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Br J Ophthalmol. 2019 Jul 4. pii: bjophthalmol-2018-313815. doi: 10.1136/bjophthalmol-2018-313815. [Epub ahead of print]

Binocular game versus part-time patching for treatment of anisometropic amblyopia in Chinese children: a randomised clinical trial.

Yao J#1,2,3, Moon HW#1,2,3, Qu X4,2,3.

Author information

Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Shanghai Medical School, Fudan University, Shanghai, China.
NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.
Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Shanghai Medical School, Fudan University, Shanghai, China
Contributed equally



To compare amblyopic-eye visual acuity (VA) and binocularity improvement of a binocular game with part-time patching in the treatment of Chinese children with anisometropic amblyopia.


103 Chinese children aged 3-13 years with anisometropic amblyopia were recruited in a randomised clinical trial. Eligible participants were randomly assigned to the binocular, patching and combined groups. Primary outcome was amblyopic-eye VA improvement at 3 months. Secondary outcomes included reduction of suppression and change of stereoacuity.


Of 85 completed participants, 44 (52%) were women and mean (SD) age was 5.99 (2.33) years. At 3 months, mean (95% CI) amblyopic-eye VA improved 0.18 (0.10-0.26), 0.28 (0.19-0.36) and 0.30 (0.21-0.39) logarithm of the minimum angle of resolution in the binocular, patching and combined groups, respectively. After adjusting for baseline VA, the difference was statistically significant (F=6.29, p=0.003), favouring as follows: the combined group, the patching group and the binocular group. After treatment, Titmus (x2 binocular=9.75, p=0.007; x2 combined=9.35, p=0.009) and dynamic stereoacuity (x2 binocular=12.56, p=0.01; x2 combined=12.66, p=0.01) improved only in the binocular and combined groups. Among groups, only Titmus improvement differed significantly (F=49.55, p<0.001). Changes of other types of stereoacuity and interocular suppression were similar.


The binocular game used in this study could improve amblyopic-eye VA and binocularity in Chinese children with anisometropic amblyopia, but it was less effective than patching in amblyopic-eye VA improvement and showed no superiority in binocularity over patching. It remains unclear whether the low treatment response of this binocular game was due to limitations of the study or its low treatment effect.


clinical trial; optics and refraction; treatment other; vision

Conflict of interest statement

Competing interests: None declared.

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