Personalized Rehabilitation for Residual Deficits: Tailoring Perceptual Learning for Improved Visual Function in Meridional Amblyopia

This study explored the efficacy and predictors of success for a novel monocular fine orientation discrimination perceptual learning (fine-PL) approach in addressing perceptual deficits in meridional amblyopia (MA). Prospective, longitudinal study. Fifty-three children with persistent MA participated in this study. Twenty-one participants underwent a 14-day regimen of monocular fine-PL focused on grating orientation discrimination exercise (±5°) aligned with the vertical or horizontal meridian near each individual's threshold spatial frequencies. Nineteen participants underwent coarse orientation discrimination perceptual learning (coarse-PL), and 13 participants received optical correction alone. Measurements included both the best-corrected and uncorrected visual acuity (VA), contrast sensitivity function (CSF), and stereoacuity, with daily VA assessments during the training. Significant improvements were observed in uncorrected VA (increased by 1.3 lines, P < 0.001) and best-corrected VA (increased by 0.3 lines, P = 0.002) in the fine-PL group. Posttraining assessments showed enhancements in all measured CSF metrics, both with and without correction (all P < 0.05), and in both distance and near stereopsis (all P < 0.05). Compared with coarse-PL, fine-PL more effectively addressed residual deficits in uncorrected vision. Early changes in VA correlated significantly with final VA outcomes. A 6-month follow-up confirmed the retention of these gains. Fine-PL offers targeted rehabilitation for perceptual distortions in MA, with early responses during training serving as potential predictors of success. This personalized approach effectively addresses residual deficits beyond optical correction, offering a promising noninvasive option for visual function improvement. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.