ORCID Profile
0000-0001-7077-3226
Current Organisation
The University of Auckland
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Publisher: Wiley
Date: 22-01-2018
DOI: 10.1111/OPO.12437
Abstract: Optical treatment alone can improve visual acuity ( VA ) in children with amblyopia, thus clinical trials investigating additional amblyopia therapies (such as patching or videogames) for children require a preceding optical treatment phase. Emerging therapies for adult patients are entering clinical trials. It is unknown whether optical treatment is effective for adults with amblyopia and whether an optical correction phase is required for trials involving adults. We examined participants who underwent optical treatment in the Binocular Treatment for Amblyopia using Videogames ( BRAVO ) clinical trial ( ANZCTR ID : ACTRN 12613001004752). Participants were recruited in three age groups (7 to 12, 13 to 17, or ≥18 years), and had unilateral amblyopia due to anisometropia and/or strabismus, with amblyopic eye VA of 0.30–1.00 log MAR (6/12 to 6/60, 20/40 to 20/200). Corrective lenses were prescribed based on cycloplegic refraction to fully correct any anisometropia. VA was assessed using the electronic visual acuity testing algorithm (e‐ ETDRS ) test and near stereoacuity was assessed using the Randot Preschool Test. Participants were assessed every four weeks up to 16 weeks, until either VA was stable or until amblyopic eye VA improved to better than 0.30 log MAR , rendering the participant ineligible for the trial. Eighty participants (mean age 24.6 years, range 7.6–55.5 years) completed four to 16 weeks of optical treatment. A small but statistically significant mean improvement in amblyopic eye VA of 0.05 log MAR was observed ( S.D. 0.08 log MAR paired t ‐test p 0.0001). Twenty‐five participants (31%) improved by ≥1 log MAR line and of these, seven (9%) improved by ≥2 log MAR lines. Stereoacuity improved in 15 participants (19%). Visual improvements were not associated with age, presence of strabismus, or prior occlusion treatment. Two adult participants withdrew due to intolerance to anisometropic correction. Sixteen out of 80 participants (20%) achieved better than 0.30 log MAR VA in the amblyopic eye after optical treatment. Nine of these participants attended additional follow‐up and four (44%) showed further VA improvements. Improvements from optical treatment resulted in one‐fifth of participants becoming ineligible for the main clinical trial. Studies investigating additional amblyopia therapies must include an appropriate optical treatment only phase and/or parallel treatment group regardless of patient age. Optical treatment of amblyopia in adult patients warrants further investigation.
Publisher: Informa UK Limited
Date: 03-2021
Publisher: Springer Science and Business Media LLC
Date: 18-02-2025
Publisher: Cold Spring Harbor Laboratory
Date: 26-05-2020
DOI: 10.1101/2020.05.25.20113126
Abstract: Home-based videogame treatments are increasingly being used for various sensory conditions, including amblyopia (“lazy eye”), but adherence continues to limit success. To examine detailed behavioral patterns associated with home-based videogame treatment, we analyzed in detail the videogame adherence data from the B inocular t reatment of a mblyopia with v ide o games (BRAVO) clinical trial (ACTRN12613001004752). Children (7-12 years), Teenagers (13-17 years) and Adults (≥18 years) with unilateral amblyopia were loaned iPod Touch devices with either an active treatment or placebo videogame and instructed to play for 1-2 hours/day for six weeks at home. Objectively-recorded adherence data from device software were used to analyze adherence patterns such as session length, daily distribution of gameplay, use of the pause function, and differences between age groups. Objectively-recorded adherence was also compared to subjectively-reported adherence from paper-based diaries. 105 of the 115 randomized participants completed six weeks of videogame training. Average adherence was 65% (SD 37%) of the minimum hours prescribed. Game training was generally performed in short sessions (mean 21.5, SD 11.2 minutes), mostly in the evening, with frequent pauses (median every 4.1 minutes, IQR 6.1). Children played in significantly shorter sessions and paused more frequently than older age groups (p .0001). Participants tended to over-report adherence in subjective diaries compared to objectively-recorded gameplay time. Adherence to home-based videogame treatment was characterized by short sessions interspersed with frequent pauses, suggesting regular disengagement. This complicates dose-response calculations and may interfere with the effectiveness of treatments like binocular treatments for amblyopia, which require sustained visual stimulation. ACTRN12613001004752
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 19-11-2018
Abstract: Suppression in amblyopia may be an unequal form of normal interocular suppression or a distinct pathophysiology. To explore this issue, we examined the orientation tuning and contrast dependence of continuous flash suppression (CFS) in adults with amblyopia and visually normal controls. Nine patients (mean age, 26.9 ± SD 4.7 years) and 11 controls (mean age, 24.8 ± SD 5.3 years) participated. In the CFS paradigm, spatially one-dimensional noise refreshing at 10 Hz was displayed in one eye to induce suppression of the other eye, and suppression strength was measured by using a grating contrast increment detection task. In experiment 1, noise contrast was fixed and the orientation difference between the noise and the grating was varied. In experiment 2, noise and grating orientations were identical and noise contrast was varied. Suppression patterns varied in both groups. In experiment 1, controls showed consistently orientation-tuned CFS (mean half-height bandwidth, 35.8° ± SD 21.5°) with near-equal strength between eyes. Five of nine patients with amblyopia exhibited orientation-independent CFS. Eight patients had markedly unequal suppression between eyes. Experiment 2 found that increasing the noise contrast to the amblyopic eye may produce suppression of the fellow eye, but suppression remained unequal between eyes. Our data revealed that orientation specificity in CFS was very broad or absent in some patients with amblyopia, which could not be predicted by clinical measures. Suppression was unbalanced across the entire contrast range for most patients. This suggests that abnormal early visual experience disrupts the development of interocular suppression mechanisms.
Publisher: Informa UK Limited
Date: 07-2017
DOI: 10.1111/CXO.12457
Publisher: American Medical Association (AMA)
Date: 02-2018
No related grants have been discovered for Tina Gao.