Aims To compare amblyopic-eye visual acuity (VA) and binocularity improvement of a binocular game with part-time patching in the treatment of Chinese children with anisometropic amblyopia.
Methods 103 Chinese children aged 3–13 years with anisometropic amblyopia were recruited in a randomised clinical trial. Eligible participants were randomly assigned to the binocular, patching and combined groups. Primary outcome was amblyopic-eye VA improvement at 3 months. Secondary outcomes included reduction of suppression and change of stereoacuity.
Results Of 85 completed participants, 44 (52%) were women and mean (SD) age was 5.99 (2.33) years. At 3 months, mean (95% CI) amblyopic-eye VA improved 0.18 (0.10–0.26), 0.28 (0.19–0.36) and 0.30 (0.21–0.39) logarithm of the minimum angle of resolution in the binocular, patching and combined groups, respectively. After adjusting for baseline VA, the difference was statistically significant (F=6.29, p=0.003), favouring as follows: the combined group, the patching group and the binocular group. After treatment, Titmus (x2 binocular=9.75, p=0.007; x2 combined=9.35, p=0.009) and dynamic stereoacuity (x2 binocular=12.56, p=0.01; x2 combined=12.66, p=0.01) improved only in the binocular and combined groups. Among groups, only Titmus improvement differed significantly (F=49.55, p<0.001). Changes of other types of stereoacuity and interocular suppression were similar.
Conclusions The binocular game used in this study could improve amblyopic-eye VA and binocularity in Chinese children with anisometropic amblyopia, but it was less effective than patching in amblyopic-eye VA improvement and showed no superiority in binocularity over patching. It remains unclear whether the low treatment response of this binocular game was due to limitations of the study or its low treatment effect.
- treatment other
- optics and refraction
- clinical trial
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JY and H-WM contributed equally.
Contributors JY: substantial contribution to conception and design, analysis and interpretation of data, drafting the article, viewing it critically for important intellectual content and final approval of the article to be published. HWM: substantial contribution to acquisition of data, analysis and interpretation of data, drafting the article and final approval of the article to be published. XQ: substantial contribution to conception and design, viewing it critically for important intellectual content and final approval of the article to be published.
Funding This research was supported by the Foundation of Shanghai Municipal Health and Family Planning Commission (grant number 201540366).
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The Institutional Review Board of Eye & ENT Hospital of Fudan University 201540366.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Data are available in a public, open access repository.