A pilot, randomized clinical trial of dichoptic 3D movies versus dichoptic 2D movies for treatment of childhood intermittent exotropia.

BACKGROUND

Surgical and nonsurgical treatments of childhood intermittent exotropia (IXT) often have unsatisfactory results due to poor sensory status. Dichoptic 3D movies may offer a novel treatment designed to reduce suppression, encourage fusion, and engage stereoacuity. Our aim was to assess whether 3D movies are superior to 2D sham movies treatment in treating children with IXT.

METHODS

In this masked, pilot randomized clinical trial, 41 children aged 3-13 years with spontaneously manifested IXT (triple office distance control score ≥3.00; mean, 3.64 ± 0.72) were assigned to watch dichoptic 3D animated movies or 2D sham movies (3 movies/week, ∼5 hours) for 4 weeks. After completing their treatment assignment, children returned to the masked pediatric eye specialist to reassess IXT control and ocular alignment, with change in triple office distance control score as the primary outcome. Distance and near stereoacuity were also assessed.

RESULTS

After 4 weeks of treatment, the 3D movie group showed a significant improvement in mean triple office distance control score (1.39 ± 1.00; P = 0.0002; n = 14); the 2D sham movie group did not (0.62 ± 1.36; P = 0.11; n = 14). The 3D movie group had significantly more improvement in distance control than the sham group (P = 0.049), but near control, ocular alignment, and stereoacuity did not change for either group.

CONCLUSIONS

In our study cohort, at-home dichoptic 3D animated movie treatment significantly improved IXT triple office distance control scores after 4 weeks, indicating that it might provide an alternative nonsurgical treatment for childhood intermittent exotropia.