An action video game for the treatment of amblyopia in children: A feasibility study.
An action video game for the treatment of amblyopia in children: A feasibility study.
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DOI：
10.1016/j.visres.2018.04.005
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发表时间：
2018-07
期刊：
影响因子：
1.8
通讯作者：
Levi DM
中科院分区：
文献类型：
--
作者：
Gambacorta C;Nahum M;Vedamurthy I;Bayliss J;Jordan J;Bavelier D;Levi DM
治疗儿童弱视的黄金标准疗法仍然是修补或惩罚对眼，导致3至8岁儿童在≈120小时修补后视力平均提高约1线(0.1logMAR)。然而，打补丁和其他治疗方案的依从性往往很差。相比之下，快节奏的动作视频游戏可以非常吸引人，而且已经被证明在成年弱视患者的视力和注意力方面有广泛的改善。在这里，我们试运行了一款定制的动作视频游戏来治疗弱视儿童。21例单眼弱视儿童，平均年龄9.95±3.14岁(n=21)，其中屈光参差性弱视12例，斜视性弱视9例。其中11例为单眼弱视，11例为双眼弱视，10例为双眼弱视。参与者在基线、游戏10小时和20小时后进行了视力(VA)、立体视力和阅读速度的评估。其他探索性分析检查了完成培训6-10周(后续)后的改善情况。经过20小时的训练，分眼组的视力平均提高了0.14logMAR(≈38%)，单眼组平均提高了0.06logMAR(≈15%)。同样，立体视力在分视训练后提高了0.07log arcsec(≈17%)，在单眼训练后提高了0.06log arcsec(≈15%)。在两个治疗组中，12名屈光参差性弱视患者中有7名立体视有改善，而9名斜视患者中只有1名有改善。大多数改善在随访时基本保持不变。我们的可行性研究表明，动作视频游戏可以作为一种有效的辅助治疗方法来治疗儿童弱视，在较短的时间内取得与黄金标准治疗相似的效果。
The gold-standard treatment for childhood amblyopia remains patching or penalizing the fellow eye, resulting in an average of about a one line (0.1 logMAR) improvement in visual acuity following ≈ 120 hours of patching in children 3 to 8 years old. However, compliance with patching and other treatment options is often poor. In contrast, fast-paced action video games can be highly engaging, and have been shown to yield broad-based improvements in vision and attention in adult amblyopia. Here, we pilot tested a custom-made action video game to treat children with amblyopia. Twenty-one (n=21) children (mean age 9.95 ± 3.14 [se]) with unilateral amblyopia (n=12 anisometropic and n=9 strabismic) completed 20 hours of game play either monocularly, with the fellow eye patched (n=11), or dichoptically, with reduced contrast to the fellow eye (n=10). Participants were assessed for visual acuity (VA), stereo acuity and reading speed at baseline, and following 10 and 20 hours of play. Additional exploratory analyses examined improvements after 6–10 weeks of completion of training (follow-up). Following 20 hours of training, VA improved on average by 0.14 logMAR (≈ 38%) for the dichoptic group and by 0.06 logMAR (≈ 15%) for the monocular group. Similarly, stereoacuity improved by 0.07 log arcsec (≈ 17%) following dichoptic training, and by 0.06 log arcsec (≈ 15%) following monocular training. Across both treatment groups, 7 of the 12 individuals with anisometropic amblyopia showed improvement in stereoacuity, while only 1 of the 9 strabismic individuals improved. Most improvements were largely retained at follow-up. Our feasibility study suggests that the action videogame approach may be used as an effective adjunct treatment for amblyopia in children, achieving results similar to those of the gold-standard treatment in shorter duration.
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影响因子：
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