Analysis of patient adherence to emerging treatment tools for improving visual functions in amblyopia: A systematic review and meta-analysis

J Optom. 2026 Apr-Jun;19(2):100591. doi: 10.1016/j.optom.2025.100591. Epub 2025 Nov 26.

ABSTRACT

Adherence plays a critical role in the success of amblyopia treatment. Traditional approaches, such as occlusion therapy, often result in poor adherence, leading to suboptimal visual outcomes. Emerging home-based digital tools, such as video games, virtual reality, and movies, offer promising alternatives by increasing patient engagement and potentially enhancing treatment efficacy. This study aimed to evaluate adherence rates associated with emerging home-based interventions, identify key factors influencing adherence, and compare their effectiveness with that of traditional approaches. A comprehensive systematic literature review was conducted across PubMed, MEDLINE, Cochrane, Scopus, and Web of Science to identify eligible studies reporting adherence rates for home-based digital amblyopia therapies. A total of 27 studies were included, involving 1.727 participants aged between 3 and 35 years. The pooled adherence rate was 74.2% ± 21.9%, with a median of 80.5% (P25 = 59; P75 = 88.1). Movies achieved significantly higher adherence (84% ± 12.3%) than video games (68.4% ± 24.4%, p = 0.038). Adherence was higher in younger participants (p = 0.023) and was reduced with longer treatment duration (p = 0.005). Higher adherence correlated with greater visual acuity improvements (p < 0.001), while the association with stereopsis was weaker and not statistically significant (p = 0.095). These results suggest that emerging amblyopia therapies achieve adherence rates exceeding 70%, higher than traditional treatments. These findings emphasize the importance of age-appropriate and engaging treatment strategies to enhance both adherence and visual outcomes.

PMID:41309334 | PMC:PMC13063279 | DOI:10.1016/j.optom.2025.100591