Portable rotating grating stimulation for anisometropic amblyopia with 6 months training

Wen-Hsiu Yeh, Li-Ju Lai, Da-Wei Chang, Wei-Sin Lin, Guan-Ming Lin, Fu-Zen Shaw, Wen-Hsiu Yeh, Li-Ju Lai, Da-Wei Chang, Wei-Sin Lin, Guan-Ming Lin, Fu-Zen Shaw

Abstract

Treatment of grating stimulation has been used in amblyopia for decades, but high dropout rate and inconvenience for daily practice occur in previous studies. We developed a home-based portable system with rotating grating stimulation on a tablet. Thirty anisometropic amblyopic children were randomly allocated into the control or Grating group. They drew contour of the picture under patch of a better eye for 6 months. Best-corrected visual acuity (BCVA), grating acuity (GA), and contrast sensitivity (CS) were assessed at the baseline, 1st, 2nd, 3rd, and 6th months of training. All participants completed the 6-month training. Patched eyes of both groups exhibited no difference. Trained eyes of the control group had significantly slight improvement in BCVA and GA. In particular, the Grating group exhibited significantly higher BCVA, GA, and CS compared with those of the control group at the 3rd and 6th months of training. Moreover, percentage of the Grating group with great improvement (BCVA ≥ 0.3 or CS ≥ 0.3) was significantly larger than those of the control group at the 3rd or 6th months of training. The portable grating stimulation system demonstrates its trainability by no dropout and effectiveness by significant improvements in all assessments through a well experimental design.Trial Registration: ClinicalTrials.gov NCT04213066, registered 30/12/2019, https://ichgcp.net/clinical-trials-registry/NCT04213066 .

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow diagram according to the Consolidated Standards of Reporting Trials (CONSORT) statement showing recruitment, randomization, and patient flow in the study.
Figure 2
Figure 2
Best-corrected visual acuity (BCVA) at the baseline (0), 1st, 2nd, 3rd, and 6th months after the training. (A) BCVAs in patched eyes of the control and Grating groups. (B) BCVAs in trained eyes of the control and Grating groups. *p < 0.05 versus baseline, #p < 0.05 versus the control group. (C) Relationship between BCVA gain from the 6th month to baseline and total training time in trained eye of the two groups. The long dashed (control) and solid (Grating) lines represent the linear regression line fit the data.
Figure 3
Figure 3
Grating acuity (GA) at the baseline (0), 1st, 2nd, 3rd, and 6th months after the training. (A) GAs in patched eyes of the control and Grating groups. (B) GAs in trained eyes of the control and Grating groups. *p < 0.05 versus baseline, #p < 0.05 versus the control group. (C) Relationship between GA gain from the 6th month to baseline and total training time in trained eye of the two groups. The long dashed (control) and solid (Grating) lines represent the linear regression line fit the data.
Figure 4
Figure 4
Contrast sensitivity (CS) of 16 cycles per degree (cpd) the baseline (0), 1st, 2nd, 3rd, and 6th months after the training. (A) CSs in patched eyes of the control and Grating groups. (B) CSs in trained eyes of the control and Grating groups. *p < 0.05 versus baseline, #p < 0.05 versus the control group. (C) Relationship between 16-cpd CS gain from the 6th month to baseline and total training time in trained eye of the two groups. The long dashed (control) and solid (Grating) lines represent the linear regression line fit the data.
Figure 5
Figure 5
Example of an amblyopic child wearing a patch and playing the training tablet. Bottom panel illustrates two stimuli for the control group (left) and the Grating group (right) respectively.

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