This is a multi-centre, open-label, parallel-group randomized controlled trial with the following objectives: Firstly, the investigators aim to evaluate the efficacy of web-based visual and perceptual training therapy on visual function in children with postoperative congenital ectopia lentis. Secondly, the investigators target to investigate the in stereoacuity, quality of life scores, and treatment compliance following visual and perceptual training intervention. Thirdly, to explore the safety profile of visual and perceptual training therapy software in this specific patient population. Lastly, this study aims to provide evidence-based recommendations for visual rehabilitation training strategies in children with postoperative congenital ectopia lentis in the Chinese population.
Congenital ectopia lentis (CEL) is a hereditary ocular disorder caused by hypoplasia or dysfunction of the lens zonules, and is one of the major etiologies of congenital visual impairment in children and adolescents. Most patients with CEL are children within the critical period of visual development (0-12 years old). Sustained abnormal visual input due to congenital developmental anomalies severely interferes with the normal connection between retinal photoreceptors and the visual center, resulting in severe visual damage. At present, surgery is the main treatment for patients with severe CEL. However, clinical practice has shown that even after standardized surgical intervention and routine postoperative visual rehabilitation training, 36.8% of affected eyes still fail to achieve normal visual levels corresponding to their age. In addition, patients with CEL who undergo IOL scleral fixation often develop a certain degree of astigmatism due to postoperative tilt or decentration of the IOL, which further compromises the improvement of visual function. In recent years, digital visual perceptual training (HVT), as a novel technique for amblyopia intervention, has attracted considerable attention. Studies have demonstrated that, compared with traditional refractive correction and occlusion therapy, visual perceptual training is characterized by faster visual acuity improvement, higher compliance, and the ability to enhance binocular visual function. Furthermore, as a form of visual perceptual training software, web-based visual perceptual training allows patients to complete training at home through gamified tasks. Meanwhile, training plans can be adjusted according to patients' conditions and progress, enabling personalized treatment regimens. This helps improve treatment compliance and patient experience, and facilitates remote management by hospitals. Notably, the meridional perceptual learning module in visual perceptual training can more effectively improve uncorrected visual function in patients with astigmatism. Nevertheless, no studies to date have focused on the efficacy of visual perceptual training in improving visual function in this specific population of patients with CEL. This study intends to evaluate the efficacy and safety of visual perceptual training on postoperative visual function in patients with CEL, so as to provide evidence for formulating postoperative visual rehabilitation training strategies for these patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
82
After receiving guidance from a trainer, treatment was conducted using the visual perception training therapy software (HVT, version number: V1.0.10000) on a network platform for 30 minutes per day, totaling 3 months.
Guangdong Provincial Clinical Research Center for Ocular Diseases, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong
Guangzhou, Guangdong, China
RECRUITINGQingyuan Hospital Affiliated to Guangzhou Medical University (Qingyuan People's Hospital)
Qingyuan, Guangdong, China
NOT_YET_RECRUITINGChange in BCVA relative to baseline in study eyes
The best corrected vision will be measured by a professional optometrist.
Time frame: From start of intervention to the end of intervention at 3 months
Changes in stereoscopic vision relative to the baseline
Measure near stereopsis using the BUTTERFLY STEROTEST's STEREOTEST-ANIMALS part at 40 cm(16 inches) distance, wearing a pair of Standard 3-D Viewers.The angle of stereopsis of participants will be classified to 400 seconds,200 seconds and 100 seconds if they could recognize the 3-D cat, rabbit or monkey.
Time frame: From start of intervention to the end of intervention at 3 months
Change in quality of life score
This study used the PedsQL 4.0 Chinese version questionnaire to assess participants' quality of life at baseline, fisrt month, second month and third month. Participants will be asked to finish this questionnaire in paper. Participants aged 4 years should have their parents complete the questionnaire on their behalf. Participants aged 5-7 years should have the questionnaire completed by the researcher based on the child's responses after questioning the child. Participants aged 8-12 years should complete the questionnaire themselves. When participants did not understand the meaning of the questionnaire or had questions about the options, the researcher or parent should explain it to them and assist them in completing the questionnaire.
Time frame: From start of intervention to the end of intervention at 3 months
adherence of intervention
Compliance with refractive correction is recorded in the case report form through self-reporting at each follow-up visit. Compliance with visual perception training therapy software (HVT) will be automatically monitored through the system backend. Compliance with refractive correction will be calculated by dividing the average actual time spent wearing glasses per day over the past week, as recalled by participants during follow-up, by the average time spent awake per day, multiplied by 100%. Compliance with visual perception training will be calculated by dividing the actual number of days participants completed the training during follow-up by the number of days since the intervention began, multiplied by 100%.
Time frame: From start of intervention to the end of intervention at 3 months
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