Nughays Reem O, Almazroy Enar A, Elyas Shahad K, Alamoudi Anas, Batais Waleed Talib, Bogari Asim Marwan, Alnabihi Ahmed, Alkharboush Dania Hamad, Almarzouki Hashem
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
Clin Ophthalmol. 2025 Jun 26;19:1999-2009. doi: 10.2147/OPTH.S513329. eCollection 2025.
This systematic review and meta-analysis compares the efficacy and safety of dichoptic therapy vs traditional patching in treating pediatric amblyopia. The primary focus was on improvements in visual acuity (VA) and stereoacuity (SA), with an evaluation of adverse events and treatment compliance.
A comprehensive search was conducted across PubMed, Scopus, Cochrane, and other databases up to August 2024. Randomized controlled trials (RCTs) comparing dichoptic therapy with eye patching in children (aged 0-18) with amblyopia were included. Studies reporting VA and SA outcomes were analyzed. The primary outcome was VA improvement; secondary outcomes included changes in SA and adverse events. Meta-analysis was performed using RevMan software, with random-effects models.
Eleven studies involving 902 children with amblyopia were included. Patching resulted in a statistically significant improvement in VA, with a pooled standardized mean difference (SMD) of 0.27 logMAR lines (95% CI: 0.07-0.48, p = 0.008), favoring patching over dichoptic therapy. Stereoacuity improvements were not significantly different between the two approaches (SMD: 0.28, 95% CI: -0.11-0.68, p = 0.16). Adverse events were more common in the patching group, with skin irritation being the most frequently reported issue. Both treatments showed moderate to high levels of compliance.
While patching demonstrated a modest advantage in improving visual acuity, dichoptic therapy provides a promising alternative, particularly due to its interactive nature and potential to improve treatment compliance. Given no significant difference in stereoacuity outcomes and the mild adverse events associated with both methods, dichoptic therapy should be considered a viable option for amblyopia treatment in children.
本系统评价和荟萃分析比较了双眼分视疗法与传统遮盖疗法治疗儿童弱视的疗效和安全性。主要关注视力（VA）和立体视锐度（SA）的改善情况，并评估不良事件和治疗依从性。
截至2024年8月，在PubMed、Scopus、Cochrane及其他数据库中进行了全面检索。纳入了比较双眼分视疗法与遮盖疗法治疗弱视儿童（0 - 18岁）的随机对照试验（RCT）。对报告VA和SA结果的研究进行分析。主要结局是VA改善情况；次要结局包括SA变化和不良事件。使用RevMan软件进行荟萃分析，采用随机效应模型。
纳入了11项涉及902名弱视儿童的研究。遮盖疗法在VA改善方面有统计学显著差异，合并标准化均数差（SMD）为0.27 logMAR行（95% CI：0.07 - 0.48，p = 0.008），表明遮盖疗法优于双眼分视疗法。两种方法在立体视锐度改善方面无显著差异（SMD：0.28，95% CI：-0.11 - 0.68，p = 0.16）。不良事件在遮盖组更常见，皮肤刺激是最常报告的问题。两种治疗方法的依从性均为中度到高度。
虽然遮盖疗法在改善视力方面显示出适度优势，但双眼分视疗法是一种有前景的替代方法，特别是因其具有交互性且有可能提高治疗依从性。鉴于两种方法在立体视锐度结果上无显著差异，且不良事件较轻，双眼分视疗法应被视为儿童弱视治疗的可行选择。
