Randomised controlled trial of video clips and interactive games to improve vision in children with amblyopia using the I-BiT system

Herbison, Nicola; Mackeith, Daisy; Vivian, Anthony; Purdy, Jon; Fakis, Apostolos; Ash, Isabel M; Cobb, Sue V; Eastgate, Richard M; Haworth, Stephen M; Gregson, Richard M; Foss, Alexander JE

Abstract

Background Traditional treatment of amblyopia involves either wearing a patch or atropine penalisation of the better eye. A new treatment is being developed on the basis of virtual reality technology allowing either DVD footage or computer games which present a common background to both eyes and the foreground, containing the imagery of interest, only to the amblyopic eye.

Methods A randomised control trial was performed on patients with amblyopia aged 4–8 years with three arms. All three arms had dichoptic stimulation using shutter glass technology. One arm had DVD footage shown to the amblyopic eye and common background to both, the second used a modified shooter game, Nux, with sprite and targets presented to the amblyopic eye (and background to both) while the third arm had both background and foreground presented to both eyes (non-interactive binocular treatment (non-I-BiT) games).

Results Seventy-five patients were randomised; 67 were residual amblyopes and 70 had an associated strabismus. The visual acuity improved in all three arms by approximately 0.07 logMAR in the amblyopic eye at 6 weeks. There was no difference between I-BiT DVD and non-I-BiT games compared with I-BiT games (stated primary outcome) in terms of gain in vision.

Conclusions There was a modest vision improvement in all three arms. Treatment was well tolerated and safe. There was no difference between the three treatments in terms of primary stated outcomes but treatment duration was short and the high proportion of previously treated amblyopia and strabismic amblyopia disadvantaged dichoptic stimulation treatment.

Citation

Herbison, N., Mackeith, D., Vivian, A., Purdy, J., Fakis, A., Ash, I. M., …Foss, A. J. (2016). Randomised controlled trial of video clips and interactive games to improve vision in children with amblyopia using the I-BiT system. British journal of ophthalmology, 100(11), 1511-1516. https://doi.org/10.1136/bjophthalmol-2015-307798

• Journal Article Type: Article
• Acceptance Date: Jan 25, 2016
• Online Publication Date: Mar 7, 2016
• Publication Date: 2016-11
• Deposit Date: Jan 17, 2019
• Publicly Available Date: Jan 17, 2019
• Journal: British Journal of Ophthalmology
• Print ISSN: 0007-1161
• Electronic ISSN: 1468-2079
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 100
• Issue: 11
• Pages: 1511-1516
• DOI: https://doi.org/10.1136/bjophthalmol-2015-307798
• Keywords: Ophthalmology; Sensory Systems; Cellular and Molecular Neuroscience
• Public URL: https://hull-repository.worktribe.com/output/786720
• Publisher URL: https://bjo.bmj.com/content/100/11/1511