Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\27832248
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 JAMA+Ophthalmol
2016 ; 134
(12
): 1402-1408
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Binocular iPad Game vs Patching for Treatment of Amblyopia in Children: A
Randomized Clinical Trial
#MMPMID27832248
Kelly KR
; Jost RM
; Dao L
; Beauchamp CL
; Leffler JN
; Birch EE
JAMA Ophthalmol
2016[Dec]; 134
(12
): 1402-1408
PMID27832248
show ga
IMPORTANCE: Fellow eye patching has long been the standard treatment for
amblyopia, but it does not always restore 20/20 vision or teach the eyes to work
together. Amblyopia can be treated with binocular games that rebalance contrast
between the eyes so that a child may overcome suppression. However, it is unclear
whether binocular treatment is comparable to patching in treating amblyopia.
OBJECTIVES: To assess the effectiveness of a binocular iPad (Apple Inc) adventure
game as amblyopia treatment and compare this binocular treatment with patching,
the current standard of care. DESIGN, SETTING, AND PARTICIPANTS: This
investigation was a randomized clinical trial with a crossover design at a
nonprofit eye research institute. Between February 20, 2015, and January 4, 2016,
a total of 28 patients were enrolled in the study, with 14 randomized to
binocular game treatment and 14 to patching treatment. INTERVENTIONS: Binocular
game and patching as amblyopia treatments. MAIN OUTCOMES AND MEASURES: The
primary outcome was change in amblyopic eye best-corrected visual acuity (BCVA)
at the 2-week visit. Secondary outcomes were change in stereoacuity and
suppression at the 2-week visit and change in BCVA at the 4-week visit. RESULTS:
Among 28 children, the mean (SD) age at baseline was 6.7 (1.4) years (age range,
4.6-9.5 years), and 7 (25%) were female. At baseline, the mean (SD) amblyopic eye
BCVA was 0.48 (0.14) logMAR (approximately 20/63; range, 0.3-0.8 logMAR [20/40 to
20/125]), with 14 children randomized to the binocular game and 14 to patching
for 2 weeks. At the 2-week visit, improvement in amblyopic eye BCVA was greater
with the binocular game compared with patching, with a mean (SD) improvement of
0.15 (0.08) logMAR (mean [SD], 1.5 [0.8] lines) vs 0.07 (0.08) logMAR (mean [SD],
0.7 [0.8] line; P?=?.02) after 2 weeks of treatment. These improvements from
baseline were significant for the binocular game (mean [SD] improvement, 1.5
[0.8] lines; P?.001) and for patching (mean [SD] improvement, 0.7 [0.8] line;
P?=?.006). Depth of suppression improved from baseline at the 2-week visit for
the binocular game (mean [SD], 4.82 [2.82] vs 3.24 [2.87]; P?=?.03) and for
patching (mean [SD], 4.77 [3.10] vs 2.57 [1.67]; P?=?.004). Patching children
crossed over to binocular game treatment, and all 28 children played the game for
another 2 weeks. At the 4-week visit, no group difference was found in BCVA
change, with children who crossed over to the binocular games catching up with
children treated with binocular games, for a mean (SD) improvement of 0.17 (0.10)
logMAR (mean [SD], 1.7 [1.0] lines) for the binocular game vs a mean (SD)
improvement of 0.16 (0.12) logMAR (mean [SD], 1.6 [1.2] lines) for the patching
crossover (P?=?.73). CONCLUSIONS AND RELEVANCE: A binocular iPad game was
effective in treating childhood amblyopia and was more efficacious than patching
at the 2-week visit. Binocular games that rebalance contrast to overcome
suppression are a promising additional option for treating amblyopia. TRIAL
REGISTRATION: clinicaltrials.gov Identifier: NCT02365090.