Abstract
BACKGROUND: Visual training based on perceptual learning and dichoptic stimulation has been developed for amblyopic treatment. However, reports on virtual reality-assisted (VR) training for amblyopia are limited. The aim of this study was to evaluate the effects of VR training and compare the visual outcomes of different treatments in children with bilateral refractive amblyopia. METHODS: Children aged 4-8 years with a best-corrected visual acuity (BCVA) less than 20/25 were included. All of the patients had worn glasses for at least 2 months before enrollment. At enrollment, age, gender, refractive status, baseline BCVA, and amblyopia severity were recorded. The treatment outcomes were evaluated in terms of BCVA at 24 weeks, the change in BCVA from baseline to 24 weeks, and the time taken to achieve treatment success (BCVA ≥ 20/25). RESULTS: The longitudinal study included 30 patients in the Cambridge Visual Stimulator (CAM) training group, 14 in the VR training group, and 26 in the control group (glasses only). Among patients with an initial BCVA between 20/100 and 20/40, a significantly higher proportion of those in the VR training group achieved treatment success compared to the control group (p = 0.022). Among those who achieved treatment success, the time taken to achieve success was significantly shorter in the CAM and VR training groups compared to the control group (p < 0.001). CONCLUSIONS: Visual training can shorten the time taken to achieve treatment success compared to glasses alone. While VR training seems more effective than CAM training, both are valuable strategies for amblyopic children who respond poorly to glasses alone.