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Purpose: Amblyopia is a serious condition resulting in monocular impairment of vision. Although traditional treatment improves vision, we attempted to explore the results of perceptual learning in this study. Methods: This prospective cohort study included all patients with amblyopia who were subjected to perceptual learning. The presenting data on vision, stereopsis and contrast sensitivity were documented in a pretested online format, and the pre? and post?treatment information was compared using descriptive, cross?tabulation and comparative methods on SPSS 2.2. The mean values were obtained, and P < 0.05 was considered statistically significant. Results: The cohort consisted of 47 patients (23 females and 24 males) with a mean age of 14.11 ± 7.13 years. A statistically significant improvement was detected in visual acuity after the perceptual learning session, and the median follow?up period was 17 days. Also, significant improvements were observed in stereopsis but not in the visual outcomes among the age groups. Conclusion: Perceptual learning with hand–eye coordination is an effective method for managing amblyopia. This approach can improve vision in all age groups. However, visual improvement is significantly influenced by ocular alignment.
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@#Amblyopia is a common eye disease in children. In recent years, people have been exploring new treatments for amblyopia patients with poor results of the traditional treatment. In the field of visual cognition, some computer programs and video games are widely used to improve the functions of the visual system. Based on the perceptual learning, new methods such as video games, dichotomous stimulation, and stereo vision training are proposed to treat amblyopia. This article combines domestic and foreign research on perceptual learning and other emerging methods. The application of therapies in the treatment of amblyopia was reviewed, the effects of different methods in the treatment of amblyopia were analyzed. Combined with the existing problems, the future development of this field was further discussed.
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As visual science developed,imbalance interocular suppression was considered as the key mechanism in patients with amblyopia,and suppression played a key role in both monocular and binocular deficits that characterized amblyopia.Suppression in amblyopia involved complicated anatomical sites,including visual pathway below V1,V1 and higher central systems.At present,quantitative assessment and reduction of suppression have become a new approach of amblyopia treatment.Therefore,we need to understand characteristics of binocular interaction of normal subject and amblyopia in detail,and to understand the similarities and differences between the mechanism of suppression of amblyopia and binocular rivalry suppression in normal observers.In recent years,the quantitative assessment of amblyopia suppression is mainly based on dichoptic psychophysical paradigm.Because different mechanisms are involved,so there is a standardization problem in clinical application.The new treatment of amblyopia focused on reducing suppression and restoring binocular function.This review aimed to provide an overview of recent studies that have investigated the key role of suppression in pathogenesis of amblyopia,and the relevant visual mechanism,anatomic locations,measurements and treatment of suppression in amblyopia.
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@#AIM: To evaluate the effects of visual perceptual learning on visual representation and binocular vision function of children with amblyopia. <p>METHODS: A total of 94 cases(94 eyes)children with amblyopia admitted to the ophthalmology clinic of our hospital from January 2014 to December 2015 were selected for the study and were grouped according to the degrees of amblyopia, and they were given visual perceptual learning for 3mo. The clinical efficacy and perceptual level of eye position and poor visual acuity before and after treatment were compared among groups, and Pearson correlation coefficient was used to analyze the relationship between difference of poor visual acuity and difference of perceptual eye position before and after treatment in children with amblyopia. <p>RESULTS: The total clinical effective rate of children with mild amblyopia was higher than that of children with moderate or severe amblyopia(<i>P</i><0.05), and there was no significant difference in the total clinical effective rate between children with moderate amblyopia and children with severe amblyopia(<i>P</i>>0.05). The perception level of eye position after treatment of children with amblyopia was significantly lower than that before treatment(<i>P</i><0.05). The perception level of eye position after treatment in children with mild, moderate or severe amblyopia was significantly decreased(<i>P</i><0.05), and the improvement of perception level of eye position in children with mild or moderate amblyopia was more significant than that in children with severe amblyopia(<i>P</i><0.05). The poor visual acuity of children with amblyopia after treatment was significantly improved compared with that before treatment(<i>P</i><0.05). The poor visual acuity after treatment in children with mild, moderate or severe amblyopia was significantly improvement(<i>P</i><0.05), and the improvement of poor visual acuity in children with mild or moderate amblyopia was more significant than that in children with severe amblyopia(<i>P</i><0.05). The difference of poor visual acuity was positively correlated with difference of perceptual eye position before and after treatment among children with amblyopia(<i>r</i>=0.371,<i> P</i><0.05). <p>CONCLUSION: Visual perceptual learning can effectively improve the visual representation and binocular vision function of children with amblyopia, and it is suitable for the clinical treatment of children with amblyopia.
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AIM: To observe the long - term effect of visual perceptual learning to correct anisometropic amblyopia in children.?METHODS: The clinical data of 200 children (200 eyes) with anisometropic amblyopia were retrospectively analyzed, which were divided into 2 groups according to therapeutic methods, and 82 children treated with traditional integrative therapy were distributed to the control group, while 118 children treated with visual perceptual learning were distributed to the observation group. After 1 year's treatment, the corrected vision, contrast sensitivity and stereo sharpness of patients were compared between groups.?RESULTS:After 1 year's treatment, the effective rate of the observation group was higher than the controls (90. 7％ vs 75. 6％, P<0. 05), and after 1 year's follow up, there was 92. 5％ patients maintained stabilization in the observation group, while that in the control group was 80. 6％, and the observation group was higher than the controls too, the difference between groups had statistical significance (P<0. 05). Before treatment, there was no significant difference in contrast sensitivity between groups (P>0. 05). After 6 and 12 months' treatment, the contrast sensitivity of both groups increased(P<0. 05), and the observation group was higher than the controls after 12 months' treatment, the difference between groups had statistical significance (P<0. 05). Before treatment, there was no significant difference in stereopsis acuity between groups ( P > 0. 05 ). After treatment, the stereopsis acuity of the observation group was better than the controls, and the difference between groups had statistical significance (P<0. 05).?CONCLUSION: The long-term curative effect of visual perception learning to correct children's refractive aberration is better than traditional comprehensive therapy.
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Amblyopia is a developmental visual disorder,which is accompanied by physiological changes in the visual cortex.Many studies that focused on the treatments of amblyopia and improvment of therapeutic effects in teenagers and adults have been paid more and more attention.Recent studies reveal that a threshold level of neurotransmitters,such as γ-aminobutyric acid (GABA),norepinephrine (NE),acetylcholine,5-hydroxytryptamine (5-HT) and dopamine,is required to open the critical period.Meanwhile,the content of specific extracellular matrix,such as extracellular protease tissue plasminogen activator (tPA) and cross-linked chondroitin sulphate proteoglycans (CSPGs),exhibits dynamic changes over the time course of the critical period,which plays a key role in synaptic modifications.Clinical studies show that suppression and deficits in visual attention towards signal from the amblyopia eye may be important factors in physiological mechanism of amblyopia,which support a basis for non-invasive brain stimulation and perceptual learning as new effective treatments.This paper described the recent advances in plasticity of visual cortex and binocular vision in the field of amplyopia treatment,especially in teenagers and adults.
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Background Amblyopia is a developmental disorder of spatial vision that results in both monocular and binocular deficits.Conventional therapy for amblyopia which focuses on monocular training can improve visual acuity.However,how to improve the binocular function,especially stereopsis is rarely studied.Objective This study was to evaluate the outcome of perceptual learning based on cloud services of improving stcreopsis and visual acuity for amblyopia.Methods A randomized-controlled clinical study was performed.One hundred and seven amblyopic patients (178 eyes) with the age of 5-18 years old were recruited in The Second Affiliated Hospital of Anhui Medical University from July 2013 to March 2014.The patients were randomized into the perceptual learning group and the conventional therapy group.A perceptual learning based on cloud services with computer under the best corrected visual acuity was carried out in the perceptual learning group with 30-day duration as a course for 5-6 cycles,and training feedback data was obtained after each cycle for the regulation of following treatment.The dominant eye was covered during the training process.In the conventional therapy group,a training regimen of health eye covering that combined with eyesight training of amblyopic eye was performed.The stereopsis and visual acuity of the patients were estimated after training.Written informed consent was obtained from the parents or custodians of the children before entering the cohort.Results The total effective rate of visual acuity improvement is significantly higher in the perceptual learning group than that in the conventional therapy group after training (Z =6.368,P=0.012).The mean stereopsis value of the amblyopic eyes in the perceptual learning group and the conventional therapy group was (127±53) and (174±67) after training,which was significantly higher than (273 ±95) and (311 ±103) before training,respectively,and the increasing range of the mean stereopsis was considerably larger in the perceptual learning group than that in the conventional therapy group(t=12.329,9.557,15.649;all at P＜0.05).In the perceptual learning group,the improving range of mean stereopsis was larger in the severe or moderate amblyopic eyes than that in the mild amblyopic eyes,and the improving range of mean stereopsis in ametropic amblyopia was larger than that in anisometropic amblyopia (all at P ＜ 0.05).Conclusions Both perceptual learning based on cloud services and conventional therapy can improve stereopsis and visual acuity in amblyopic eyes.However,perceptual learning based on cloud services can improve the treating compliance of children.
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Amblyopia is a developmental abnormality that results from physiological alterations in the visual cortex and impairs form vision. Based on multimedia, visual perceptual learning was widely applied in amblyopia treatment. Perceptual learning provided an impor-tant new method for treating amblyopia both in children and adults, and it reflects alterations of neural responses in the visual pathway. The therapeutic efficacy of perceptual learning was related to age, amblyopic types and degrees, training time and programs closely.
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Objective To investigate the compliance and its impact factors of amblyopic children treating with visual perceptual learning.Methods 116 amblyopic children treating with visual perceptual learning were investigated using self-made compliance questionnaire for amblyopic children treating with visual perceptual learning.Results The average compliance score of amblyopia in treatment of visual perceptual learning was(71.45±10.10) points,ranging from 36 to 92 points.The univariate linear regression analysis showed thatawareness of parents on the amblyopia training,communication with medical staff,parents supervise children training and eyesight improvement speed of children were the statistical significant impact factors.The further multivariate linear regression analysis showed that awareness of parents on the amblyopia training and parents supervise children training were also the statistically significant impact factors.Conclusions The compliance of amblyopic children treating with visual perceptual learning was satisfactory and its impact factors were associated with parents,the supervision and awareness of parents were the key impact factors for amblyopic children treating with visual perceptual learning.
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Visual perceptual learning refers to the special improvement of perceptual performance benefit from repetitive training with a visual task.A typical time course of visual perceptual learning presents an initial rapid improvement,and then gradually processes like an asymptote in gain.During the process of perceptual learning,the influence of critical amount and perceptual learning rules on learning effect,memory consolidation and interference,and the role of sleep on preventing interference and promoting consolidation in perceptual learning,all get involved.This article reviewed the aforesaid content and then elaborated some strategies in application of visual perceptual learning in the treatment of amblyopia.
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The most common forms of treatment for amblyopia are occlusion therapy and pharmacologic penalization. But these methods can not recover all the visual deficits of amblyopes and there are some disadvantages of the treatment which need to be considered, including adverse effects, compliance and social stigma. Recently, some novel approaches are investigated for improving the effectiveness and compliance of treatment for amblyopia.
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Objective To investigate the refraction change and nursing character in myopic amblyopia during the perceptual learning treatment. Methods Refraction of 54 children (98 eyes) with myopic amblyopes were selected,which were selected from the amblyopia clinic between 2007 and 2009, the spherical diopter, astigmatism and spherical equivalent were collected before and after perceptual learning,the refractive dynamic was compared according to the degree of amblyopia. Results The spherical average annual growth of myopic amblyopia during treatment was 0.52D, the growth of astigmatism was 0.03D;the spherical equivalent average annual growth was less than 0.50D accounted for 57.14%. The dynamic changes of spherical or SE of mild, moderate and severe amblyopia had significant difference, but the cylinder had not significant difference in change. Conclusions The treatment of perceptual learning in patients has little effect on the growth of refraction in myopic amblyopia, however, it is still necessary to pay close attention to refraction changes of in myopic amblyopia in the course of treatment.
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In order to investigate the interactions between first- and second-order motion perception systems, 14 adult subjects with normal or correct to normal visual acuity were recruited and divided into two groups. Then these two groups were trained, in their parafovea, to discriminate the direction of first- and second-order motion gratings respectively. The spatial frequency of the gratings used in study was fixed at 2 cycles/degree and the temporal frequency was fixed at 8 Hz during training. Contrast sensitivity of subjects in these two training groups for first- and second- order motion was measured before and after 7 days' training to estimate the effects of training. In addition, the differences between the two training groups(14 subjects) and another control group (11 subjects) were studied. The results showed that: 1) the training with first-order motion gratings can improve subjects' performance in first-order motion direction discrimination but the improvement can't be transferred to the performance in second-order motion task; 2) the training with second-order motion gratings can improve subjects' performance in both first- and second-order motion direction discrimination tasks. In conclusion, an " asymmetric transfer" occurred between the training effect of first- and second-order motion gratings. These results indicate that there are two mechanisms for perceiving first- and second-order motion respectively. However, they are not completely different from each other but only partly separated.