Multicenter Clinical Evaluation Of The Results Of Dichoptic Therapy On An Online Platform For The Treatment Of Anisometropic Amblyopia In A Spanish Population
Published 2024 - 42nd Congress of the ESCRS
Reference: PO1082 | Type: Poster | DOI: 10.82333/3z4z-4188
Authors: David Pablo P Pinero* 1 , Ainhoa Molina-Martin 2 , Elena Martínez-Plaza 2 , Amparo Gil-Casas 3 , Javier Hurtado 4
1Optics, Pharmacology and Anatomy,University of Alicante,Alicante,Spain;Ophthalmology,Vithas Medimar International Hospital,Alicante,Spain, 2Optics, Pharmacology and Anatomy,University of Alicante,Alicante,Spain, 3Optometric Clinic,Fundacio Lluis Alcanyís,Valencia,Spain, 4Clínica Rementeria,Madrid,Spain
Purpose
In the last decade, multiple binocular therapies have emerged as a possible adjuvant for the treatment of amblyopia, one of them being dichoptic therapy. In this type of therapy, the images presented are seen simultaneously by both eyes, but projected independently in each eye, so that the differences between the dominant eye and the amblyopic eye are adjusted to allow simultaneous and balanced work of both eyes. The Bynocs commercial platform (Bynocs 2020 SL, Barcelona, Spain) is based on this concept, but using an online platform that works in the cloud.
Setting
Department of Ophthalmology, Medimar International Hospital, Alicante
Optometric Clinic, Fundació Lluís Alcanyís, Valencia
Clínica Rementeria, Madrid
Methods
Twenty children (age, 5-15 years) with anisometropic amblyopia were recruited from three Spanish centers. The following inclusion criteria was used: difference ≥1.00 D in spherical equivalent and ≥1.50 D in astigmatism between eyes, difference in visual acuity (VA) ≥ 0.10logMAR between eyes, no previous treatment of amblyopia, and previous adequate refractive correction for at least 2 months before initiating the visual training. Changes in VA, sensory status of binocular vision, ocular alignment and stereopsis (Bynocs and TNO tests) were analyzed during 1.5 months of treatment (5 weekly sessions, 20 minutes/day, total 30 sessions) with different video games of the platform (SuperCar, SuperMan, SuperDragon, SuperBee and Convergence).
Results
The logMAR VA of the non-dominant eye improved with therapy on average from 0.28±0.24 to 0.13±0.20 (p<0.001). At baseline, only 40% of participants achieved VA in the nondominant eye <0.20 logMAR and none achieved VA<0.10 logMAR. After therapy, these percentages increased to 78% and 52%, respectively. There were no significant changes in the near phoria during treatment (p≥0.307). The BF (Binocular Function) index was calculated, which is the logarithmic value of stereopsis in seconds of arc, assigning a value of 4 in case of fusion or diplopia without stereopsis and 5 in case of suppression. With therapy, BF value improved significantly from 2.82±1.11 to 2.32±0.94 (p<0.001). The average number of sessions performed was 27.0±4.5 (16-31).
Conclusions
The use of the Bynocs online dichoptic platform for a month and a half allows an improvement in visual acuity and visual function in children with anisometropic amblyopia, with a resolution of amblyopia in a large number of cases and the necessity of the extension of the treatment in some others. Long-term studies are necessary to assess the maintenance of the effect achieved with the treatment.