明，与对照组相比，实验组的标准化均数差（SMD）具有统计学意义，为-0.68，表明视力有所改善（P < 0.05）。亚组分析表明，感知学习和视频游戏训练也能改善视力（P < 0.05）。此外，结果表明，双眼分视训练或单眼训练可显著提高视力，实现视力改善（P < 0.05）。
这些发现表明，有针对性的视觉训练可促进神经可塑性，减少双眼间抑制，并加强与视觉处理相关的神经通路。虽然基于视频游戏的干预是一种可行且引人入胜的康复策略，但联合方法可能在增强单眼和双眼功能方面最为有效。未来的研究应侧重于完善训练方案，以更有效地提高单眼和双眼视觉功能。
