Patch-free Streaming Contrast-rebalanced Dichoptic Cartoons Versus Patching for Treatment of Amblyopia in Children Aged 3 to 5 Years: a Pilot, Randomized Clinical Trial

Overview

Journal J AAPOS

Specialty Pediatrics

Date 2024 Sep 13

PMID 39270746

Authors

Reed M Jost

Eileen E Birch

Yi-Zhong Wang

Lori M Dao

David Stager

Becky Luu

Cynthia L Beauchamp

Prashanthi Giridhar

Taylor A Brin

Alex S Baldwin

Robert F Hess

Benjamin Thompson

Affiliations

Soon will be listed here.

Abstract

Background: We developed and tested a dichoptic treatment designed for younger children that can be viewed freely and involves a dichoptic manipulation of a popular animation series that enables contrast-rebalancing without disrupting fusion. Our aim was to assess whether this novel amblyopia treatment is superior to patching in children aged 3-5 years.

Methods: A total of 34 children with amblyopia were randomly assigned to contrast-rebalanced dichoptic cartoons (4 hours/week) or patching (14 hours/week) for 2 weeks. Children in the cartoon group continued watching cartoons for an additional 2 weeks. Designed to target the youngest and most treatable children, the dichoptic cartoons presented the entire scene to the amblyopic eye at 100% contrast, while the fellow eye view was presented at reduced contrast with the main character omitted. Best-corrected visual acuity (BCVA), stereoacuity, suppression, and manual dexterity were measured at each visit.

Results: After 2 weeks, improvement in amblyopic eye BCVA was greater for dichoptic treatment than for patching, with a mean improvement of 0.11 ± 0.08 versus 0.06 ± 0.09 logMAR, respectively (P = 0.04). Stereoacuity, suppression, and manual dexterity did not improve significantly more in the dichoptic group than the patching group at 2 weeks. After 4 weeks of dichoptic cartoon treatment, mean visual acuity improvement in the dichoptic group was 0.16 logMAR (95% CI, 0.10-0.21).

Conclusions: In our study cohort, a contrast-rebalanced dichoptic cartoon was more effective than patching in treating childhood amblyopia after 2 weeks. Dichoptic cartoons that rebalance contrast to overcome suppression provide an additional treatment option for amblyopia in young children.

Citing Articles

Baseline and outcome stereoacuity of children with anisometropic amblyopia undergoing dichoptic amblyopia treatment.

Birch E, Jost R, Kelly K J AAPOS. 2025; 29(1):104116.

PMID: 39864584 PMC: 11885016. DOI: 10.1016/j.jaapos.2025.104116.

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