Orthoptek Magnocellular Stimulation for Amblyopia Across Age Groups: Visual Recovery Beyond Childhood.

PURPOSE: To assess the outcome of Orthoptek Magnocellular Stimulator (OMS) therapy on visual acuity, binocular vision and stereopsis in patients with amblyopia across various age groups and to evaluate treatment efficacy.

METHODS

This prospective observational study included 106 patients with amblyopia who received OMS therapy. A 20-session course (30 minutes per session) was prescribed; actual treatment exposure varied and averaged 5.17 sessions. We assessed outcomes at the last available post-treatment visit (mean follow-up, 36.79 days; median, one day). We compared pre- and post-treatment visual acuity, stereopsis, central macular thickness (CMT) and retinal nerve fibre layer (RNFL) thickness. We performed regression analyses to identify factors associated with the final visual outcome.

RESULTS

Study participants' mean age was 17.55 ± 13.91 years. Refractive amblyopia was the most common subtype (67.9%), followed by strabismic amblyopia (30.2%). Mean amblyopic-eye visual acuity improved from 0.97 ± 0.53 to 0.75 ± 0.52 logarithm of the minimum angle of resolution (logMAR) (p < 0.001). Distance stereopsis improved significantly from 349.24 ± 281.62 to 291.05 ± 271.96 arc seconds (p < 0.001), while near stereopsis remained unchanged (p = 0.261). Optical coherence tomography (OCT) showed no clinically meaningful change in RNFL thickness. A small increase in amblyopic-eye CMT was statistically significant (mean change, 6.87 µm; p = 0.013) but was not associated with visual improvement and was considered of uncertain clinical relevance. Baseline visual acuity was the strongest predictor of outcome (β = 0.82, p < 0.001). Greater treatment exposure was independently associated with better visual recovery (β = -0.021, p = 0.014), whereas age, follow-up duration and amblyopia subtype were not significant predictors.

CONCLUSION

Orthoptek Magnocellular Stimulator therapy was associated with improved visual acuity and distance stereopsis. Retinal nerve fibre layer thickness remained stable, while the small statistically significant increase in amblyopic-eye CMT was not associated with visual improvement and had uncertain clinical significance. The absence of an age-related association suggests that visual improvement may be achievable beyond the traditional critical period. These preliminary findings support further controlled evaluation of OMS as a potential adjunct to amblyopia rehabilitation in younger and older patients.