目的:评估联合使用立体3D视频电影和兼职贴片治疗对传统贴片治疗反应或依从性差的老年弱视儿童的有效性,并将这种联合治疗与单独贴片进行比较。
方法:32名年龄在5-12岁的弱视儿童伴有屈光参差,斜视,或两者均纳入一项随机临床试验.符合条件的参与者被随机分配到联合组和修补组。这里,双目治疗是指使用Bangerter滤镜模糊对方的眼睛,随后观看具有大视差的特写3D电影。主要结果是弱视眼(AE)6周时最佳矫正视力(BCVA)改善。此外,次要结局包括3周时AE改善的BCVA和立体视力的改变.
结果:在32名参与者中,平均(SD)年龄为6.63(1.46)岁,19名(59%)为女性。在6周,平均(SD)弱视眼VA改善0.17±0.08logMAR(双侧95%CI,0.13至0.22;F=57.2,p<0.01)和0.05±0.04logMAR(双侧95%CI,0.05至0.09;F=8.73,p=0.01)在联合组和修补组中,分别。差异具有统计学意义(平均差异,0.13logMAR[1.3线];95%CI,0.08-0.17logMAR[0.8-1.7线];t25=5.65,p<0.01)。治疗后,只有联合组有显著改善的立体敏锐度,如双眼功能评分(中位数[四分位距],2.30[2.23至2.68]vs.1.69[1.60至2.30]对数弧秒;配对,z=-3.53,p<0.01),平均立体视敏度增益为0.47logarcsec(±0.22)。其他类型的立体视敏度的变化相似。
结论:我们的基于实验室的双眼治疗策略具有高水平的依从性,这导致了对传统补片治疗反应差或依从性差的老年弱视儿童的短期治疗后视觉功能的实质性增加。值得注意的是,改善的立体敏锐度显示出更大的优势。
OBJECTIVE: To assess the effectiveness of combined use of stereoscopic 3D video movies and part-time patching in treating older amblyopic children with poor response or compliance to traditional patching treatments and comparing this combined treatment with patching alone.
METHODS: Thirty-two children aged 5-12 years with amblyopia associated with anisometropia, strabismus, or both were recruited in a randomized clinical
trial. Eligible participants were assigned randomly to the combined and patching groups. Here, binocular treatment refers to using the Bangerter filter to blur the fellow eye and subsequently watching a close-up 3D movie with large parallax. The primary outcome was amblyopic eye (AE) best-corrected visual acuity (BCVA) improvement at six weeks. In addition, secondary outcomes included BCVA of AE improvement at three weeks and change of stereoacuity.
RESULTS: Of 32 participants, mean (SD) age was 6.63 (1.46) years, and 19 (59%) were female. At 6 weeks, mean (SD) amblyopic eye VA improved by 0.17 ± 0.08 logMAR (2-sided 95% CI, 0.13 to 0.22; F = 57.2, p < 0.01) and 0.05 ± 0.04 logMAR (2-sided 95% CI, 0.05 to 0.09; F = 8.73, p = 0.01) in the combined and patching groups, respectively. The difference was statistically significant (mean difference, 0.13 logMAR [1.3 line]; 95% CI, 0.08-0.17 logMAR [0.8-1.7 lines]; t25 = 5.65, p < 0 .01). After treatment, only the combined group had significantly improved stereoacuity, such as binocular function score (median [interquartile range], 2.30 [2.23 to 2.68] vs. 1.69 [1.60 to 2.30] log arcsec; paired, z = -3.53, p < 0.01), and mean stereoacuity gain was 0.47 log arcsec (± 0.22). Changes in other types of stereoacuity were similar.
CONCLUSIONS: Our laboratory-based binocular treatment strategy engaged a high level of compliance that led to a substantial gain in visual function after a short period of treatment for older amblyopic children having poor response or compliance to traditional patching treatments. Notably, the improving stereoacuity showed a greater advantage.