Dichoptic virtual reality training for treatment of amblyopia

ISRCTN ISRCTN62086471
DOI https://doi.org/10.1186/ISRCTN62086471
Secondary identifying numbers DVR1
Submission date
05/06/2017
Registration date
13/06/2017
Last edited
26/11/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Eye Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Anisometropic amblyopia occurs when there is an unequal focus between the eyes. It causes a reduction of the best corrected visual acuity (best distance vision) of the eye without an cause. This condition can lead to permanent vision loss in one eye and limit the vision with both eyes. The main treatments in amblyopia are for children and involve wearing an eye patch over one eye to strengthen the other eye. This treatment is thought to be only effective in the first years of life. A new method of treatment for amblyopia based on the use of a dichoptic (presenting independent and not coordinated stimulus to the eyes) games in a virtual reality environment could help amblyopia for those who are not children. This type of treatment is promising as is non-invasive, without risks associated and motivating for patient as it consists of a game. The aim of this study is to evaluate the effect of dichoptic visual training using a virtual reality head mounted display in a sample of anisometropic amblyopic adults and to evaluate the potential usefulness of this option of treatment.

Who can participate?
Adults aged 17 and older who have anisometropic amblyopia

What does the study involve?
Participants undergo an eye examine prior to the training. Participants receive dichoptic visual training using computer games and a wearable virtual reality system. Participants attend two training sessions a week for one month. Training sessions take 40 minutes and include two different types of games. Participants are followed up for stereopsis (the perception of depth) and visual acuity after their last training session and again three months later.

What are the possible benefits and risks of participating?
There are no notable benefits or risks with participating.

Where is the study run from?
1. Commenius University (Slovakia)
2. University of Alicante (Spain)

When is the study starting and how long is it expected to run for?
May 2016 to October 2016

Who is funding the study?
University of Alicante (Spain)

Who is the main contact?
Dr David Pablo Pinero

Contact information

Dr David Pablo Pinero
Scientific

Department of Optics
Pharmacology and Anatomy
University of Alicante
Crta San Vicente del Raspeig s/n
San Vicente del Raspeig
03690
Spain

Study information

Study designProspective interventional non randomised pilot study
Primary study designInterventional
Secondary study designNon randomised study
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet’
Scientific titleAmblyopia treatment of adults with Dichoptic training using the Virtual Reality oculus rift head mounted display: Preliminary results
Study acronymDVR
Study hypothesisDichoptic visual training using a virtual reality head mounted display is able to restore visual acuity and stereopsis in adults with anisometropic amblyopia.
Ethics approval(s)Ethics Committe of Jessenius Medical School Commenius University, 08/03/2016, ref: EK 1795/2016
ConditionAnisometropic amblyopia
InterventionParticipants all undergo a baseline ophthalmological examination including visual testing, manifest and cycloplegic refraction, cover test, four dot Worth test, anterior segment examination with the slit lamp, corneal topography and funduscopy.

Participants then undergo a dichoptic visual training was performed using the beta version of the computer game Diplopia Game which was run in the Oculus Rift OC DK2 virtual reality head mounted display. Two games are used, a space game in which subjects were flying spaceship through a system of rings and a breaker game which is a typical block breaker game, but played in a virtual reality 3D setting. Both games had a dichoptic setting in which the central part of the picture was different for each eye.

Each participant undergoes eight training sessions, being performed twice a week. Each session included 40 minutes of training with the two different games (20 minutes per game). This takes one month.

Stereopsis and visual acuity were tested after finishing the last session of training (one month after beginning the training) and three months after the end of training.
Intervention typeDevice
Pharmaceutical study type(s)
Phase
Drug / device / biological / vaccine name(s)
Primary outcome measure1. Visual acuity is measured using calibrated liquid crystal display (LCD) optotype with Snellen charts (CC-X10, Topcon, Japan) at baseline, one and three months
2. Stereopsis is measured using the Stereo Randot graded circle test (Stereo Optical, IL, USA) at baseline, one and three months
Secondary outcome measures1. Compliance is measured using the computer registration of the training sessions at one month
2. Refraction is measured using retinoscopy and subjective refraction in trial frame at baseline, one and three months
Overall study start date10/05/2016
Overall study end date10/10/2016

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participants17
Total final enrolment17
Participant inclusion criteria1. Anisometropic amblyopia
2. Age of 17 years old or more
3. Willing to perform the visual training
Participant exclusion criteria1. Strabismus
2. Previous ocular surgery
3. Corneal irregularity
4. Opacification of ocular media including cataracts
5. Active ocular disease
Recruitment start date09/03/2016
Recruitment end date09/05/2016

Locations

Countries of recruitment

  • Slovakia
  • Spain

Study participating centres

Commenius University
Eye Clinic Jessenius Faculty of Medicine Martin
L. Novomeského 9
Bratislava
036 01
Slovakia
University of Alicante
Department of Optics, Pharmacology and Anatomy
Crta San Vicente del Raspeig s/n
San Vicente del Raspeig
Alicante
03690
Spain

Sponsor information

Commenius University
University/education

Faculty of Medicine
Špitálska 24
Bratislava
813 72
Slovakia

ROR logo "ROR" https://ror.org/0587ef340

Funders

Funder type

University/education

University of Alicante

No information available

Results and Publications

Intention to publish date01/09/2017
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planPlanned publication of the results in BMC Ophthalmology journal.
IPD sharing planThe datasets generated during and/or analysed during the current study are/will be available upon request from Peter Ziak, 1ziakpeter@gmail.com or David P Piñero, david.pinyero@ua.es

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 28/06/2017 26/11/2020 Yes No

Editorial Notes

26/11/2020: The following changes were made to the trial record:
1. Publication reference added.
2. The total final enrolment was added.