Personalized Rehabilitation for Residual Deficits: Tailoring Perceptual Learning for Improved Visual Function in Meridional Amblyopia.

PURPOSE

This study explored the efficacy and predictors of success for a novel monocular fine orientation discrimination perceptual learning (fine-PL) approach in addressing perceptual deficits in meridional amblyopia (MA).

DESIGN

Prospective, longitudinal study.

PARTICIPANTS

Fifty-three children with persistent MA participated in this study.

METHODS

Twenty-one participants underwent a 14-day regimen of monocular fine-PL focused on grating orientation discrimination exercise (±5°) aligned with the vertical or horizontal meridian near each individual's threshold spatial frequencies. Nineteen participants underwent coarse orientation discrimination perceptual learning (coarse-PL), and 13 participants received optical correction alone.

MAIN OUTCOME MEASURES

Measurements included both the best-corrected and uncorrected visual acuity (VA), contrast sensitivity function (CSF), and stereoacuity, with daily VA assessments during the training.

RESULTS

Significant improvements were observed in uncorrected VA (increased by 1.3 lines,  < 0.001) and best-corrected VA (increased by 0.3 lines,  = 0.002) in the fine-PL group. Posttraining assessments showed enhancements in all measured CSF metrics, both with and without correction (all  < 0.05), and in both distance and near stereopsis (all  < 0.05). Compared with coarse-PL, fine-PL more effectively addressed residual deficits in uncorrected vision. Early changes in VA correlated significantly with final VA outcomes. A 6-month follow-up confirmed the retention of these gains.

CONCLUSIONS

Fine-PL offers targeted rehabilitation for perceptual distortions in MA, with early responses during training serving as potential predictors of success. This personalized approach effectively addresses residual deficits beyond optical correction, offering a promising noninvasive option for visual function improvement.

FINANCIAL DISCLOSURES

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.