Establishing New Treatment Approaches for Amblyopia: Perceptual Learning and Video Games

NCT05522972 | Recruiting

• 1 other identifier: 2022-344
• Study Type: interventional
• Target: 180
• Locations: 1 country
• Sites: 1

Brief Summary

Amblyopia, a developmental abnormality that impairs spatial vision, is a major cause of vision loss, resulting in reduced visual acuity and reduced sensitivity to contrast. This study uses psychophysical measures to study neural plasticity in both adults and children with amblyopia.

Conditions

Amblyopia

Keywords

perceptual learning; video games; visual plasticity; amblyopia treatment; pathophysiology of amblyopia; vision training; stereoacuity; strabismus

Outcome Measures

Primary Outcomes (2)

• Change in visual acuity before and after the intervention

  "Visual acuity", the gold standard for vision testing, will be measured. Participants will be asked to read letters on a LogMAR letter chart. The smallest letters that can be read correspond to visual acuity (e.g., Snellen acuity of 20/20, letter-stroke width = 1 minute of arc).

  9 months

• Change in stereoacuity before and after the intervention

  "Stereoacuity" will be measured psychophysically using a new stereoacuity function test (1.25, 2.5, 5, 10, 15, \& 20 cycles per degree) developed in our previous studies (Li et al 2016). A custom-built 4-mirror haploscope will be used to present a stereogram to each eye. Stereoacuity is the smallest stereo disparity that can be seen in binocular vision (in the unit of seconds of arc, arcsec). The conventional stereoacuity tests (including Randot Stereoacuity Test, Stereofly Test \& Preschool Stereo Test) will also be used to measure stereoacuity. Participants will be asked to wear a pair of 3D glasses and to identify the target 3D pictures at various 3D levels. The smallest 3D disparities that can be seen correspond to stereoacuity (e.g. normal range of stereoacuity: 50 seconds of arc or better).

  9 months

Secondary Outcomes (2)

• Change in contrast sensitivity before and after the intervention

  9 months

• Change in positional (or Vernier) acuity before and after the intervention

  9 months

Study Arms (3)

Video Games

EXPERIMENTAL

Participants will be required to play video games for a period of time: 1-2 hrs per session, 4-5 sessions/week for \~1-6 months

Behavioral: Video Game Vision Training

Perceptual learning

EXPERIMENTAL

Participants will be required to practice a visual discrimination task (e.g. visual acuity, position acuity, contrast sensitivity, \& stereoacuity) for a period of time: 1-2 hrs per session, 4-5 sessions/week for \~1-6 months

Behavioral: Perceptual Learning

Occlusion therapy

ACTIVE COMPARATOR

Participants will be required to cover the dominant eye during the day in order to push the brain to use the fellow amblyopic eye: 1-2 hrs per session, 4-5 sessions/week for \~1-6 months

Behavioral: Occlusion Therapy

Interventions

Video Game Vision Training BEHAVIORAL

A new approach for improving amblyopic vision using video games

Video Games

Perceptual Learning BEHAVIORAL

A new approach for improving amblyopic vision with perceptual learning

Perceptual learning

Occlusion Therapy BEHAVIORAL

Conventional treatment for amblyopia

Occlusion therapy

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• adults and children with normal vision or amblyopia
• amblyopia: interocular VA difference of 0.1 logMAR or more

You may not qualify if:

• any ocular pathological conditions, nystagmus

Sponsors & Collaborators

• Nova Southeastern University: lead

Study Sites (1)

Nova Southeastern University College of Optometry

Fort Lauderdale, Florida, 33328, United States

RECRUITING

Related Publications (12)

• Li RW, Li BZ, Chat SW, Patel SS, Chung STL, Levi DM. Playing three-dimensional video games boosts stereo vision. Curr Biol. 2024 Jun 3;34(11):R524-R525. doi: 10.1016/j.cub.2024.04.032.

  PMID: 38834021 BACKGROUND

• Leung TW, Li RW, Kee CS. Brief Adaptation to Astigmatism Reduces Meridional Anisotropy in Contrast Sensitivity. Invest Ophthalmol Vis Sci. 2023 Sep 1;64(12):4. doi: 10.1167/iovs.64.12.4.

  PMID: 37656478 BACKGROUND

• Li RW, Levi DM. Characterizing the mechanisms of improvement for position discrimination in adult amblyopia. J Vis. 2004 Jun 1;4(6):476-87. doi: 10.1167/4.6.7.

  PMID: 15330715 BACKGROUND

• Li RW, Klein SA, Levi DM. Prolonged perceptual learning of positional acuity in adult amblyopia: perceptual template retuning dynamics. J Neurosci. 2008 Dec 24;28(52):14223-9. doi: 10.1523/JNEUROSCI.4271-08.2008.

  PMID: 19109504 BACKGROUND

• Li RW, Provost A, Levi DM. Extended perceptual learning results in substantial recovery of positional acuity and visual acuity in juvenile amblyopia. Invest Ophthalmol Vis Sci. 2007 Nov;48(11):5046-51. doi: 10.1167/iovs.07-0324.

  PMID: 17962456 BACKGROUND

• Li RW, Young KG, Hoenig P, Levi DM. Perceptual learning improves visual performance in juvenile amblyopia. Invest Ophthalmol Vis Sci. 2005 Sep;46(9):3161-8. doi: 10.1167/iovs.05-0286.

  PMID: 16123415 BACKGROUND

• Li RW, Ngo CV, Levi DM. Relieving the attentional blink in the amblyopic brain with video games. Sci Rep. 2015 Feb 26;5:8483. doi: 10.1038/srep08483.

  PMID: 25715870 BACKGROUND

• Li RW, Ngo C, Nguyen J, Levi DM. Video-game play induces plasticity in the visual system of adults with amblyopia. PLoS Biol. 2011 Aug;9(8):e1001135. doi: 10.1371/journal.pbio.1001135. Epub 2011 Aug 30.

  PMID: 21912514 BACKGROUND

• Li RW, Tran KD, Bui JK, Antonucci MM, Ngo CV, Levi DM. Improving Adult Amblyopic Vision with Stereoscopic 3-Dimensional Video Games. Ophthalmology. 2018 Oct;125(10):1660-1662. doi: 10.1016/j.ophtha.2018.04.025. Epub 2018 May 18. No abstract available.

  PMID: 29779684 BACKGROUND

• Li RW, Tran TT, Craven AP, Leung TW, Chat SW, Levi DM. Sharpening coarse-to-fine stereo vision by perceptual learning: asymmetric transfer across the spatial frequency spectrum. R Soc Open Sci. 2016 Jan 20;3(1):150523. doi: 10.1098/rsos.150523. eCollection 2016 Jan.

  PMID: 26909178 BACKGROUND

• Li RW, So K, Wu TH, Craven AP, Tran TT, Gustafson KM, Levi DM. Monocular blur alters the tuning characteristics of stereopsis for spatial frequency and size. R Soc Open Sci. 2016 Sep 21;3(9):160273. doi: 10.1098/rsos.160273. eCollection 2016 Sep.

  PMID: 27703690 BACKGROUND

• Li RW, Levi DM, Klein SA. Perceptual learning improves efficiency by re-tuning the decision 'template' for position discrimination. Nat Neurosci. 2004 Feb;7(2):178-83. doi: 10.1038/nn1183. Epub 2004 Jan 18.

  PMID: 14730311 BACKGROUND

MeSH Terms

Conditions

Amblyopia; Strabismus

Condition Hierarchy (Ancestors)

Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vision Disorders; Sensation Disorders; Neurologic Manifestations; Eye Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Ocular Motility Disorders; Cranial Nerve Diseases

Study Officials

• Roger W Li, OD, PhD

  Nova Southeastern University College of Optometry

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Roger W Li, OD, PhD

CONTACT

954-262-1436; wli@nova.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: August 24, 2022
• First Posted: August 31, 2022
• Study Start: September 13, 2022
• Primary Completion (Estimated): August 31, 2029
• Study Completion (Estimated): August 31, 2029
• Last Updated: December 16, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)