Outcomes of binocular treatment using a Bangerter occlusion film and computer games in patients with intractable unilateral amblyopia
PURPOSE: To report outcomes following binocular treatment using a Bangerter occlusion filter (BF) and computer games in patients with intractable amblyopia. METHODS: Eight patients (4 boys, mean ± SD age: 8.0 ± 0.8 years) with unilateral amblyopia that did not respond to conventional treatments were studied. They were instructed to play action games for one hour a day while wearing spectacles with an adequate level of BF in front of the non-amblyopic eye so that the visual input became the same between the two eyes. They continued this exercise for eight weeks, and we assessed their visual acuity and spatial sensitivity at baseline, and at 4- and 8-week visits. To confirm the maintenance of efficacy after the treatment, we assessed them again at a 12-week visit. RESULTS: The mean log MAR at distance improved from 0.32 to 0.24 at the 4-week visit (p < 0.05), and appeared to continue up to eight weeks, but returned to the baseline level at the 12-week visit (four weeks after terminating the treatment). There was no significant improvement in the mean log MAR at near. Contrast sensitivity significantly improved only at three cycles/degree (p < 0.05), and this effect persisted until the 12-week visit. The distance log MAR at the 12-week visit had a significant correlation with the strength of suppression for the amblyopic eye at baseline (r = 0.71, p < 0.05). CONCLUSIONS: Binocular treatment improved visual function only in terms of contrast sensitivity at low spatial frequency. Patients who have weak suppression may gain some benefit from this treatment.