Biofeedback method to treat pediatric amblyopia: outcomes

<p> А.Е. Voronina^1,2, E.A. Petrosyan¹ </p> <p> ¹Orenburg Branch of the S. Fyodorov Eye Microsurgery Federal State Institution, Orenburg,&nbsp;Russian Federation </p> <p> ²Orenburg State Medical University, Orenburg, Russian Federation </p> <p> <b>Background: </b>amblyopia is caused by abnormal visual experience within the first 7–10 years of a child's life. As each amblyopia case is unique, a therapeutic method suitable for one patient may be a bad match for another. For example, a patient's age, amblyopia severity and concomitant diseases may require treatment adjustment. Since therapeutic approaches can be personalized due to method diversity, this may increase the treatment efficiency. </p> <p> <b>Aim:</b> to evaluate outcomes of comprehensive amblyopia treatment by a biofeedback method in children. </p> <p> <b>Materials and Methods: </b>96 children (144 eyes) with different degrees of amblyopia were monitored. All patients were randomized into 2 similar groups. The Group 1 received comprehensive treatment with a laser ophthalmotherapeutic device for retinal stimulation, a physiotherapeutic device for transcranial electrical stimulation and running magnetic field therapy, as well as a visual simulator for vision correction. In addition to the abovementioned devices, the Group 2 underwent a biofeedback method. </p> <p> <b>Results: </b>at baseline the best corrected visual acuity (BCVA) was 0.48±0.03 in the Group 1, but it increased to 0.62±0.02 on the Day 10. As for the Group 2, baseline BCVA was 0.47±0.02. Similarly, it increased to 0.69±0.04 (p&lt;0.05) upon the discharge. In 5 months, BCVA decreased by 1.61% in the Group 1, while average BCVA increased by 5.8% in the Group 2. When assessing pre- and post-treatment BCVA values, depending on a type of amblyopia, the best results were reported in patients with refractive amblyopia in the Group 2. Thus, the baseline BCVA increased by 47.06% (from 0.51±0.04 to 0.75±0.03) on Day 10, while it barely decreased in 5 months. As for dysbinocular amblyopia, the Group 1 demonstrated better outcomes. In particular, BCVA increased from 0.43±0.02 to 0.58±0.03 during the 5-month follow-up, whereas significantly less pronounced improvement was reported in the Group 2. At baseline BCVA values were lower in patients with anisometropic amblyopia than in those with other amblyopia types in both Groups 1 and 2. It was revealed that mild and moderate amblyopia treatment is the most efficient because increased BCVA values were reported in both groups. Improvement was also reported in patients with severe amblyopia. After the treatment, BCVA increased 1.5 and 2.1 times in Groups 1 and 2, respectively. Moreover, it increased 1.88 and 3.29 times in Groups 1 and 2, respectively, in 5 months. </p> <p> <b>Conclusion: </b>although comprehensive device treatment of amblyopia (regardless of type and severity) is efficient, a biofeedback method used as its part increases efficiency significantly. Besides, it leads to more stable BCVA values in 5 months after the treatment. </p> <p> <b>Keywords:</b> amblyopia, comprehensive treatment, biofeedback, refractive amblyopia, anisometropic amblyopia, dysbinocular amblyopia. </p> <p> <b>For citation:</b> Voronina А.Е., Petrosyan E.A. Biofeedback method to treat pediatric amblyopia: outcomes. Russian Journal of Clinical Ophthalmology. 2025;25(Special Issue):110–115 (in Russ.). DOI: 10.32364/2311-7729-2025-25-Suppl-16 </p>