Clinical Study
Eye (2009) 23, 124–131; doi:10.1038/sj.eye.6702977; published online 12 October 2007
Assessment of a computer-based treatment for older amblyopes: the Glasgow Pilot Study
M Cleary1, A D Moody2, A Buchanan1, H Stewart1 and G N Dutton3
- 1Orthoptic Department, Gartnavel General Hospital, Glasgow, Scotland
- 2Virtual Reality Applications Research Team (VIRART), University of Nottingham, Nottingham, UK
- 3Department of Ophthalmology, Royal Hospital for Sick Children, Yorkhill Hospitals, Glasgow, Scotland
Correspondence: M Cleary, Orthoptic Department, Gartnavel General Hospital, Upper Ground Floor, 1053 Great Western Road, Glasgow G12 0YN, Scotland. Tel: +0141 211 2053; Fax: +0141 211 2054; E-mail: marie.cleary@northglasgow.scot.nhs.uk
Received 16 February 2007; Revised 12 August 2007; Accepted 13 August 2007; Published online 12 October 2007.
Abstract
Purpose
There have been few viable alternatives to patching the better eye as a treatment of amblyopia for more than two centuries. The success of patching depends on compliance, which is problematic for up to 59% of children and their families.
Methods
This pilot study trialled the interactive binocular treatment (I-BiT) system as an alternative amblyopia treatment in 12 older amblyopes (6.1–11.4 years, median 8.2), who had not complied with or responded to occlusion. Virtual reality images were projected to each eye simultaneously via a headset during eight treatment sessions of 25-min duration. Outcome measures were changes in high- (HCVA) and low-contrast log MAR acuity (LCVA) at 1 week, 4 weeks and a final follow-up (3–18 months) after the final treatment.
Results
Sustained improvements in HCVA were observed in seven children (58%) and in LCVA in eight children (67%), including two for whom amblyopia was eliminated. Five children had visual acuities equivalent to 6/12 or better at least 6 months after stopping treatment, compared with one child prior to treatment. Significant improvements in HCVA occurred up to the fourth treatment; in LCVA to the seventh treatment.
Conclusion
Sustained improvements in visual acuity were observed for 58% of this small group of children using the I-BiT system, despite prior failure with conventional treatment. This offers hope for a potential time-saving alternative to patching, in which compliance can easily be monitored, but the results need to be validated by means of a randomised controlled trial.
Keywords:
amblyopia, virtual reality, binocular treatment, suppression
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