Breaking News
January 18, 2019 - Let’s map our DNA and save billions each year in health costs
January 18, 2019 - AI demonstrates potential to identify irregular heart rhythms as well as humans
January 17, 2019 - Study shows link between air pollution and increased risk of sleep apnea
January 17, 2019 - Neck-strengthening exercises can protect athletes from concussions
January 17, 2019 - Computer model shows how to better control MRSA outbreaks
January 17, 2019 - Pain is unpleasant, and now scientists have identified the set of responsible neurons
January 17, 2019 - CUIMC Celebrates 2018-2019
January 17, 2019 - Study reveals potential pathway for endothelial cells to avoid apoptosis
January 17, 2019 - Hamilton Storage launches LabElite DeCapper SL to expand LabElite product family
January 17, 2019 - Location of epigenetic changes co-locate with genetic signal causing psychartric disorder
January 17, 2019 - Researchers awarded 6.1 million euros to address female fertility problems
January 17, 2019 - Counseling appointments fail to reduce weight gain during pregnancy, shows study
January 17, 2019 - Contraceptive patch that could provide 6 months of contraception within seconds
January 17, 2019 - Yeast model may pave way for development of novel therapies for metabolic disorders
January 17, 2019 - Study determines impact of antibiotic perturbation of the gut microbiome on skeletal health
January 17, 2019 - Cardiometabolic Risk Up With Tourette, Chronic Tic Disorder
January 17, 2019 - Hong Kong scientists claim ‘broad-spectrum’ antiviral breakthrough
January 17, 2019 - Researchers discover the brain cells that make pain unpleasant | News Center
January 17, 2019 - Hepatitis Is Common in New Cancer Patients
January 17, 2019 - Podcast: KHN’s ‘What The Health?’ Drug Prices Are Rising Again. Is Someone Going To Do Something About It?
January 17, 2019 - Smoking significantly increases your biological age, study shows
January 17, 2019 - B-group vitamins may be beneficial for people with first episode psychosis
January 17, 2019 - Researchers demonstrate how manganese produces parkinsonian syndrome
January 17, 2019 - Researchers suggest link between personality type and attitude towards others’ bodies
January 17, 2019 - Mutant mice administered with cocaine failed to exhibit hyperactivity, shows study
January 17, 2019 - Health Tip: Understanding a Heart Murmur
January 17, 2019 - Gut protein mutations shield against spikes in glucose
January 17, 2019 - Engineered immune cells target broad range of pediatric solid tumors in mice | News Center
January 17, 2019 - Study finds link between high pesticide exposure and poor sense of smell among farmers
January 17, 2019 - Many cancer patients have undiagnosed hepatitis
January 17, 2019 - New study finds only 13% of outpatient antibiotic prescriptions to be appropriate
January 17, 2019 - Stem cell-based approach to diabetes offers hope for treatment
January 17, 2019 - New project receives €8.65 million from EU and Canada to ease genomic, health data sharing
January 17, 2019 - Improvements in pharmacological study to fight cognitive impairment in schizophrenia
January 17, 2019 - Study looks at trends over time in oral antibiotic prescribing by dermatologists
January 17, 2019 - Most substance use disorder treatment facilities do not offer medication treatment
January 17, 2019 - Multiple sclerosis could benefit from stem cell therapy
January 17, 2019 - Researchers manipulate T cells to improve transplant success
January 17, 2019 - Put away your rulers and reach for your phone
January 17, 2019 - Mindfulness linked with fewer menopausal symptoms
January 17, 2019 - Integrated care to women with PMADs offered at several levels
January 17, 2019 - Researchers identify MANF as a rejuvenating factor in parabiosis
January 17, 2019 - Truncal mutations study suggests new direction in origins of cancer
January 17, 2019 - Beckman Coulter launches new ClearLLab 10C System for clinical flow cytometry lab
January 17, 2019 - Effects of linoleic acid on the body are largely dependent on genes, shows study
January 17, 2019 - Pre-injury exercise reduces damage to both muscles and nerves, study finds
January 17, 2019 - Minimizing Antibody Size to Maximize Research Potential
January 17, 2019 - Research finds large genome in tiny forest defoliator
January 17, 2019 - Technology helps reduce the yearning for unhealthy food
January 17, 2019 - Imec develops prototype cardiovascular device
January 17, 2019 - New Drug Application for Insomnia Disorder Treatment Lemborexant Submitted in the United States
January 17, 2019 - What you should know about teeth whitening
January 17, 2019 - Why Older Adults Should Eat More Protein (And Not Overdo Protein Shakes)
January 17, 2019 - Colorectal cancer mortality rates predicted to increase globally
January 17, 2019 - Scientists discover mutational signatures of tumor hypoxia
January 17, 2019 - New evidence shows how fever alters immune cells
January 17, 2019 - Researchers find new class of blood pressure-regulating peptides in vampire bat venom
January 17, 2019 - Promega to exhibit new Maxwell RSC48 platform at 2019 Festival of Genomics
January 17, 2019 - Study pinpoints immune cells that could be key to tackling hypertension
January 17, 2019 - Couples Intervention May Aid Partners of Diabetes Patients
January 17, 2019 - Your weight history may predict your heart failure risk
January 17, 2019 - Explore a cornucopia of accomplishments in prematurity research
January 17, 2019 - New study identifies four characteristics that predict severity of postpartum depression
January 17, 2019 - AHF urges United Nations to follow own mandate for protecting Ebola response efforts
January 17, 2019 - New, scalpel-free treatment for reducing Parkinson’s tremor gets FDA approval
January 17, 2019 - Neurobiologists uncover key component of how the human brain marks time
January 17, 2019 - LifeTime receives fund to develop a plan to embed its vision for healthier future
January 17, 2019 - WTC first responders at higher risk for head and neck cancers, study finds
January 17, 2019 - New NSF funded study may help physicians decrease brain injury deaths
January 17, 2019 - Ham bones contain peptides that could have cardioprotective effects
January 17, 2019 - Research finds how Candida albicans adapt to low oxygen levels to cause infection
January 17, 2019 - Cobra Biologics announces appointment of Dr Darrell Sleep as Director of Innovation
January 17, 2019 - Cellular protein that interacts with viruses appears to enable infection process of Zika virus
January 17, 2019 - Opioids Now More Deadly for Americans Than Traffic Accidents
January 17, 2019 - Women who start periods early are at greater risk of cardiovascular problems
January 17, 2019 - The brain-circuitry clash that keeps you from diving into that plate of ribs when you’re dining with royalty
January 17, 2019 - Poo transplant can successfully treat patients with ulcerative colitis
January 17, 2019 - Study suggests key role for glial cells in Parkinson’s disease
January 17, 2019 - Educational videos in clinical settings increase HPV vaccination rates among adolescents
January 17, 2019 - Better understanding of aggressive brain tumour
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