Comparative Effectiveness of Gamified Binocular Treatment Versus Conventional Patching for Amblyopia: A Randomized Clinical Trial

Ying Chen^1*Yuzhen Chen²Xiao Han²Zijian Yang^1*

• ¹Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
• ²Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghai, China

The authors would like to extend their sincere gratitude to Sunshine Rehabilitation Center, Tongji University for its invaluable support and collaboration throughout this study. We are especially grateful for the clinical insights and technical expertise provided by the hospital's team, which were instrumental to the success of this research.Special thanks are also due to Ting-Chun Liao for his dedication and contribution in the development and completion of this work included data collection.Introduction: Amblyopia, a prevalent visual disorder in children, leading to deficits in visual acuity, stereoacuity, and daily functioning. Conventional treatments like eye patching often encounter adherence challenges and relapse, especially in younger patients. This study investigates the effectiveness of a home-based, gamified binocular therapy (GBT), compared with traditional patching in East Asian children.Methods: A randomized controlled trial was conducted with 42 participants aged 4-8 years diagnosed with amblyopia from Sunshine Rehabilitation Center, Shanghai. Participants were randomly assigned to the GBT (n=20) or the patching group (n=22). Visual acuity (VA) and stereoacuity improvements were assessed at baseline, 1, 3, and 6 months.Results: Both groups demonstrated significant VA and stereoacuity improvements from baseline from 1 months.GBT participants exhibited faster initial VA improvement, with significant gains at 1 month compared to patching (mean difference = 0.072 logarithm of the minimum angle of resolution[logMAR], p = 0.0029). By 6 months, both groups showed similar improvements in VA (GBT: 0.19 ± 0.10 logMAR; Patching: 0.23 ± 0.16; p = 0.156) and stereoacuity (GBT: 0.95 ± 0.76 log arcseconds; Patching: 0.82 ± 0.59; p = 0.712). No significant adverse events were reported in either group.Conclusions: The study indicates that GBT is as effective as patching in improving amblyopic visual outcomes among East Asian children 4 to 8 years of age. These findings suggest that gamified binocular therapy could play an important role in personalized amblyopia treatment, with further studies needed to confirm long-term effects across diverse populations.