目的:确定弱视治疗朱拉隆功大学(ATCU)在改善弱视儿童对闭塞治疗的依从性中的应用效果。方法:我们开发了一个智能手机应用程序,称为弱视治疗朱拉隆功大学(ATCU),其中包括教育,修补日历,迷你游戏,和通知,为护理人员提供一个全面的工具,通过信息内容提高弱视治疗的依从性,交互式功能,和个性化的提醒。4-12岁儿童斜视,屈光参差,剥夺,我们招募了或混合型弱视患者,并将其随机分配至使用ATCU进行眼部修补(A组)或接受标准护理(B组).对眼部修补的依从性(主要结果)以实际修补时间的百分比来衡量,该百分比由护理人员主观地报告。与规定的修补时间相比,评估在1个月和3个月的随访。次要结果包括最佳矫正视力(BCVA)。结果:在2018年10月至2019年12月之间,有45名儿童参加了我们的研究,所有符合资格标准。一名参与者失去了随访,只有一个孩子被诊断为弱视,而其他人则接受了修补作为预先治疗。在1个月,A组(85%)的依从性显著高于B组(64%)[中位数差异22%(95%CI,3~48;p=0.037)].3个月时,A组(80%)的依从性也高于B组(55%),但不显著[中位数差异13%(95%CI,-6至30;p=0.096)]。在两个随访期间,A组的BCVA改善均高于B组[1个月时的平均差异0.04logMAR(95%CI,0.01至0.07;p=0.025)和3个月时的0.04logMAR(95%CI,0.01至0.08;p=0.022)]。结论:ATCU的应用显着提高了1个月时闭塞治疗的依从性。该应用可作为弱视治疗的辅助工具。
Aim: To determine the effectiveness of the Amblyopia Treatment Chulalongkorn University (ATCU) application in improving compliance to occlusion therapy in amblyopic children. Methods: We developed a smartphone application called Amblyopia Treatment Chulalongkorn University (ATCU), which includes education, patching calendar, mini-games, and notifications, offering caregivers a comprehensive tool to enhance amblyopia treatment adherence through informative content, interactive features, and personalized reminders. Children aged 4-12 years with strabismic, anisometropic, deprivation, or mixed-type amblyopia were recruited and randomly assigned to either use ATCU application to facilitate eye patching (group A) or receive standard care (group B). Compliance with eye patching (primary outcome) was measured as a percentage of actual patching hours which were subjectively reported by caregivers, compared to prescribed patching hours, assessed at 1 and 3-month follow-up. Secondary outcomes include best corrected visual acuity (BCVA). Results: Between October 2018 and December 2019, 45 children were enrolled in our study, with all meeting eligibility criteria. One participant was lost to follow-up, and only one child was newly diagnosed with amblyopia, while the others had undergone patching as a prior treatment. At 1-month, compliance was significantly higher in group A (85%) than in group B (64%) [median difference 22% (95% CI, 3 to 48; p = .037)]. At 3-months, the compliance was also higher in group A (80%) than group B (55%), but not significantly [median difference 13% (95% CI, -6 to 30; p = .096)]. BCVA improvement in group A was higher than group B at both follow-up periods [mean difference 0.04 logMAR (95% CI, 0.01 to 0.07; p = .025) at 1-month and 0.04 logMAR (95% CI, 0.01 to 0.08; p = .022) at 3-month follow-up]. Conclusion: The ATCU application significantly improved compliance with occlusion therapy at 1-month. This application may be helpful as an adjunctive tool in the treatment of amblyopia.