2020 - 1 Issue

Original article

Visual Training in Virtual Reality in Adult Patients With Anisometric Amblyopia

Juraj Halička ORCID
Erik Sahatqija – Michal Krasňanský – Karolína Benca Kapitánová ORCID – Monika Fedorová – Peter Žiak ORCID

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DOI: 10.31348/2020/3

Published in Czech and Slovak Ophtalmology: 2020 - 1

Published on website: 30.08.2020

Keywords: anisometropic amblyopia, visual training, virtual reality, video games, adult patient, pleoptics

Summary

Purpose: Amblyopia is one of the most common childhood disease. The average prevalence of amblyopia in children is estimated at 2-5 %. It arises during the child development until the age of six, if not treated then, it persist throught adulthood. The aim of our work is to retrospectively analyze the results of treatment of anisometropic amblyopia using dichoptical training in virtual reality in adult amblyopic patients.

Materials and Methods: Our group consisted of 84 amblyopic patients with anisometropic amblyopia with an average age of 33.8 ± 9.4 years. Patients played a video game twice a week in the Oculus Rift 3D virtual reality. Together they completed 8 visual trainings, with one training lasting 60 minutes. Before and after the training we evaluated the best corrected visual acuity (BCVA).

Discussion: Throughout the group, we observed an improvement of 0.1 BCVA from 0.48 to 0.58 Sloan table (p <0.05). 17% of patients before training and 31% after visual training reached BCVA better or equal to 0.9. The overall response rate was 56% in adult patients (n = 47). Conclusion: Our results suggest that a certain degree of residual neuro-plasticity in the visual cortex can be revealed in the adult brain, thereby improve visual acuity in adult amblyopic patients.

References

  1. Diamond, GR., Eggers, HM.: Textbook of ophthalmology. Vol. 5, Strabismus and pediatric ophthalmology. London, Mosby, 1993, 70 p.
  2. Divišová, G.: Strabizmus. 2. vyd. Praha, Avicenum, 1990, 312 s..
  3. Williams, C., Northstone, K., Harrad, RA. et al.: Amblyopia treat - ment outcomes after preschool screening v school entry screening: observational data from a prospective cohort study. Br J Ophthalmol, 87 (8); 2003: 988–993.
  4. Wu, C., Hunter, DG.: Amblyopia: diagnostic and therapeutic op - tions. Am J Ophthalmol, 141 (1); 2006: 175–184.
  5. Elflein, HM., Fresenius, S., Lamparter, J. et al.: The prevalence of amblyopia in Germany: data from the prospective, population-based Gutenberg Health Study. Deutsches Arzteblatt international, 112(19); 2015: 338–344.
  6. Gao, TY., Anstice, N., Babu, RJ. et al.: Optical treatment of amblyopia in older children and adults is essential prior to enrolment in a clinical trial. Ophthalmic Physiol Opt., 38(2); 2018:129-143.
  7. Loudon, SE., Simonsz, HJ.: The history of the treatment of ambly - opia. Strabismus, 13 (2); 2005: 93–106.
  8. Simonsz-Tóth, B., Joosse, MV., Besch, D.: Refractive adaptation and efficacy of occlusion therapy in untreated amblyopic patients aged 12 to 40 years. Graefes Arch Clin Exp Ophthalmol., 257(2); 2019: 379-389.
  9. Li, J., Thompson, B., Deng, D. et al.: Dichoptic training enables the adult amblyopic brain to learn. Curr Biol, 23 (8); 2013: 308–309.
  10. Hess, RF., Babu, RJ., Clavagnier, S. et al.: The iPod binocular home-based treatment for amblyopia in adults: efficacy and compliance. Clin Exp Optom., 97(5); 2014: 389-98.
  11. Gao, TY., Guo, CX., Babu, RJ. et al.: Effectiveness of a Binocular Video Game vs Placebo Video Game for Improving Visual Functions in Older Children, Teenagers, and Adults With Amblyopia: A Randomized Clinical Trial. JAMA Ophthalmol., 136(2); 2018: 172- 181.
  12. Rahi, JS., Logan, S., Cortina-Borja, M. et al.: Prediction of improved vision in the amblyopic eye after visual loss in the non-amblyopic eye. Lancet, 360 (9333); 2002: 621–622.
  13. El Mallah, MK., Chakravartz U., Hart, PM.: Amblyopia: is visual loss permanent? Br J Ophthalmol, 84 (9); 2000: 952–956.
  14. Restani, L., Cerri, C., Pietrasanta, M. et al.: Functional masking of deprived eye responses by callosal input during ocular dominance plasticity. Neuron, 64 (5); 2009: 707-18.
  15. Proscialloy, P., Proscialloy E.: The accuracy of binocular fixation preference for the diagnosis of strabismic amblyopia. J Pediatr Ophthalmol Strabismus, 14; 2010: 205–10.
  16. Siu, CR., Beshara, SP., Jones, DG. et al.: Development of Glutamatergic Proteins in Human Visual Cortex across the Lifespan. J Neurosci., 37(25); 2017: 6031-6042.
  17. Tommila, V., Tarkkanen, A.: Incidence of loss of vision in the healthy eye in amblyopia. Br J Ophthalmol, 65 (8); 1981: 575-7.
  18. Cotter, SA., Edwards, AR., Wallace, DK. et al.: Treatment of anisometropic amblyopia in children with refractive correction. Ophthalmology, 113 (6); 2006: 895-903.
  19. Li, SL., Reynaud, A., Hess, RF. et al.: Dichoptic movie viewing treats childhood amblyopia. J AAPOS, 19 (5); 2015: 401–405.
  20. Hess, RF., Thompson, B.: Amblyopia and the binocular approach to its therapy. Vision Res., 114; 2015: 4-16.
  21. Žiak, P., Holm, A., Halička, J. et al.: Amblyopia treatment of adults with dichoptic training using the virtual reality oculus rift head mounted display: preliminary results. BMC Ophthalmol, 17 (1); 2017: 105.