Introduction: Background: The first approach to a frequency-selective visual training in amblyopia had been proposed in the sixties by the physiologist Fergus Campbell. During the stimulation, his grating was moving very slowly, i.e., only once a minute around its axis. Therefore, the CAM-stimulator was based exclusively on the proposed influence of spatial frequency selectivity, however there was no significant contribution of the temporal frequency of the stimulus. Accordingly, we are convinced that this was one of the main reasons for the failure of Campbell's approach after the evaluation by a multiple of placebo-controlled studies. The aim of the present work, therefore, was to investigate in the influence of visual exercises, which contained moving circular gratings as compared to such of stationary gratings implemented into computer games on the development of visual acuity. Especially we were interested in the effects of such type of visual exercises using a circular sinusoidal grating on the visual acuity development in patients with meridonal amblyopia. We assume, in particular, that such a ring-shaped stimulus can reach all angular positions equally, and thus excite the most ametropic meridians, as compared to the least ametropic meridians, in a particular way. Methods: Overall, we investigated in two groups of patients with meridional amblyopia who had been selected according to the age structure and to their type of disturbance. Using a cross-over design, the first group was alternately exercised 10 days with the moving followed by 10 days with the stationary grating stimulus, and the second group was alternately exercised 10 days with the stationary followed by 10 days with the moving grating stimulus, i.e. in reverse order. For the treatment, a sinusoidally modulated drifting grating had been implemented as a background stimulus into simple computer games. These games served for the attraction of attention of the children. For the present study these exercises were provided by the telemedical portal of the Amblyocation ltd. in the following two versions. The first version contained a concentric outward-moving ring-shaped sinusoidal grating behind of the computer games during the process of visual stimulation. The grating was fixed at a spatial frequency of 0.3 cyc/deg with the time frequency of 1 cyc/sec, which gave an angular velocity of 3.33 deg/sec. The second version of the program contained the same grating, but in a non-moving presentation. In order to additionally distinguish between the envisaged meridional stimulus effects, we examined our patients with regard to their corrected visual acuity using a directionally sensitive set of optical characters developed at the Kharkevich Institute. The monocular corrected visual acuity was tested in all patients at 4 meridians: 0, 45, 90 and 135 degrees. Additionally, in all patients of the first group and all patients of the second group, the binocular visual acuity was examined too. Results: In the measurements of the corrected visual acuity along four meridians, a statistically significant improvement was found with alignment of the directional optical characters close to the meridian with maximal ametropia, and the minimal improvement in the orientation perpendicular thereto. In the patients of the both groups, the corrected visual acuity had significantly increased as a result of the treatment performed in the stage with a series of exercises with the moving circular sinusoidal grating. After the stage of treatment using the stationary grating, however, there was found no statistically significant improvement. Conclusions: Telemedical exercises using special computer games that contained a moving circular sinusoidal grating resulted in a statistically significant positive dynamics of visual acuity development in the most ametropic meridian as compared to the least ametropic meridian. No statistically significant improvement was observed after exercises with the stationary grating.

中文翻译：

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比较移动式和固定式正弦光栅在经络性弱视功能辅助治疗中的应用结果

简介：背景：生理学家Fergus Campbell于60年代提出了弱视中频率选择性视觉训练的第一种方法。在刺激过程中，他的光栅移动非常缓慢，即每分钟仅绕其轴移动一次。因此，CAM刺激器完全基于所建议的空间频率选择性的影响，但是，刺激的时间频率没有显着贡献。因此，我们确信，这是在通过多个安慰剂对照研究进行评估后，坎贝尔方法失败的主要原因之一。因此，当前工作的目的是调查视觉练习的影响，与视力发展到计算机游戏中的固定式光栅相比，它包含可移动的圆形光栅。特别是，我们对使用圆形正弦光栅的这类视觉锻炼对子午弱视患者视力发展的影响感兴趣。特别地，我们假设这样的环形刺激可以平等地到达所有角位置，从而以特定的方式与最小屈光性子午线相比，激发最大屈光性子午线。方法：总体而言，我们调查了根据年龄结构和障碍类型选择的两组经络性弱视患者。使用跨界设计，第一组交替运动10天，然后移动，然后用固定光栅刺激进行10天，第二组交替运动10天，静止时，然后用移动光栅刺激10天，即以相反的顺序进行。为了进行这种治疗，正弦调制的漂移光栅已作为简单计算机游戏的背景刺激而实现。这些游戏引起了孩子们的注意。对于本研究，这些练习由Amblyocation ltd的远程医疗门户提供。在以下两个版本中。第一个版本在视觉刺激过程中在计算机游戏的后面包含一个同心的向外移动的环形正弦光栅。光栅固定在0的空间频率上。3 cyc / deg，时间频率为1 cyc / sec，角速度为3.33 deg / sec。该程序的第二个版本包含相同的光栅，但显示方式不变。为了进一步区分设想的经络刺激效果，我们使用了哈尔科维奇研究所开发的一组方向敏感的光学字符，检查了患者的矫正视力。在所有患者的4个子午线（0度，45度，90度和135度）上测试了单眼矫正视力。另外，在第一组的所有患者和第二组的所有患者中，也检查了双眼视敏度。结果：在测量四个子午线的矫正视力时，在具有最大屈光不正的接近子午线的方向性光学特征的排列以及与之垂直的方向的最小改善的情况下，发现统计学上的显着改善。在两组患者中，由于在该阶段对患者进行了一系列运动，使用可移动的正弦曲线形光栅进行矫正，因此矫正的视力显着提高。但是，在使用固定式光栅进行治疗之后，没有发现统计学上的显着改善。结论：使用特殊的计算机游戏进行的远程医学练习包含移动的圆形正弦光栅，与最小屈光度子午线相比，在屈光度最高的子午线中，视力发育具有统计学上显着的正动态变化。