虚拟现实技术在弱视患儿视觉训练中应用的范围综述

doi:10.3761/j.issn.0254-1769.2024.16.004

摘要/Abstract

摘要：

目的对虚拟现实技术在弱视患儿视觉训练中应用的相关研究进行范围综述，为规范其应用提供参考。方法依据范围界定审查指南，系统检索Embase、Web of Science、CINAHL、Cochrane Library、Scopus、PubMed、中国生物医学文献数据库、万方数据库、维普数据库、中国知网中的相关研究，检索时限为建库至2023年11月1日，对纳入文献进行归纳和分析。结果共纳入24篇文献。其中，二分法训练、视感知训练和视觉推拉模型训练为基于虚拟现实技术进行视觉训练的主要方式，通常以游戏、动画、视频影像的形式进行干预。评估指标包括视觉分辨率、最佳矫正视力、立体视、立体视敏锐度、对比敏感度、视觉诱发电位、三级视功能，以及安全性、训练依从性、接受度和满意度等。结论基于虚拟现实技术的视觉训练在弱视患儿中应用安全可行，可改善患儿视力、提高训练依从性。未来可基于虚拟现实技术开发智能化视觉训练系统，并根据患儿的年龄、弱视类型和程度，构建更科学、有效的结构化视觉训练方案。

关键词: 虚拟现实, 弱视, 视觉训练, 范围综述, 儿科护理学

Abstract:

Objective To provide a scoping review of relevant studies on the application of virtual reality technology in visual training for children with amblyopia，in order to provide a reference for standardising its application. Methods In accordance with the guidelines for scoping reviews，a systematic search of relevant studies was conducted in Embase，Web of Science，CINAHL，Cochrane Library，Scopus，PubMed，CBM，Wanfang Database，VIP Database，and CNKI from the establishment of the database to 1 November 2023. Following this search，the included literature was screened，summarized，and analyzed. Results A total of 24 papers were included. Among them，dichoptic training，visual perception training and visual push-pull model training are the main modalities of visual training based on virtual reality technology，usually with interventions in the form of games，animations，and video images. Evaluation indicators include visual resolution，best-corrected visual acuity，stereopsis，stereopsis acuity，contrast sensitivity，visual evoked potentials，tertiary visual function，as well as safety，training compliance，acceptance and satisfaction. Conclusion The application of visual training based on virtual reality technology in amblyopic children is safe and feasible，which can improve the children’s visual acuity and training compliance. In the future，an intelligent visual training system can be developed based on virtual reality technology，and a more scientific and effective structured visual training programme can be constructed according to the age，type and degree of amblyopia of the children.

Key words: Virtual Reality, Amblyopia, Visual Training, Scoping Review, Pediatric Nursing

王康, 王俏, 李静. 虚拟现实技术在弱视患儿视觉训练中应用的范围综述[J]. 中华护理杂志, 2024, 59(16): 1948-1956.

WANG Kang, WANG Qiao, LI Jing. Virtual reality applications in visual training for amblyopic children：a scoping review[J]. Chinese Journal of Nursing, 2024, 59(16): 1948-1956.

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参考文献 35

[1]	Fu ZJ, Hong H, Su ZC, et al. Global prevalence of amblyopia and disease burden projections through 2040:a systematic review and meta-analysis[J]. Br J Ophthalmol, 2020, 104(8):1164-1170.
[2]	Birch EE, Kelly KR, Giaschi DE. Fellow eye deficits in amblyopia[J]. J Binocul Vis Ocul Motil, 2019, 69(3):116-125. DOI PMID
[3]	Birch EE, Kelly KR. Amblyopia and the whole child[J]. Prog Retin Eye Res, 2023,93:101168.
[4]	Le T, Örge F. Treatment compliance in amblyopia:a mini-review and description of a novel online platform for compliance tracking[J]. Surv Ophthalmol, 2022, 67(6):1685-1697.
[5]	Caponnetto P, Triscari S, Maglia M, et al. The simulation game-virtual reality therapy for the treatment of social anxiety disorder:a systematic review[J]. Int J Environ Res Public Health, 2021, 18(24):13209.
[6]	Peters MDJ, Godfrey CM, Khalil H, et al. Guidance for conducting systematic scoping reviews[J]. Int J Evid Based Healthc, 2015, 13(3):141-146.
[7]	王喜益, 叶志弘, 汤磊雯. 范围综述在护理领域的应用进展[J]. 中华护理杂志, 2019, 54(8):1259-1263. DOI
	Wang XY, Ye ZH, Tang LW. An integrative review of scoping review applied in nursing literature[J]. Chin J Nurs, 2019, 54(8):1259-1263.
[8]	Rajavi Z, Sabbaghi H, Amini Sharifi E, et al. The role of interactive binocular treatment system in amblyopia therapy[J]. J Curr Ophthalmol, 2016, 28(4):217-222.
[9]	Rajavi Z, Sabbaghi H, Amini Sharifi E, et al. Comparison between patching and interactive binocular treatment in amblyopia:a randomized clinical trial[J]. J Curr Ophthalmol, 2019, 31(4):426-431.
[10]	Rajavi Z, Soltani A, Vakili A, et al. Virtual reality game playing in amblyopia therapy:a randomized clinical trial[J]. J Pediatr Ophthalmol Strabismus, 2021, 58(3):154-160. DOI PMID
[11]	Bankó éM, Barboni MTS, Markó K, et al. Fixation instability,astigmatism,and lack of stereopsis as factors impeding recovery of binocular balance in amblyopia following binocular therapy[J]. Sci Rep, 2022, 12(1):10311. DOI PMID
[12]	Huang X, Xia HK, Zhang Q, et al. New treatment for amblyopia based on rules of synaptic plasticity:a randomized clinical trial[J]. Sci China Life Sci, 2022, 65(3):451-465. DOI PMID
[13]	Jost RM, Hudgins LA, Dao LM, et al. Randomized clinical trial of streaming dichoptic movies versus patching for treatment of amblyopia in children aged 3 to 7years[J]. Sci Rep, 2022, 12(1):4157.
[14]	Leal Vega L, Piñero DP, Hernández Rodríguez CJ, et al. Study protocol for a randomized controlled trial of the NEIVATECH virtual reality system to improve visual function in children with anisometropic amblyopia[J]. BMC Ophthalmol, 2022, 22(1):253. DOI PMID
[15]	Li L, Xue HL, Lai TC, et al. Comparison of compliance among patients with pediatric amblyopia undergoing virtual reality-based and traditional patching method training[J]. Front Public Health, 2022,10:1037412.
[16]	Tan F, Yang XB, Fan YC, et al. The study of short-term plastic visual perceptual training based on virtual and augmented reality technology in amblyopia[J]. J Ophthalmol, 2022,2022:2826724.
[17]	Xiao S, Angjeli E, Wu HC, et al. Randomized controlled trial of a dichoptic digital therapeutic for amblyopia[J]. Ophthalmology, 2022, 129(1):77-85.
[18]	Emmanouil B, Spaho J, Chatzea M, et al. Dichoptic game training in strabismic amblyopia improves the visual evoked response[J]. Cureus, 2023, 15(9):e45395.
[19]	Kadhum A, Tan ETC, Fronius M, et al. Supervised dichoptic gaming versus monitored occlusion therapy for childhood amblyopia:effectiveness and efficiency[EB/OL]. (2023-04-20)[2023-11-01]. https://pubmed.ncbi.nlm.nih.gov/37078540/.
[20]	Meqdad Y, El-Basty M, Awadein A, et al. Randomized controlled trial of patching versus dichoptic stimulation using virtual reality for amblyopia therapy[EB/OL]. (2023-10-20)[2023-11-01]. https://pubmed.ncbi.nlm.nih.gov/37878538/.
[21]	Molina-Martín A, Leal-Vega L, de Fez D, et al. Amblyopia treatment through immersive virtual reality:a preliminary experience in anisometropic children[J]. Vision, 2023, 7(2):42.
[22]	陈珊珊. 目力精细训练联合虚拟现实视觉训练治疗弱视患儿的临床疗效[J]. 当代医学, 2022, 28(22):69-71.
	Chen SS. Clinical effect of fine visual training combined with virtual reality visual training in the treatment of children with amblyopia[J]. Contemp Med, 2022, 28(22):69-71.
[23]	杜玲芳, 高娜, 何芳, 等. 虚拟现实技术视觉训练联合家庭训练治疗大龄弱视儿童的效果观察[J]. 当代医学, 2022, 28(14):103-106.
	Du LF, Gao N, He F, et al. Observation on the effect of virtual reality visual training combined with family training on elderly amblyopia children[J]. Contemp Med, 2022, 28(14):103-106.
[24]	韩立坡, 王凤仙, 张诚玥. 精细训练联合虚拟现实视觉训练治疗弱视的疗效分析[J]. 国际眼科杂志, 2020, 20(9):1649-1652.
	Han LP, Wang FX, Zhang CY. Analysis of the effect of fine training combined with virtual reality vision training on amblyopia[J]. Int Eye Sci, 2020, 20(9):1649-1652.
[25]	李超颖, 杨成明, 聂晓梅. 虚拟现实训练在弱视患儿中的应用效果及其对视觉诱发电位的影响[J]. 中外医学研究, 2022, 20(5):28-31.
	Li CY, Yang CM, Nie XM. Application effect of virtual reality training in amblyopia children and its influence on visual evoked potential[J]. Chin Foreign Med Res, 2022, 20(5):28-31.
[26]	刘津津. 弱视患儿应用精细训练联合虚拟现实视觉训练治疗的效果观察[J]. 中国实用医药, 2021, 16(24):196-198.
	Liu JJ. Observation on the effect of fine training combined with virtual reality visual training in amblyopia children[J]. China Pract Med, 2021, 16(24):196-198.
[27]	韦仕岗, 蓝剑青, 谢文娟, 等. 虚拟现实视感知觉平台在近视性屈光参差性弱视患者立体视功能可塑性的临床应用研究[J]. 中国斜视与小儿眼科杂志, 2019, 27(4):13-15.
	Wei SG, Lan JQ, Xie WJ, et al. Clinical application of virtual reality visual perception platform in stereoscopic visual plasticity of patients with myopic anisometropic amblyopia[J]. Chin J Strabismus Pediatr Ophthalmol, 2019, 27(4):13-15.
[28]	魏聪. 基于推拉模型的虚拟现实技术在弱视患者的临床应用研究[D]. 开封: 河南大学, 2020.
	Wei C. Research on clinical application of virtual reality technology based on push-pull model in amblyopic patients[D]. Kaifeng: Henan University, 2020.
[29]	邢文肖. 虚拟现实训练在儿童弱视治疗中的应用研究[J]. 医药卫生, 2023, 16(7):35-37.
	Xing WX. Study of virtual reality training in the treatment of amblyopia in children[J]. Med Heal Sci, 2023, 16(7):35-37.
[30]	徐莺歌, 张欣星, 钱锦芳, 等. 虚拟现实视觉训练对斜视性弱视患儿病情的影响分析[J]. 中国医学工程, 2023, 31(7):80-83.
	Xu YG, Zhang XX, Qian JF, et al. Effects of virtual reality visual training on strabismus amblyopia in children[J]. China Med Eng, 2023, 31(7):80-83.
[31]	张威, 余爱华, 蔡小军. 视觉虚拟现实训练与传统训练方法治疗儿童弱视的比较[J]. 中华眼视光学与视觉科学杂志, 2020, 22(11):842-846.
	Zhang W, Yu AH, Cai XJ. Comparison of visual virtual reality training and traditional treatment for childhood amblyopia[J]. Chin J Optom Ophthalmol Vis Sci, 2020, 22(11):842-846.
[32]	徐雪芬, 王红燕, 郭萍萍, 等. 人工智能在慢性病患者健康管理中的应用进展[J]. 中华护理杂志, 2023, 58(9):1063-1067. DOI
	Xu XF, Wang HY, Guo PP, et al. Progress on the application of artificial intelligence in chronic disease health management[J]. Chin J Nurs, 2023, 58(9):1063-1067. DOI
[33]	梅阳阳, 张琪, 林晓琼, 等. 以患者为中心的居家护理服务质量评价指标的构建[J]. 中华护理杂志, 2021, 56(10):1533-1539. DOI
	Mei YY, Zhang Q, Lin XQ, et al. Construction of patient-centered evaluation index of home nursing service quality[J]. Chin J Nurs, 2021, 56(10):1533-1539. DOI
[34]	卢明, 俞燕娟, 李中东, 等. 基于家庭医护平台延续性护理模式的构建及应用[J]. 中华护理杂志, 2019, 54(12):1851-1855. DOI
	Lu M, Yu YJ, Li ZD, et al. Construction and application of continuity nursing model based on family medical platform[J]. Chin J Nurs, 2019, 54(12):1851-1855. DOI
[35]	王之惠, 任永霞, 史宇红, 等. 弱视儿童视功能相关生活质量量表的编制及信效度检验[J]. 中华护理杂志, 2022, 57(20):2507-2514. DOI
	Wang ZH, Ren YX, Shi YH, et al. Development of Visual Function Related Quality of Life Scale for Children with Amblyopia and the test of its reliability and validity[J]. Chin J Nurs, 2022, 57(20):2507-2514.