Baseline and outcome stereoacuity of children with anisometropic amblyopia undergoing dichoptic amblyopia treatment.

Background: One rationale for dichoptic amblyopia therapy is that it may promote recovery of binocular function. Yet data on binocular outcomes in anisometropic amblyopia following dichoptic therapy are sparse. We report factors associated with pre- and post-treatment binocular function in anisometropic amblyopia, and examine binocular function in children who recover normal visual acuity compared to those with residual amblyopia.

Methods: Baseline and outcome stereoacuity and binocular function (BF) scores were pooled across 185 children (3-12 years of age) with anisometropic amblyopia who participated in one of eight clinical trials of contrast-rebalanced dichoptic amblyopia treatment conducted at a single site. Associations of baseline variables (visual acuity, suppression, type and amount of anisometropia, prior treatment) with baseline and outcome stereoacuity and BF scores were analyzed, as well the association between improvement in visual acuity with improvement in stereoacuity and BF scores.

Results: Better baseline stereoacuity and BF score were associated with better baseline visual acuity, less baseline suppression, less anisometropia, and anisometropia due to astigmatism. Better outcome stereoacuity and BF score were associated with better baseline stereoacuity and BF score, more improvement in visual acuity, less anisometropia, and anisometropia due to astigmatism. Children aged 3-6 years who recovered normal visual acuity with dichoptic treatment had better stereoacuity and BF score outcomes than those with residual amblyopia.

Conclusions: Dichoptic therapy is an effective amblyopia treatment. Although there was no substantive advantage in promoting binocular function, stereoacuity outcomes were similar to those previously reported for patching and Bangerter filters.