Short-term clinical outcomes of neuroplasticity-based binocular visual training in pediatric amblyopia

OBJECTIVE: This study aimed to evaluate the short-term efficacy of neuroplasticity-based binocular visual training compared with conventional spectacle correction combined with occlusion therapy in children diagnosed with ametropic amblyopia. METHODS: A single-center randomized controlled trial was conducted involving 70 children aged 4 to 16 years with a clinical diagnosis of amblyopia. Participants were randomly allocated to an intervention group (spectacle correction combined with 20 sessions of neuroplasticity training) or a control group (spectacle correction combined with occlusion therapy). Primary outcome measures included best corrected visual acuity (BCVA), stereoacuity, and binocular suppression index. RESULTS: Following 10 training sessions, participants in the intervention group demonstrated statistically significant improvement in BCVA, increasing from 0.72 to 0.88 in the right eye and from 0.70 to 0.90 in the left eye, with outcomes superior to the control group (both p < 0.001). Stereoacuity improved from 253.6 arc seconds (arcsec) to 160.7 arcsec in the intervention group, which was significantly greater than the improvement observed in the control group (250.4 arcsec to 132.7 arcsec); after adjusting for baseline stereoacuity differences using analysis of covariance (ANCOVA), the intergroup difference in corrected stereoacuity outcomes reached statistical significance (p = 0.001). The intervention group showed superior long-term stability of stereoacuity at 3-month follow-up (158.32 ± 35.21 arcseconds versus 145.24 ± 32.09 arcseconds in the control group, p = 0.023), and achieved a significantly higher rate of combined efficacy endpoint (stereoacuity improvement ≥30% plus perceptual eye alignment error ≤30 pixels, 85.7%) compared with the control group (62.3%, p < 0.01), which served as the core basis for the efficacy conclusion. The foveal suppression index decreased from 51.4% to 14.3% in the intervention group. No serious adverse events were reported during the intervention period. CONCLUSIONS: Neuroplasticity training was associated with significant short-term improvements in BCVA and binocular visual function in children with amblyopia, demonstrating a favorable safety and efficacy profile. These findings support its potential application in clinical practice.