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Optimizing care for children with visual impairments

 

Denver, Colo.—Many current treatments for visual impairments can be uncomfortable and even painful for the patients. Whether the visual damage is from a brain injury or an eye movement disorder, treatments can still cause discomfort. Additionally, some of the assessments can provide inaccurate results or poor timing, affecting treatment plans. Three studies presented this week at the Association for Research in Vision and Ophthalmology’s (ARVO) 2022 Annual Meeting in Denver, Colo. demonstrate how their advances can either reduce patients’ discomfort, improve prognosis, or more closely provide realistic results.

Novel approach treats amblyopia with higher approving results than patching

Lead researcher Oren Yehezkel, PhD, and others from NovaSight Ltd, the Goldschleger Eye Institute at Sheba Medical Center, the Sheba Medical Center, and the Sackler Faculty of Medicine at Tel Aviv University in Israel conducted a study on a new system for treating amblyopia in children. This new approach is a binocular eye-tracking based device and was also tested against the commonly used amblyopia treatment of patching. "Patching - the gold standard amblyopia treatment, though proven to be effective, has inherent shortcomings such as low adherence and discomfort.” Yehezkel pointed out.

The researchers tested the new system on 103 children ages 4-9 that had strabismic, anisometropic and mixed amblyopia. The children watched content of their choice from the internet on the system’s screen for 90 minutes five times a week or did 120 minutes of patching seven days a week for 16 weeks.

Yehezkel said their findings showed that binocular therapy with the new system had favorable results. It “improves both visual acuity and binocularity at the comfort of the patient’s home, with high adherence and satisfaction level.”

  • Abstract title: A Prospective, Multicenter, Randomized, Masked, Controlled Pivotal Trial to Assess the Safety and Efficacy of an Eye-Tracking-Based Treatment for Amblyopia Under Binocular Conditions versus-Patching- Interim Results
  • Presentation start/end time: Monday, May 2, 10am – 12pm MT
  • Location: Poster Hall (Denver Convention Center/Virtual)
  • Also available on the virtual meeting site at https://arvo2022.arvo.org/ beginning May 1
  • Abstract Number: A0345

Eye movements used to observe visual health of children recovering from brain injury

Presently, visual impairment in children suffering with brain injury like spontaneous arteriovenous malformation (AVM) rupture are challenging to monitor via typical procedures. This is due to their concurrence with cognitive and communicative disabilities. Thus, visual impairment is usually concluded through “subjective evaluations of gaze-based reactions to different forms and movements.”

Researchers at the Burke Neurological Institute, Blythedale Children’s Hospital, and Weill Cornell Medicine created a system, the “Visual Ladder,” to efficiently grade visual health established on eye movements and data from gaze-based tracking behaviors. They used the Visual Ladder to periodically evaluate visual impairment and function recovery in children that had just been treated for AVM rupture. Lead researcher Nazia M. Alam, BSc, PhD, and their team’s system graded the children’s “saccades, pursuits, visual field responsiveness, and spatial visual function from tracking responses to static and moving stimuli.”

All the children showed improvement not only in their eye-movement-based metrics, but also in their physical, communicative and cognitive abilities. Alam said that the system having the “ability to monitor visual health during recovery of consciousness holds promise to aid in the prognosis of recovery and in the quantification of treatment efficacy.”

  • Abstract title: Improvement of eye-tracking based metrics in children with arteriovenous malformation rupture
  • Presentation start/end time: Tuesday, May 3, 1 – 3pm MT
  • Location: Poster Hall (Denver Convention Center/Virtual)
  • Also available on the virtual meeting site at https://arvo2022.arvo.org/ beginning May 1
  • Abstract Number: A0307

Are we measuring amblyopic eye visual acuity correctly?

Physicians typically assess vision in children with amblyopia by measuring best-corrected monocular visual acuity (BCVA) while the non-viewing eye is blocked. However, monocular visual acuity testing does not take into account the effect of suppression by the fellow eye; thus, measuring amblyopic eye (AE) BCVA in this way might not be a reliable representation of AE function during natural binocular viewing. Hence, researchers at the Retina Foundation of the Southwest and the University of Texas Southwestern Medical Center carried out a comparative study of AE BCVA with monocular versus binocular (dichoptic) acuity.

Eileen E. Birch, PhD, FARVO, lead researcher, and her team tested 66 children with amblyopia or a history of amblyopia aged 6-12 using an Optec Vision Tester. They discovered that 72% of the children had worse AE BCVA when they were tested in binocular conditions than monocular ones. This suggests that AE BCVA measured with the non-viewing eye occluded is not an accurate representation of how a child sees in their everyday life both eyes open. The researchers also assessed the children’s reading speed and motor skills during binocular viewing, and found poorer performance was associated with dichoptic, but not monocular, AE BCVA.

“We found that suppression of the amblyopic eye was associated with dichoptic visual acuity deficits (measured with different letters presented separately to each eye), which were worse than the monocularly measured visual acuity deficits,” said Birch. “Dichoptic, but not monocular, visual acuity was associated with impaired eye-hand coordination and slow reading, suggesting that some children with amblyopia may benefit from extra time for school tasks requiring eye-hand coordination or reading.”

  • Abstract title: Monocular visual acuity does not accurately represent function of the amblyopic eye during binocular viewing
  • Presentation start/end time: Tuesday, May 3, 10:30 – 10:47am MT
  • Location: 4CD Mile High Blrm (Denver Convention Center)
  • Also available on the virtual meeting site at https://arvo2022.arvo.org/ starting May 11
  • Abstract Number: 2284

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The Association for Research in Vision and Ophthalmology (ARVO) is the largest eye and vision research organization in the world. Members include approximately 10,000 eye and vision researchers from over 75 countries. ARVO advances research worldwide into understanding the visual system and preventing, treating and curing its disorders. Learn more at ARVO.org.

The 2022 ARVO Annual Meeting will take place in Denver, Colo. from May 1 – 4 and virtually May 11 - 12. The Meeting is the premiere gathering of nearly 10,000 eye and vision researchers from around the world. During the Meeting, 4,800 abstracts will be presented on the latest basic and translational research in eye and vision science.

All abstracts accepted for presentation at the Annual Meeting represent previously unpublished data and conclusions. This research may be proprietary or may have been submitted for journal publication. Embargo policy: Journalists must seek approval from the presenter(s) before reporting data from paper or poster presentations. Press releases or stories on information presented at the ARVO Annual Meeting may not be released or published until the following embargo dates:

  • May 1: Official launch of presentations of all posters (both presented in-person and virtually)
  • Rolling basis: Paper session, Symposia, Minisymposia, Cross-sectional Groups, and invited speaker sessions that have specific presentation times will be embargoed until the end of those individual time slots.

Media contact:
Jenniffer Scherhaufer
1.240.221.2923
media@arvo.org