Dichoptic video game play has become an increasingly popular treatment for moderate to severe amblyopia, with a new pilot study suggesting individuals with mild forms of this condition can also benefit from this approach, with noted improvements seen in distance visual (DVA) and stereo acuity.

The single-masked study included 23 patients who either played an anaglyphic, contrast-balanced dichoptic video game or an identical non-dichoptic game that served as a placebo. The primary outcome was change in amblyopic DVA at six weeks, with near VA, stereo acuity and fixation stability also under analysis. The investigators conducted follow-ups at 12 and 24 weeks.

The researchers observed mean amblyopic DVA of 0.21 logMAR and 0.18 logMAR for the active and placebo groups, respectively. They noted that amblyopic DVA improved significantly more in the active group (0.09 logMAR) than in the placebo group (0.03 logMAR). This difference between groups remained at 12 weeks but not at the 24-week follow-up. The researchers speculated that this was not due to a regression effect in the active group, but rather a gradual improvement in the placebo group.

After six weeks of gameplay, researchers found that stereo acuities had significantly improved in the active group (0.40 log arcsec) vs. the placebo group (0.09 log arcsec). They noted that this finding remained consistent at 24 weeks, but they didn’t find differences between the groups on any of the secondary outcomes.

The study’s sample size was much smaller compared with recent randomized clinical trials, and its results suggest that stricter DVA stability criteria and a longer optical treatment period are required for participants with mild amblyopia, as visual acuity improvements may be particularly gradual in this group, the investigators concluded.

Pang PCK, Lam CSY, Hess RF, et al. Effect of dichoptic video game treatment on mild amblyopia—a pilot study. Acta Ophthlmologica. September 30, 2020. [Epub ahead of print].