Inverse Occlusion: A Binocularly Motivated Treatment for Amblyopia. (19th March 2019)

• Record Type: Journal Article
• Authors: Zhou, Jiawei; He, Zhifen; Wu, Yidong; Chen, Yiya; Chen, Xiaoxin; Liang, Yunjie; Mao, Yu; Yao, Zhimo; Lu, Fan; Qu, Jia; Hess, Robert F.
• Other Names: Lunghi Claudia Guest Editor.
• Is Part Of: Neural plasticity. Volume 2019(2019)
• Publication Date: 2019-03-19
• Subjects: Neuroplasticity -- Periodicals; 612.82
• DOI: 10.1155/2019/5157628
• Languages: English
• ISSNs: 2090-5904

Abstract

Abstract : Recent laboratory findings suggest that short-term patching of the amblyopic eye (i.e., inverse occlusion) results in a larger and more sustained improvement in the binocular balance compared with normal controls. In this study, we investigate the cumulative effects of the short-term inverse occlusion in adults and old children with amblyopia. This is a prospective cohort study of 18 amblyopes (10-35 years old; 2 with strabismus) who have been subjected to 2 hours/day of inverse occlusion for 2 months. Patients who required refractive correction or whose refractive correction needed updating were given a 2-month period of refractive adaptation. The primary outcome measure was the binocular balance which was measured using a phase combination task; the secondary outcome measures were the best-corrected visual acuity which was measured with a Tumbling E acuity chart and converted to logMAR units and the stereoacuity which was measured with the Random-dot preschool stereogram test. The average binocular gain was 0.11 in terms of the effective contrast ratio (z = − 2.344, p = 0.019, 2-tailed related samples Wilcoxon Signed Rank Test). The average acuity gain was 0.13 logMAR equivalent (t 17 = 4.76, p < 0.001, 2-tailed paired samplest -test). The average stereoacuity gain was 339 arc seconds (z = − 2.533, p = 0.011 ). Based on more recent research concerning adult ocular dominance plasticity, we conclude that inverse occlusion in adults and old children with amblyopia does produce long-term gains to binocular balance and that acuity and stereopsis can improve in some subjects.