Smartphone-Based Digital Therapeutics for Pediatric Amblyopia: A Systematic Review of Mobile Applications for Vision Training, Treatment Monitoring, and Clinical Outcome Assessment

Abstract

One of the most prevalent types of avoidable visual impairment in children is amblyopia that affects the quality of life and visual development profoundly. The traditional methods of patching, pharmacologically penalizing, are usually associated with difficulties in compliance and poor engagement. Digital therapeutics based on smartphone have become a recent innovation and have been proposed as an alternative to traditional methods of enhancing treatment outcomes and adherence through interactive interfaces, gamification and real-time monitoring. The proposed systematic review will review the effectiveness and clinical utility of smartphone-based applications to manage pediatric amblyopia, specifically vision training, treatment monitoring, and outcome assessment. The search was performed in major databases, such as PubMed, Scopus, Web of Science, and Cochrane Library, as a result of a systematic screening procedure, according to pre-determined inclusion and exclusion criteria, and according to PRISMA requirements. The review found a selection of applications with the implementation of such features as dichoptic training, perceptual learning, and compliance tracking. Comprehensively, the results indicate that such digital interventions demonstrate encouraging progress in terms of visual acuity and patient compliance when compared to the conventional ones, but the inconsistency in study designs and app features is observed. Although promising, the constraints on the small sample sizes and absence of long-term evidence indicate that new studies and standardization should be done.