Breaking News
October 20, 2018 - Antidepressant treatment may lead to improvements in sleep quality of patients with depression
October 20, 2018 - Study reports increased risk of death in children with inflammatory bowel disease
October 20, 2018 - Number of Autism Genes Now Tops 100
October 20, 2018 - Total diet replacement programmes are effective for treating obesity
October 20, 2018 - CLARIOstar used for fluorescence measurements on CSIRO’s purpose-built research vessel
October 20, 2018 - People with more copies of AMY1 gene digest starchy carbohydrates faster
October 20, 2018 - Case Comprehensive Cancer Center wins NIH grant to study health disparities
October 20, 2018 - Newly discovered compound shows potential for treating Parkinson’s disease
October 20, 2018 - High rate of non-adherence to hormonal therapy found among premenopausal early breast cancer patients
October 20, 2018 - Immunotherapy medicine found to be effective in treating uveitis
October 20, 2018 - The Pistoia Alliance Calls for Greater Collaboration to Realise Benefits of Innovation and Announces Winners of the 2018 President’s Startup Challenge
October 20, 2018 - Female internists consistently earn less than men
October 20, 2018 - Stanford team looks at dangers of teens’ vaping habits
October 20, 2018 - New approach to understanding cancers will accelerate development of better treatments
October 20, 2018 - LJI and UC San Diego awarded $ 4.5 million as part of NCI’s Cancer Moonshot initiative
October 20, 2018 - School-based HPV vaccination did not increase risky sexual behaviors among adolescent girls
October 20, 2018 - Eye discovery to pave way for more successful corneal transplants
October 20, 2018 - New analysis examines the importance of location in the opioid crisis
October 20, 2018 - Green filters increase reading speed for children with dyslexia
October 19, 2018 - Bariatric Sx Cuts Macrovascular Complications in Obesity, T2DM
October 19, 2018 - Better assessments for early age-related macular degeneration
October 19, 2018 - Visible and valued: Stanford Medicine’s first-ever LGBTQ+ Forum | News Center
October 19, 2018 - Understanding of metal-free enzymes used by bacteria could lead to new effective antibiotics
October 19, 2018 - Beckman Coulter Life Sciences announces new research-focused website
October 19, 2018 - Study finds link between refined soluble fibers, gut microbiota and liver cancer
October 19, 2018 - Social media reduces risk of depression among seniors with pain
October 19, 2018 - Newly developed synthetic DNA molecule may one day be used as ‘vaccine’ for prostate cancer
October 19, 2018 - Preoperative weight loss may not provide health benefits after surgery
October 19, 2018 - U.S. Birth Rates Continue to Drop as Age of New Moms Rises
October 19, 2018 - New technology can keep an eye on babies’ movements in the womb
October 19, 2018 - Juul e-cigarettes pose addiction risk for young users | News Center
October 19, 2018 - Gene sequencing reveals crucial molecular aspects of Trypanosoma brucei
October 19, 2018 - New DNA vaccine strategy protects mice against lethal challenge by multiple H3N2 viruses
October 19, 2018 - Study shows close link between cytokine interleukin-1ß and obesity-promoted colon cancer
October 19, 2018 - Muscle mass plays a critical role in health, shows research
October 19, 2018 - Study finds undiagnosed prediabetes in many infertile men
October 19, 2018 - The Current issue of “The view from here” is concerned with Nanotherapeutic strategies
October 19, 2018 - Delay in replacing the Pap smear with HPV screening is costing lives
October 19, 2018 - Physicians battle pediatric diseases of ear, nose, throat in Zimbabwe | News Center
October 19, 2018 - Researchers investigate why some cancers affect only young women
October 19, 2018 - Drugmakers funnel millions to lawmakers; a few dozen get $100,000-plus
October 19, 2018 - Unselfish people tend to have more children and receive higher salaries
October 19, 2018 - New findings reveal potential cellular players in tumor microenvironment
October 19, 2018 - Some countries take more time for reimbursement decisions on new cancer drugs
October 19, 2018 - Human brain cell transplant offers insights into neurological conditions
October 19, 2018 - Parental education associated with increased family health care spending
October 19, 2018 - New statistical method estimates long- and short-term risk of recurrence of breast cancer in US women
October 19, 2018 - Father’s exposure to nicotine may cause cognitive deficits in descendants
October 19, 2018 - Could we prevent Alzheimer’s disease by treating herpes?
October 19, 2018 - Nurse-led care can be more successful in managing gout
October 19, 2018 - Trump administration, pharma exchange verbal volleys on drug-price transparency
October 19, 2018 - Duke researchers find way to detect blood doping in athletes
October 19, 2018 - Many primary care doctors are still prescribing sedative drugs for older adults
October 19, 2018 - Finger length can predict sexuality in women say researchers
October 19, 2018 - Study finds differences in side-effects experienced by male and female OG cancer patients
October 19, 2018 - Dysfunction of single gene leads to miscarriages
October 19, 2018 - Few Seniors Who Self-Harm Referred for Mental Health Care
October 19, 2018 - Don’t sweat the sweet stuff
October 19, 2018 - URMC researchers discover new approach to deliver therapeutics to the brain
October 19, 2018 - Speech Pathology Australia raises awareness about Developmental Language Disorder
October 19, 2018 - Middlemen suppliers can increase drug prices and hospital bills, say Johns Hopkins researchers
October 19, 2018 - Survey finds high prevalence of HTLV-1 infection among teens and adults in Gabon
October 19, 2018 - Bliss funds research to find whether parental touch can help alleviate pain in premature infants
October 19, 2018 - Human neurons employ highly compartmentalized signaling, study shows
October 19, 2018 - Ultromics expands multiple clinical trials for coronary heart disease to the U.S.
October 19, 2018 - $11 million NIH grant for Clemson University helps launch new center for musculoskeletal research
October 19, 2018 - A new approach identified to control Zika virus, dengue fever
October 19, 2018 - Head Blows Without Concussion May Not Damage Brain, Study Claims
October 19, 2018 - US opioid use not declined, despite focus on abuse and awareness of risk
October 19, 2018 - Next-generation RNA sequencing technology sheds new light on human mitochondrial diseases
October 19, 2018 - UT Southwestern biochemist receives 2019 Breakthrough Prize in Life Sciences for innate immunity discovery
October 19, 2018 - The immune system also plays a key role in day-to-day function of healthy organs
October 19, 2018 - New tool may reveal how the brain structure impacts brain activity, human behavior
October 19, 2018 - Trump Administration announces ‘Winning on Reducing Food Waste’ initiative
October 19, 2018 - For-profit nursing home residents more likely to experience health issues caused by substandard care
October 19, 2018 - Incidence of stroke has risen steadily among marijuana users, show studies
October 19, 2018 - Conceptual framework proposed to examine role of exercise in multiple sclerosis
October 19, 2018 - Near infrared spectroscopy technique for accurate evaluation of chondral injuries
October 19, 2018 - Scientists receive $5.1 million grant to develop stem cell-based therapy for blinding retinal conditions
October 19, 2018 - Shorter physician encounters associated with antibiotic prescribing
Binocular Video Game Tx Disappoints in ‘Lazy Eye’ Trial

Binocular Video Game Tx Disappoints in ‘Lazy Eye’ Trial

image_pdfDownload PDFimage_print

Action Points

  • In difficult-to-treat amblyopia (“lazy eye”) among older children, teenagers, and adults, binocular video game treatment proved to be no more effective than treatment with a placebo video game in a randomized clinical trial.
  • Note that while adherence to the active video game treatment was poor in this study and in an earlier pediatric trial, improved outcomes may be possible with more interesting video games.

Binocular treatment incorporating a therapeutic Tetris-like video game proved to be no more effective than treatment with a placebo video game among older children, teenagers, and adults with difficult-to-treat amblyopia, Canadian researchers reported.

The home-based binocular modified falling-blocks video game used in the trial appeared to have no significant impact on visual function in study participants with the visual disorder, widely known as “lazy eye.” Mean amblyopic eye visual acuity improved 0.06 (SD 0.12) logMAR from baseline in the active group (n=56) and 0.07 (SD 0.10) logMAR in the placebo group (n=59), according to Benjamin Thompson, PhD, of the University of Waterloo in Waterloo, Ontario, and colleagues.

Adherence to the active falling-block video game treatment was poor in this study, and the 2016 Pediatric Eye Disease Investigator Group (PEDIG) trial, but improved outcomes may be possible with more interesting video games, they suggested in JAMA Ophthalmology.

The current Binocular Treatment of Amblyopia Using Video Games (BRAVO) trial and PEDIG trial showed no significant benefit for the binocular approach to treating amblyopia, Thompson’s group noted.

“Future development of more engaging video games, more sophisticated means of monitoring compliance and attention, and proven effectiveness in randomized clinical trials are required before binocular treatments are ready for use,” they wrote.

Both the active and placebo treatments in the BRAVO trial were falling-blocks video games on Apple iPod Touch devices viewed through red-green anaglyphic glasses worn over refractive correction.

The active video game showed different game elements to each eye, with the amblyopic eye shown a subset of game elements at 100% contrast, while the non-amblyopic eye was shown remaining game elements at a lower contrast set individually using a dichoptic global motion measure of interocular suppression.

“Where participants could not reliably perform this test, fellow eye contrast was manually set to allow simultaneous perception of all game elements during binocular viewing,” the researchers wrote. “Binocular combination was required to successfully play the active video game. Fellow eye contrast increased proportionally by 15% each day if the game was played for at least 15 minutes and a high score of at least 1,000 points was achieved the previous day.”

The placebo game presented all game elements to both eyes at full contrast, simulating a normal video game experience.

The multicenter, double-masked, randomized clinical trial involved 115 participants who were ages ≥7 years with unilateral amblyopia.

The trial design specified that the falling-blocks video game was to be played at home for 1 hour a day for 6 weeks. Change in amblyopic eye visual acuity at 6 weeks was the main measured outcome, while secondary outcomes included compliance, stereoacuity, and interocular suppression.

Of the 115 included participants, 65 (56.5%) were male and 83 (72.2%) were white, and mean age at randomization was 21.5 years.

The authors also reported that mean treatment difference between groups, adjusted for baseline visual acuity and age group, was −0.02 logMAR (95% CI −0.06 to 0.02, P=0.25).

Compliance with more than 25% of prescribed game play was achieved by 36 participants (64%) in the active group and by 49 (83%) in the placebo group.

At 6 weeks, 36 participants (64%) in the active group achieved fellow eye contrast greater than 0.9 in the binocular video game. No group differences were observed for any secondary outcomes and adverse effects included three reports of transient eye strain.

The researchers noted that compliance fell in weeks 4 to 6, compared with weeks 1 to 3 of treatment, with some participants stating declining interest in the falling-blocks video game during follow-up.

“More engaging content, along with greater game play variety, will help to maintain compliance and attentional engagement over longer treatment periods,” the researchers wrote, adding that the recently developed prescription game DigRush (Amblyotech) may offer a more exciting experience, leading to better compliance.

A randomized trial conducted by the PEDIG investigators comparing DigRush plus spectacle correction with spectacle correction alone in young children began recruitment in early 2017.

In an accompanying commentary, Jonathan Holmes, BM, BCh, of the Mayo Clinic in Rochester, Minnesota, noted that adherence to treatment with the DigRush does appear to be better than with the game used in the BRAVO trial.

“The forthcoming PEDIG randomized clinical trial will provide additional data to answer the question. Is there a dose-response relationship between duration of binocular treatment and improvement in amblyopic eye visual acuity?,” Holmes wrote, adding that, “A positive answer to this question would support the use of binocular treatment for amblyopia.”

The study was funded by the Health Research Council of New Zealand, the Hong Kong Health and Medical Research Fund, and the Victoria government.

Thompson and one co-author disclosed being inventors on two patents that cover the binocular video game treatment used in the trial. One co-author disclosed a relevant relationship with Amblyotech.

Holmes disclosed a relevant relationship with PEDIG.


Tagged with:

About author

Related Articles