October 23, 2011 (Orlando, Florida) — A regimen that adds playing video games and the drug citicoline to standard treatment can improve visual acuity and binocular function in older children with amblyopia (or lazy eye), researchers reported here at the American Academy of Ophthalmology 2011 Annual Meeting.
"When children older than 8 years go to any ophthalmologist with amblyopia..., they will be told there is nothing that can be done for them; as a result, they will end up being handicapped. When they go to apply to college, they will be rejected, even though they may have brilliant marks," lead author Somen Ghosh, MD, an ophthalmologic surgeon from Kolkata, Bengal, India, told Medscape Medical News. "So I started thinking of some way to help those unfortunate older kids."
It has been believed that if amblyopia is not diagnosed and corrected before a child reaches school age, it is difficult if not impossible to correct. But a recent study sponsored by the National Eye Institute, and conducted in the United States by the Pediatric Eye Disease Investigation Group, found that 27% of older children showed significant vision gains after undergoing treatment for amblyopia.
The results prompted Dr. Ghosh to test new approaches to determine what might help these older children.
The study involved 100 children 10 to 18 years of age. All study subjects followed the general treatment protocol for amblyopia, which required them to wear eyeglasses that blocked the stronger eye for at least 2 hours a day while they did orthoptic exercises using the weaker eye.
In addition to the general treatment protocol (control subjects), children were divided into 3 treatment groups: antioxidant tablets (which are thought to promote good vision); at least 1 hour of video games daily (up to 2 hours; consisting of shooting guns and car racing) using the weaker eye only; and video games plus citicoline 500 mg twice daily for 3 months.
The children were followed for a minimum of 2 years.
By the end of the study, visual acuity improved by 52% in control group and 56% in the antioxidant group. But in the video-game group, visual acuity increased by 64%, and in the video-game plus citicoline group, visual acuity increased by 72%.
"Kids love to play video games. It's a process of helping them the way they want it and not the way we want it. When we added citicoline, which is used in Alzheimer's disease but has never been used in this context before, we had even better results," he said.
Cooperation of the patient is crucial to the success of this treatment, Dr. Ghosh said.
"There is always a brighter side and we should never give up hope that we can help these young patients," he added.
This is good news if the data are correct and meaningful, Herb Kaufman, MD, from Louisiana State University Medical School, Baton Rouge, told Medscape Medical News.
"The reason docs don't treat older kids is that it has been found not to work over the years. I think there is a need for others to confirm these novel findings to be sure they are generally applicable," Dr. Kaufman said.
Dr. Ghosh has disclosed no relevant financial relationships.
American Academy of Ophthalmology (AAO) 2011 Annual Meeting: Abstract P0150. Presented October 23, 2011
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