Clinical observation of visual perception learning based on Gobar visual standard in the treatment of refractory amblyopia

doi:10.3877/cma.j.issn.2095-2007.2023.03.002

Abstract

Abstract:

Objective

The aim of this study is to explore the clinical efficacy of Gabor based visual perception learning in the treatment of refractory amblyopia.

Methods

Seventy-six amblyopia patients (152 eyes) who did not improve their best corrected visual acuity (BCVA) after 12 months of traditional amblyopia treatment or whose age has exceeded the visual sensitivity period from January 2021 to December 2021 in the Pediatric Ophthalmology Department of Shenzhen Eye Hospital were collected. Among them, there were 44 males (88 eyes) and 32 females (64 eyes) with an average age of (10.6±7.0) years-old (ranged from 5 to 33 years-old). All patients′ amblyopic eyes were trained systematically using Gabor based visual perception learning software. The BCVA before and after training using a standard logarithmic visual acuity chart was examined, and the treatment effectiveness based on the average improvement in BCVA before and after training was evaluated. The patients′ BCVA with overall and anisometropic amblyopia did not conform to normal distribution through normality testing, and were described using median and upper and lower quartiles [M (P25, P75)]. The BCVA of patients with ametropic amblyopia, strabismus amblyopia, and form deprivation amblyopia were described by the number of cases (eyes) and percentage. The BCVA between healthy and weak eyes in patients with overall and anisometropic amblyopia was compared using Mann-Whitney U rank sum test, and before and after training was compared using the wilconxon signed rank sum test. The method of correlation analysis was to use Pearson linear correlation analysis for data that conforms to a normal distribution, ortherwise was used by Spearman rank correlation analysis.

Results

The median BCVA of the overall patient before and after training was 0.5 (0.3, 0.7), and 0.7 (0.5, 0.9), respectively. After training, the BCVA of the overall patient increased, and the difference was statistically significant (Z=7.282, P<0.05). Among them, there were 9 cases (18 eyes) with ametropic amblyopia, 12 cases (14 eyes) with strabismus amblyopia, 10 cases (12 eyes) with form deprivation amblyopia. After training, there were 8 cases (15 eyes) with improvement in BCVA for ametropic amblyopia, 10 cases (11 eyes) for strabismus amblyopia, 6 cases (8 eyes) for form deprivation amblyopia, accounting for 83.3% (15/18), 78.6% (11/14), 66.7% (8/12), respectively. The BCVA of patients for 43 cases (43 eyes) with anisometropic amblyopia before and after training was 0.50 (0.16, 0.70), 0.70 (0.50, 0.90), respectively. After training, the BCVA increased compared to before training, and the difference was statistically significant (Z=5.106, P<0.05). There were 2 cases (4 eyes) of other patients with concomitant nystagmus, which were not analyzed separately. The correlation analysis between the increase in BCVA and the age of all patients, the baseline BCVA showed a negative correlation (r=-0.350, -0.396; P<0.05); the number of training sessions was positively correlated with the increase in BCVA (r=0.480, P<0.05).

Conclusions

Visual perception learning therapy based on Gabor visual standard can improve BCVA of amblyopia in patients with refractory amblyopia. However, for different types of refractory amblyopia, the average improvement and treatment effectiveness is various. Patients with younger the age during training, the lower the baseline BCVA, and the more training times, show the higher the improvement in BCVA after training.

Key words: Visual perception learning, Refractory amblyopia, Best corrected visual acuity, Gobar visual standard, Lateral masking

Yu Tang, Hongwei Deng, Zhengyang Tao, Zongyue Lyn. Clinical observation of visual perception learning based on Gobar visual standard in the treatment of refractory amblyopia[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2023, 13(03): 134-139.

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