Trial reportJournal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus2020
A randomized clinical trial of contrast increment protocols for binocular amblyopia treatment.
Trial report in Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Short- and long-term outcomes of binocular gaming versus patching in childhood amblyopia: a systematic review and meta-analysis.European journal of pediatrics · 2026Pooled it
- Interventions for improving adherence to amblyopia treatments in children.The Cochrane database of systematic reviews · 2025Pooled it
- Patch-free streaming contrast-rebalanced dichoptic cartoons versus patching for treatment of amblyopia in children aged 3 to 5 years: a pilot, randomized clinical trial.Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2024Trial
- Randomized clinical trial of streaming dichoptic movies versus patching for treatment of amblyopia in children aged 3 to 7 years.Scientific reports · 2022Trial
- Dichoptic Visual Search at Varied Fellow Eye Contrasts and Visual Function Deficits in Amblyopia.Investigative ophthalmology & visual science · 2025Article
- Baseline and outcome stereoacuity of children with anisometropic amblyopia undergoing dichoptic amblyopia treatment.Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2025Article
- Evaluating Eye Tracking During Dichoptic Video Viewing With Varied Fellow Eye Contrasts in Amblyopia.Investigative ophthalmology & visual science · 2024Article
- Risk of recurrence after cessation of dichoptic, binocular treatment of amblyopia.Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2023Article
- Amblyopia and the whole child.Progress in retinal and eye research · 2023Review
- Binocular amblyopia treatment improves manual dexterity.Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2023Article
- Recent Advances in Screening and Treatment for Amblyopia.Ophthalmology and therapy · 2021Review
- Leveraging neural plasticity for the treatment of amblyopia.Survey of ophthalmologyReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundMost clinical trials of contrast-rebalanced binocular amblyopia treatment used a contrast increment protocol of 10% daily with successful play. Paired with a definition of success requiring only 15-30 min/day of gameplay, this increment protocol could allow children to reach 100% fellow eye contrast in 3-9 hours; however, this may not provide adequate therapeutic time with reduced fellow eye contrast. The purpose of this study was to compare the original protocol against three alternative contrast increment protocols designed to increase the number of treatment hours.
methodsIn this prospective study, 63 amblyopic children (4-10 years; amblyopic eye visual acuity, 20/40-125) were randomly assigned one of four daily contrast increment protocols for 4 weeks, all starting with 20% fellow eye contrast: 10%, 5%, 0%, or 10% for first 4 weeks then reset to 20% and repeat 10% increment for the final 4 weeks. Children played contrast-rebalanced games for 1 hour/day, 5 days/week. Best-corrected visual acuity, stereoacuity, and suppression were assessed at baseline and every 2 weeks until the 8-week outcome visit.
resultsAt baseline, mean amblyopic eye best-corrected visual acuity was 0.47 ± 0.14 logMAR (20/60), improving overall 0.14 ± 0.08 logMAR (1.4 lines; P < 0.0001) at 8 weeks. All four protocols resulted in similar improvement in visual acuity (0.13-0.16 logMAR; all Ps < 0.0002). Stereoacuity and suppression also improved (all Ps < 0.05).
conclusionsNone of the new protocols resulted in less improvement than the original 10% contrast increment protocol. Contrast-rebalanced binocular games yielded significant improvements in visual acuity, stereoacuity, and suppression with or without daily contrast increments.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.