@misc{10481/111792,
year = {2026},
month = {2},
url = {https://hdl.handle.net/10481/111792},
abstract = {Objectives: Persistent amblyopia often shows limited response to occlusion therapy once 
visual acuity improvement plateaus. This study evaluated the efficacy of a two-phase pro
tocol combining occlusion therapy and home-based perceptual learning (PL) in children 
with persistent amblyopia, including those with congenital pathology. Methods: This lon
gitudinal case series included 40 patients (mean age 9.4 ± 3.4 years). Phase I consisted of 
occlusion therapy until best-corrected visual acuity (BCVA) plateaued. Phase II combined 
continued occlusion with home-based PL training until BCVA in amblyopic eye reached 
0.00 logMAR or treatment was discontinued. BCVA and stereoacuity (TNO test) were as
sessed at baseline, after Phase I, after Phase II when applicable, and at a prospective eval
uation visit. Treatment success was defined as a gain of ≥2 logMAR lines or a final BCVA 
≤0.10 logMAR. Patients were stratified according to cumulative training exposure (<10 h 
vs. ≥10 h). Results: After Phase I, mean BCVA improved from 0.45 ± 0.23 to 0.26 ± 0.19 
logMAR (p < 0.01). After Phase II, BCVA further improved to 0.13 ± 0.16 logMAR (p < 0.01). 
Stereoacuity showed a modest but significant improvement, from 928 ± 505 to 748 ± 558 
arcsec (p = 0.01). Treatment success was achieved in 72% of patients completing ≥10 h of 
perceptual learning compared with 40% in those completing <10 h (RR = 1.94, 95% CI 
1.01–3.73). Patients with non-pathological amblyopia achieved greater final BCVA than 
those with congenital pathology. Conclusions: The combination of occlusion therapy and 
home-based PL was associated with further improvement in visual acuity and modest 
gains in stereoacuity in children with persistent amblyopia. Greater cumulative training 
exposure was associated with higher treatment success, supporting PL as a clinically val
uable adjunct to standard amblyopia management.},
publisher = {MDPI},
keywords = {Persistent amblyopia},
keywords = {Perceptual learning},
keywords = {Occlusion therapy},
title = {Combined Occlusion Therapy and Home-Based Perceptual  Learning in Children with Persistent Amblyopia: A Longitudinal Case Series},
doi = {10.3390/jcm15051817},
author = {Pérez Benito, Maria and Amigo Gamero, Raquel and Calderón González, Teresa and Cardona Pérez, Juan De La Cruz and Martín González, Santiago and Portela Camino, Juan A.},
}