Evaluation of the Therapeutic Efficacy of Perceptual Learning Using the Bartimeus Training Program in the Clinic as an Additional Therapy to Glasses or Patching

Abtract

Background The Bartimeus training program (BT) is a perceptual learning task that consists of a drawing assignment performed in 12 sessions of 30 minutes duration. Here we aim to retrospectively assess visual improvement in children who underwent BT and in whom visual acuity had not improved by glasses or patching in relation to patient age and diagnosis.

Material and Methods Retrospective chart analysis of patients who had undergone BT at our institution after consent. Visual acuity prior to and following BT was analyzed, as were diagnosis and age at BT.

Results Thirteen patients (20 eyes) with a mean age of 7 years (range: 3.9 – 10.75) were included. Overall acuity (LogMar) improved in 75%. Six patients aged 6.5 – 7.5 years had a mean improvement of 1.4 lines. The greatest improvement (5 lines crowding acuity) was seen in a 9-year-old with recent onset amblyopia due to corneal scarring. Two patients aged 6 years with deprivation amblyopia following surgery of a congenital cataract and one 5-year-old with retinitis pigmentosa did not benefit from BT.

Conclusions BT is a cheap noninvasive method that may help improve visual outcomes. Further studies with larger numbers are needed to assess optimal indication, timing, and length of treatment.

Zusammenfassung

Hintergrund Beim Bartimeus-Training (BT) werden Malübungen in 12 Sitzungen à 30 Minuten durchgeführt. Wir haben retrospektiv untersucht, ob und in welchem Maß Kinder, bei denen herkömmliche Methoden wie Brille und Okklusions-Pflaster keinen Visusanstieg mehr zeigten, mit diesem prezeptuellen Lerntraining eine Visusverbesserung erzielen konnten.

Methoden und Material Retrospektive Datenanalyse. Untersucht wurde der Visus vor und nach BT, die Diagnose und das Alter zum Zeitpunkt, bei dem BT absolviert wurde.

Resultate Dreizehn Patienten (20 Augen) mit einem Durchschnittsalter von 7 Jahren (3,9 – 10,75) wurden miteingeschlossen. Der Visus verbesserte sich bei 75% der Kinder. 6 Patienten im Alter von 6,5 – 7,5 Jahren zeigten einen durchschnittlichen Visusanstieg von 1,4 Linien. Die größte Verbesserung (5 Linien Crowding acuity) erzielte eine 9-jährige mit kürzlich ausgelöster Amblyopie aufgrund einer parazentralen Hornhautnarbe. Zwei 6-jährige Patienten mit Deprivationsamblyopie nach einer Operation wegen kongenitalem Katarakt sowie eine 5-Jährige mit Retinitis pigmentosa zeigten keinen Visusanstieg.

Schlussfolgerung BT ist eine günstige, noninvasive Methode, die helfen kann, das visuelle Ergebnis zu verbessern. Weitere Studien mit grösseren Teilnehmerzahlen werden benötigt um die optimale Indikation, den optimalen Zeitpunkt und die richtige Anwendungsdauer zu identifizieren.

Key words

amblyopia in children - Bartimeus Crowding Training - perceptual learning

Schlüsselwörter

Amblyopie - perzeptuelles Lernen - Bartimeus Training - Kinderophthamologie - Strabologie

Publication History

Received: 26 September 2022

Accepted: 03 January 2023

Article published online:
25 April 2023

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