Evaluation of the clinical effect of 4D digital strabismus and amblyopia visual function correction system combined with traditional comprehensive treatment methods on anisometropic amblyopia
Authors: Li Huangen , Peng Ting , Qin Yinyan 
Published: May 2024

Purpose
The objective of this study is to evaluate the clinical efficacy of the 4D digital strabismus and amblyopia visual function correction system(4D-DSAAVFCS) in combination with conventional modalities compared to conventional modalities alone in children with anisometropic amblyopia.
Methods
This is a non-randomized controlled study that collected data on best-corrected visual acuity (BCVA), simultaneous vision, fusion vision, near stereoscopic vision, P100 amplitude (graphic evoked visual potentials), and P100 latency from both eyes at the beginning of the treatment and one year later. The study used the Mann-Whitney U test to compare BCVA contrasts in different subgroups and the independent samples t-test to compare P100 wave amplitude and latency contrasts in different subgroups. The study compared the basic cure rate, simultaneous visual function recovery rate, fusion vision recovery rate, and near stereoscopic recovery rate contrasts in different subgroups using the chi-square test.
Results
This study included 393 children (217 males and 176 females) aged 3 to 12 years with anisometropic amblyopia who attended the Aier Eye Hospital of Wuhan University from January 2020 to December 2022. The children were divided into two groups: the 4D group (263 cases) and the traditional group (130 cases) based on the treatment modality. The children in the traditional group received treatment through the conventional method of masking and regular training. Meanwhile, the children in the 4D group received treatment through the traditional method and the 4D-DSAAVFCS. The study divided the 4D group of children into two age groups: 3–6 years old (161 cases) and 6 ~ 12 years old (102 cases). The basic cure rate of the 4D group was significantly better than that of the traditional group (χ2 = 4.318, P < 0.05). There were no statistically significant differences found in the comparison of BCVA, latency period of the P100 wave, and amplitude of the P100 wave between the 4D group and the traditional group before treatment (U=-0.117, t=-0.05, P > 0.05 for all). After one year of treatment, a statistically significant difference was observed between the 4D group and the conventional group in terms of BCVA, P100 wave latency, and P100 wave amplitude (U=-1.243, t=-0.853, t=-1.546, P all < 0.05). These results suggest that the 4D group experienced a better therapeutic effect compared to the conventional group. The recovery rates of simultaneous vision, convergent fusion, divergent fusion, and near stereoscopic were significantly higher in the 4D group compared to the conventional group (χ2 = 4.344, 4.726, 5.123, 2.036, all P < 0.05). Additionally, the basic cure rate of children aged 3 ~ 6 years in the 4D group was significantly higher than that of children aged 6 ~ 12 years (χ2 = 2.365, P < 0.05). In the study, BCVA was found to be significantly lower in the 3 ~ 6 years old group compared to the 6 ~ 12 years old group (U = -1.267, P < 0.05). Similarly, P100 wave amplitude was also significantly higher in the 3 ~ 6 years old group compared to the 6 ~ 12 years old group (t = -1877, P < 0.05). The latency of the P100 wave was lower in the 3 ~ 6 years old group compared to the 6 ~ 12 years old group (t=-0.998, P < 0.05). Additionally, the recovery rate of near stereoscopic function was higher in the 3 ~ 6 years old group than in the 6 ~ 12 years old group, with a statistically significant difference (χ2 = 4.534, P < 0.05).
Conclusion
The study demonstrated that the combination of the traditional method with the 4D-DSAAVFCS was more effective than the traditional method alone in treating amblyopic children. This approach was particularly helpful in improving the visual acuity of the children and restoring their optic nerve conduction function, simultaneous vision, fusion vision, and near stereoscopic vision. The combination of the traditional method and the 4D-DSAAVFCS is more effective for younger children.