Binocularity-stimulating Treatment Using a Stereoscopic 3D Game in Patients with Amblyopia

Purpose: We investigated the effect of binocularity-stimulating treatment using stereoscopic 3D games in patients with amblyopia. Methods: We retrospectively analyzed amblyopia patients who had at least 12 months of patch therapy from 2020 to 2023 without further improvement who then underwent binocularity-stimulating treatment using stereoscopic 3D games displayed on a 3D TV. The level of blur and focal length of the screen viewed by the fellow eye were adjusted according to the visual acuity of the amblyopic eye. Each session lasted 30 min and patients participated in 16 sessions. We compared visual acuity, stereopsis, and contrast sensitivity before and after treatment. Results: The study included 24 patients with a mean age of 11.5 years at the time of treatment. The visual acuity of the amblyopic eye improved from 0.29 ± 0.27 logarithm of the minimal angle of resolution (logMAR) to 0.19 ± 0.24 logMAR (p=0.001), with that of 7 (29%) patients improving by two or more lines. Stereopsis improved from 2.89 ± 0.41 to 2.63 ± 0.35 log arcsec (p < 0.001), while contrast sensitivity improved from 1.69 ± 0.11 to 1.73 ± 0.08 log 1/c after treatment (p = 0.059). Conclusions: Additional visual function improvement was achieved through binocularity-stimulating treatment using stereoscopic 3D games in amblyopia patients whose vision did not improve despite patching for a sufficient period of time and in adult amblyopia patients who missed the timing of vision development. Individualized treatment was possible by adjusting the intensity of the stimulus presented to the fellow eye based on the visual acuity of the amblyopic eye, using separate 3D screens.