Active treatment of patients with amblyopia: meta-analysis and systematic bibliographic review

Abstract

PURPOSE: The aim of the study was evaluation of the scientific evidence about the efficacy of the active treatments dichoptic training, perceptual learning and video gaming in children, teenagers and adult with amblyopia by performing a meta-analysis and systematic bibliographic review.. METHODOLOGY: A search in the online databases PubMed, ScienceDirect, Scopus and Google Scholar, of 2517 publications 22 papers were selected that met our inclusion criteria. We included randomized controlled trials, cohort, case-control, or nonrandomized studies of intervention. A meta‐analysis was performed to determine effect sizes and the heterogeneity thereof. Meta‐regression was used to evaluate the contribution of the possible moderating factors of age, duration of active treatment, and initial visual acuity to the heterogeneity of the studies. RESULTS: Active treatments of amblyopia resulted in a moderate positive effect size of 0.15 logMAR (95% confidence interval 0.10 to 0.20) mean improvement on visual acuity, although the heterogeneity was very significant (Q = 510.99, I2 = 95%, p = .0000). Meta‐regression indicated that effect sizes were not influenced by age, that effect size increased with treatment duration, and that worst initial visual acuity was associated with higher effect sizes. CONCLUSIONS: Our meta-analysis founded a significant moderate evidence for the successful management of amblyopia with active treatments. Further robust clinical trials on these active treatments are still warranted to establish their role in treating amblyopia