1
|
Li Y, Duffy S, Wilks S, Keel R, Beswick R, Dai S. Prevalence of visual abnormalities detected through paediatric vision screening in Queensland, Australia. Clin Exp Ophthalmol 2024. [PMID: 39363480 DOI: 10.1111/ceo.14448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 08/03/2024] [Accepted: 09/13/2024] [Indexed: 10/05/2024]
Abstract
BACKGROUND Vision screening programs can provide epidemiological information regarding visual impairment in children. This study aims to report the characteristics of visual abnormalities diagnosed through the Primary School Nurse Health Readiness Program (PSNHRP) in Queensland, Australia. METHODS A retrospective review of vision screening records from the PSNHRP between January 2017 and December 2020 was undertaken. Children aged between 4 and 7 who underwent vision screening were included for review. Children with a visual acuity of worse than 6/9-1 using the Parr 4 m letter-matching chart or those who failed the SPOT Vision Screener were referred to an optometrist or ophthalmologist for review. RESULTS 164 890 children underwent vision screening. 12148 children failed visual screening (7.4%) and were referred for an eye assessment. 6011 (69.4%) of the 8659 children who attended ophthalmic review had a confirmed visual abnormality. Of 164 890 screened children, 1187 (0.72%) were confirmed to have anisometropia, 3843 (2.33%) had refractive error, 194 (0.12%) had strabismus, 755 (0.46%) had anisometropic amblyopia, 136 (0.08%) had strabismic amblyopia, and 1356 (0.82%) had an unspecific abnormality. There was no statistically significant difference in the age at screening between any visual abnormality (p = 0.94). Anisometropia, refractive error, and strabismus were significantly more common in females than males (p = 0.03, p < 0.01, and p = 0.03 respectively), whereas anisometropic amblyopia was more common in males (p < 0.01). CONCLUSIONS We report the prevalence of visual abnormalities detected through the PSNHRP vision screening program. Identification of medical or socioeconomic risk factors that are likely to be associated with visual abnormalities can help to optimise vision screening programs.
Collapse
Affiliation(s)
- Ye Li
- Department of Ophthalmology, Queensland Children's Hospital, Children's Health Queensland, Brisbane, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Shelley Duffy
- Child and Youth Community Health Services, Children's Health Queensland, Brisbane, Australia
| | - Sagen Wilks
- Child and Youth Community Health Services, Children's Health Queensland, Brisbane, Australia
| | - Rachel Keel
- Child and Youth Community Health Services, Children's Health Queensland, Brisbane, Australia
| | - Rachael Beswick
- Child and Youth Community Health Services, Children's Health Queensland, Brisbane, Australia
| | - Shuan Dai
- Department of Ophthalmology, Queensland Children's Hospital, Children's Health Queensland, Brisbane, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| |
Collapse
|
2
|
Altamirano F, Gonzalez E, Shah AS, Oke I. Preventable vision loss in children with Coats disease. J AAPOS 2024:104000. [PMID: 39278531 DOI: 10.1016/j.jaapos.2024.104000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 07/16/2024] [Accepted: 07/19/2024] [Indexed: 09/18/2024]
Abstract
PURPOSE To describe the prevalence and risk factors associated with amblyogenic refractive error in children with Coats disease. METHODS The medical records of children (<18 years of age) with unilateral Coats disease treated at a single tertiary care center were retrospectively reviewed. Data collected included patient demographics, ocular examinations, and treatments. Outcomes included the prevalence and factors associated with amblyogenic refractive error. RESULTS A total of 50 children (82% male) were included; of these, 37 (74%) had refractive data to review. The median age at presentation was 5 years (IQR, 2-10). The Coats disease classification was stage 1 in 1 (2%), stage 2 in 29 (58%), and stage 3 or greater in 20 (40%). Most children (76%) had at least one visit with a pediatric specialist; the rest were only seen by a retina specialist. Among patients with refractive data, amblyogenic refractive error was identified in 46%. Glasses were prescribed to 50% of children. Children diagnosed at an earlier age had increased odds of amblyogenic refractive error (OR = 0.72; 95% CI, 0.57-0.91; P = 0.006) than those diagnosed at an older age. CONCLUSIONS Our results suggest that amblyogenic refractive error is prevalent among children with Coats disease, and refractions are not always performed. There is a need to coordinate care between pediatric and retina specialists caring for children with Coats disease to ensure timely diagnosis of amblyogenic refractive error to optimize visual outcomes in this population.
Collapse
Affiliation(s)
- Francisco Altamirano
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Efren Gonzalez
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ankoor S Shah
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Isdin Oke
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
| |
Collapse
|
3
|
Wang S, Zhang B, Liu Q, Zhou F, Chen Y, Xu J. Spectacle correction may affect refractive progression in children with unilateral myopic anisometropia: A retrospective study. Ophthalmic Physiol Opt 2024. [PMID: 39193652 DOI: 10.1111/opo.13382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 08/11/2024] [Accepted: 08/12/2024] [Indexed: 08/29/2024]
Abstract
OBJECTIVE To investigate the effect of spectacle correction on refractive progression in children with unilateral myopic anisometropia (UMA). METHODS In this retrospective study, 153 children with UMA (aged 8-12 years) were recruited and classified into an uncorrected (UC) group (n = 47) and a spectacle (SP) group (n = 106). The spherical equivalent refraction (SER) of the myopic eyes ranged from -0.75 to -4.00 D; the SER of the emmetropic eyes ranged from +1.00 to -0.25 D; anisometropia was ≥1.00 D and the follow-up duration was 1 year. Nineteen subjects from the SP group with follow-up records spanning at least 6 months before and after wearing spectacles were selected as a subgroup. Changes in the SER and axial length (AL), the degree of anisometropia and interocular AL differences of the two groups and the subgroup were analysed. RESULTS During the 1-year follow-up period, AL and SER changes in myopic eyes were significantly greater than those in emmetropic eyes in the UC group (p < 0.001). For the UC group, the degree of anisometropia and AL change increased (all p < 0.001). For the SP group, there were no significant differences in the degree of anisometropia or AL change (all p > 0.05). When comparing the groups, AL elongation of the myopic eyes in the UC group occurred significantly faster than in the SP group (p = 0.02), and AL elongation for the emmetropic eyes in the UC group occurred significantly slower than in the SP group (p = 0.04). For the subgroup, the AL and SER changes in the myopic eyes 6 months before wearing spectacles occurred significantly faster than those after correction (p < 0.001). CONCLUSIONS Spectacle correction could prevent increased anisometropia in uncorrected children with UMA by slowing myopia progression in the myopic eyes and accelerating the myopic shift in the contralateral eye.
Collapse
Affiliation(s)
- Shuai Wang
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Engineering Research Centre of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Beilei Zhang
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Engineering Research Centre of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Qiming Liu
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Engineering Research Centre of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Fan Zhou
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Engineering Research Centre of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yunyun Chen
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Engineering Research Centre of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jingjing Xu
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Engineering Research Centre of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| |
Collapse
|
4
|
Jia WN, Chen ZX, Wang YL, Shen X, Chen XY, Chen TH, Sun Y, Liu Y, Song LH, Huo QY, Jiang YX. Genotype Associated With Visual Prognosis in Patients With Congenital Ectopia Lentis Following Lens Surgery: A Prospective Cohort Study. Am J Ophthalmol 2024; 268:285-295. [PMID: 39121940 DOI: 10.1016/j.ajo.2024.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 08/01/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024]
Abstract
PURPOSE To investigate the relationship between visual prognosis and genotype in patients undergoing lens surgery for congenital ectopia lentis (EL). DESIGN Prospective clinical cohort study. METHODS Patients with congenital EL who underwent lens removal and intraocular lens implantation received panel-based next-generation sequencing. Patients were grouped into children and adolescents/adults based on the age at surgery. The visual prognosis, including best-corrected visual acuity (BCVA) and amblyopia, was stratified into short-term and medium to long-term. RESULTS This study included 329 probands with congenital EL, with a median age at lens surgery of 7.00 years (interquartile range [IQR] = 5.00, 12.50 years). Children with the non-FBN1 mutation exhibited inferior medium to long-term postoperative BCVA (0.26 [IQR: 0.14, 0.33] vs 0.15 [IQR: 0.10, 0.22], P = .034) and a higher prevalence of amblyopia (44.4% vs 16.8%, P = .012) compared to those with FBN1 mutation. Multivariable analysis showed that genotype (FBN1 vs non-FBN1 mutation) was significantly associated with medium to long-term postoperative BCVA (b = -0.128, 95% CI -0.214 to -0.042, P = .004) and amblyopia (OR = 0.20, 95% CI 0.05-0.78, P = .020) in children. Further classification of FBN1 genotype did not yield significant correlations with visual prognosis. However, no significant correlation was observed between genotype and short-term visual prognosis in the children. Children with less severe EL (OR = 0.13, 95% CI 0.02-0.85, P = .033) had lower risks of amblyopia in the short-term follow-up. For adolescent and adult patients with congenital EL, those with poor preoperative BCVA and long axial length should be informed of suboptimal visual prognosis. CONCLUSIONS Genotype significantly influences the medium to long-term visual prognosis in children with congenital EL. Genotype, along with preoperative BCVA, may assist in establishing reasonable expectations for patients regarding their visual outcomes after the lens surgery.
Collapse
Affiliation(s)
- Wan-Nan Jia
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Ze-Xu Chen
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Ya-Lei Wang
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Xin Shen
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Xin-Yao Chen
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Tian-Hui Chen
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Yang Sun
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Yan Liu
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Ling-Hao Song
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Qiu-Yi Huo
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Yong-Xiang Jiang
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China.
| |
Collapse
|
5
|
Kinori M, Nitzan I, Szyper NS, Achiron A, Spierer O. Correlation of Refractive Error with Anisometropia Development in Early Childhood. Am J Ophthalmol 2024; 264:145-153. [PMID: 38552933 DOI: 10.1016/j.ajo.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/08/2024] [Accepted: 03/11/2024] [Indexed: 05/04/2024]
Abstract
PURPOSE This study aims to investigate the relationship between the type and severity of refractive error and anisometropia development in preschool children. DESIGN Retrospective cohort study. METHODS Data from Maccabi Healthcare Services, Israel's second-largest Health Maintenance Organization (HMO), were analyzed. The study included all isometropic children aged 1 to 6 years, re-examined for refraction at least 2 years following their initial examination between 2012 and 2022. Anisometropia was defined as a ≥1 diopter interocular difference in spherical equivalent. Relationships were assessed using logistic regression models adjusted for key sociodemographic factors. RESULTS Among 33,496 isometropic children (51.2% male, mean age 3.2 ± 1.5 years), the prevalences of emmetropia, myopia, and hyperopia were 26.7% (n = 8944), 4.2% (n = 1397), and 69.1% (n = 23,155), respectively. Over a mean follow-up period of 5.1 ± 2.4 years, 2593 children (7.7%) were diagnosed with anisometropia. Adjusted odds ratios (ORs) for anisometropia gradually increased with baseline refractive error severity, reaching 13.90 (5.32-36.34) in severe myopia and 4.19 (3.42-5.15) in severe hyperopia. This pattern was also evident in cylindrical anisometropia, where ORs increased with greater baseline astigmatism, peaking at 12.10 (9.19-15.92) in children with high astigmatism (≥3 D). Associations remained consistent in sensitivity and subgroup analyses including across both sexes and when using a stricter anisometropia criterion. CONCLUSIONS Children aged 1 to 6 years, initially without anisometropia but showing increasing severity of myopia, hyperopia, or astigmatism, are more likely to develop anisometropia. This underscores the importance of follow-up refractive measurements within this population to promptly diagnose and treat anisometropia and prevent potential visual complications.
Collapse
Affiliation(s)
- Michael Kinori
- Department of Ophthalmology (M.K.), Assuta Medical Center Ashdod, Israel and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Itay Nitzan
- Department of Ophthalmology (I.N.), Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Department of Military Medicine, Faculty of Medicine (I.N.), Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Asaf Achiron
- Department of Ophthalmology (A.A.), Tel Aviv Medical Center, Tel Aviv, Israel; Faculty of Medicine (A.A., O.S.), Tel Aviv University, Tel Aviv, Israel
| | - Oriel Spierer
- Faculty of Medicine (A.A., O.S.), Tel Aviv University, Tel Aviv, Israel; Department of Ophthalmology (O.S.), E. Wolfson Medical Center, Holon, Israel
| |
Collapse
|
6
|
Ong J, Waisberg E, Masalkhi M, Suh A, Kamran SA, Paladugu P, Sarker P, Zaman N, Tavakkoli A, Lee AG. "Spaceflight-to-Eye Clinic": Terrestrial advances in ophthalmic healthcare delivery from space-based innovations. LIFE SCIENCES IN SPACE RESEARCH 2024; 41:100-109. [PMID: 38670636 DOI: 10.1016/j.lssr.2024.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/08/2024] [Indexed: 04/28/2024]
Abstract
The phrase "Bench-to-Bedside" is a well-known phrase in medicine, highlighting scientific discoveries that directly translate to impacting patient care. Key examples of translational research include identification of key molecular targets in diseases and development of diagnostic laboratory tests for earlier disease detection. Bridging these scientific advances to the bedside/clinic has played a meaningful impact in numerous patient lives. The spaceflight environment poses a unique opportunity to also make this impact; the nature of harsh extraterrestrial conditions and medically austere and remote environments push for cutting-edge technology innovation. Many of these novel technologies built for the spaceflight environment also have numerous benefits for human health on Earth. In this manuscript, we focus on "Spaceflight-to-Eye Clinic" and discuss technologies built for the spaceflight environment that eventually helped to optimize ophthalmic health on Earth (e.g., LADAR for satellite docking now utilized in eye-tracking technology for LASIK). We also discuss current technology research for spaceflight associated neuro-ocular syndrome (SANS) that may also be applied to terrestrial ophthalmic health. Ultimately, various advances made to enable to the future of space exploration have also advanced the ophthalmic health of individuals on Earth.
Collapse
Affiliation(s)
- Joshua Ong
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, United States.
| | - Ethan Waisberg
- Department of Ophthalmology, University of Cambridge, Cambridge, United Kingdom
| | - Mouayad Masalkhi
- University College Dublin School of Medicine, Belfield, Dublin, Ireland
| | - Alex Suh
- Tulane University School of Medicine, New Orleans, LA, United States
| | - Sharif Amit Kamran
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV, United States
| | - Phani Paladugu
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States
| | - Prithul Sarker
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV, United States
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV, United States
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV, United States
| | - Andrew G Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, United States; Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, United States; The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX, United States; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, United States; Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, United States; University of Texas MD Anderson Cancer Center, Houston, TX, United States; Texas A&M College of Medicine, TX, United States; Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| |
Collapse
|
7
|
Kirik F, Ozbas C, Elbay A, Ekinci Aslanoglu C, Ozdemir H. Characteristics of myopic and hyperopic eyes in patients with antimetropia. Clin Exp Optom 2024; 107:291-298. [PMID: 37216951 DOI: 10.1080/08164622.2023.2213825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 04/10/2023] [Accepted: 05/07/2023] [Indexed: 05/24/2023] Open
Abstract
CLINICAL RELEVANCE Antimetropia is a rare type of anisometropia in which one eye is myopic and the fellow is hyperopic, This optical condition condition permits the evaluation of both sides of the emmetropisation process failure in the same individual by minimising genetic and environmental factors. BACKGROUND This study aimed to evaluate the ocular biometric, retinal, and choroidal characteristics of myopic and hyperopic eyes of antimetropic subjects older than six years. METHODS In this retrospective study, myopic and hyperopic eyes of 29 antimetropic patients with a spherical equivalent (SE) difference of at least 2.00D between the eyes were included. Axial length (AL), mean corneal keratometry, anterior chamber depth, the proportion of anterior chamber depth in AL, crystalline lens power, central macular thicknesses, disc-to-fovea distance, fovea-disc angle, peripapillary retinal nerve fibre layer (RNFL) thicknesses, and subfoveal choroidal features were compared between the eyes. The prevalence of amblyopia was determined. Refractive parameters and total astigmatic profile were evaluated in eyes with and without amblyopia. RESULTS The median absolute SE and AL differences between the eyes were 3.50D (interquartile range:1.75) and 1.18 mm (interquartile range:0.76), respectively (p < 0.001). Myopic eyes had lower crystalline lens power and proportion of anterior chamber depth in AL, and longer disc-to-fovea distance. Macular thicknesses, global RNFL, and temporal RNFL were thicker in myopic eyes, and there was no difference in other RNFL quadrants. Despite the increase in the choroidal vascularity index, other choroidal parameters were decreased in myopic eyes. Amblyopia was found in three of the myopic eyes and seven of the hyperopic eyes (p = 0.343). The highest interocular SE and AL difference and the highest frequency of anisoastigmatism were observed in patients with amblyopia in the myopic eye. CONCLUSION Each ocular structure may respond differently to, or may be affected differently by, ametropic conditions.
Collapse
Affiliation(s)
- Furkan Kirik
- Department of Ophthalmology, Bezmialem Vakif University, Istanbul, Turkey
| | - Cumhur Ozbas
- Department of Ophthalmology, Bezmialem Vakif University, Istanbul, Turkey
| | - Ahmet Elbay
- Department of Ophthalmology, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Hakan Ozdemir
- Department of Ophthalmology, Bezmialem Vakif University, Istanbul, Turkey
| |
Collapse
|
8
|
Hashemi H, Khabazkhoob M, Lança C, Emamian MH, Fotouhi A. Prevalence of anisometropia and its associated factors in school-age children. Strabismus 2024; 32:1-10. [PMID: 38230509 DOI: 10.1080/09273972.2023.2293883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
PURPOSE To determine the prevalence of anisometropia and the associated demographic and biometric risk factors in children. METHODS This cross-sectional study was conducted on the elementary school children of Shahroud, east of Iran, in 2015. All rural students were recruited, while multistage cluster sampling was used to select the students in urban areas. All children underwent optometric examinations including the measurement of uncorrected and corrected visual acuity, autorefraction, and subjective refraction with cycloplegia. Biometric components were measured using the Allegro Biograph. Myopia and hyperopia were defined as a spherical equivalent ≤-0.5 and ≥ +2.00 diopter, respectively. Students with a history of ocular trauma or lack of cycloplegic refraction at least in one eye were excluded from the study. RESULTS Of 6624 selected children, 5620 participated in the study. After applying the exclusion criteria, the data of 5357 students (boys: 52.8%, n = 2834) were analyzed. The mean age of the subjects was 9.2 ± 1.7 years (range: 6-12 years). The prevalence of anisometropia ≥ 1 D was 1.1% (95% CI: 0.8 to 1.4) in all children, 1.0% (95% CI: 0.7-1.3) in boys, 1.3% (95% CI: 0.8-1.7) in girls, 1.1% (95% CI: 0.8-1.4) in urban children, and 1.4% (95% CI: 0.5-2.3) in rural children. The prevalence of anisometropia was 8.8% (95% CI: 5.3-12.2) in myopic and 5.7% (95% CI: 2.8-8.5) in hyperopic children. Axial length asymmetry (OR = 40.9; 95%CI: 10.2-164.1), myopia (OR = 17.9; 95% CI: 9.4-33.9), and hyperopia (OR = 10.1; 95% CI: (5.1-19.7) were associated with anisometropia in multiple logistic regression model. More anisometropia was associated with more severe amblyopia. The odds of amblyopia (OR = 82.3: 38.2-177-3) and strabismus (OR = 17.6: 5.5-56.4) were significantly higher in anisometropic children. The prevalence of amblyopia was 21.7% in children with myopic anisometropia ≥ 3D, 66.7% in children with hyperopic anisometropia ≥ 3D, and 100% in cases with antimetropia ≥ 3D. CONCLUSION The prevalence of anisometropia was low in Iranian school children. However, a high percentage of anisometropic students had amblyopia and strabismus. Axial length was the most important biometric component associated with anisometropia.
Collapse
Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Carla Lança
- Escola Superior de Tecnologia da Saúde de Lisboa (ESTeSL), Instituto Politécnico de Lisboa, Lisboa, Portugal
- Comprehensive Health Research Center (CHRC), Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
9
|
Li Q, Xie X, Yang J, Gao P, Li W. Bilateral Femtosecond Laser-Assisted Clear Lens Extraction with Trifocal Intraocular Lens Implantation for Presbyopia Correction: A Short-Term Observational Study in Chinese Adults. Clin Ophthalmol 2024; 18:623-630. [PMID: 38481540 PMCID: PMC10936733 DOI: 10.2147/opth.s453143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/25/2024] [Indexed: 03/17/2024] Open
Abstract
Purpose To observe the outcome of bilateral femtosecond laser-assisted clear lens extraction with trifocal intraocular lens (IOL) implantation for presbyopia correction and evaluate its feasibility in early presbyopic adults. Methods Prospective case series of eyes with clear crystalline lenses that underwent femtosecond laser-assisted lens extraction and trifocal IOL (Acrysof IQ PanOptix, Model TFNT00, Alcon) implantation between 2021 and 2023 were followed up for at least 3 months after surgery. Outcome measures included monocular uncorrected visual acuity at near (UNVA, 40 cm), intermediate (UIVA, 60 cm), and distance (UDVA, 5 m), monocular manifest refraction, corrected distance visual acuity (CDVA), defocus curve assessment, and spectacle independence at both near and distance. Results A total of 60 eyes from 30 consecutive patients were included, and their mean age was 50.4±6.5 years. After surgery, the mean UNVA (LogMAR) increased from 0.28±0.16 to 0.08±0.07, UIVA increased from 0.25±0.12 to 0.09±0.06, and UDVA increased from 0.27±0.21 to 0.01±0.08. The enhancements of UNVA, UIVA and UDVA were all significant (P < 0.05). The optometric results showed that the mean postoperative spherical equivalent (SE) was -0.21±0.24 D, and the mean postoperative CDVA (LogMAR) was -0.00±0.06. The preoperative spectacle independences at near and distance were 46.7% (14/30) and 56.7% (17/30), respectively, and both increased to 100% at 3 months after surgery. Conclusion Satisfactory visual outcomes and safe surgical procedures were observed in this study, which demonstrate that bilateral femtosecond laser-assisted clear lens extraction with PanOptix IOL implantation could be a feasible approach for presbyopia correction in working-age Chinese patients.
Collapse
Affiliation(s)
- Qingchen Li
- Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Shanghai Aier Eye Institute, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, 410011, People’s Republic of China
| | - Xiaolin Xie
- Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Shanghai Aier Eye Institute, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
| | - Jiasong Yang
- Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Shanghai Aier Eye Institute, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, 410015, People’s Republic of China
| | - Peng Gao
- Department of Ophthalmology, Shanghai Tenth People’s Hospital of Tongji University, Tongji University School of Medicine, Shanghai, 200072, People’s Republic of China
| | - Wensheng Li
- Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Shanghai Aier Eye Institute, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, 410015, People’s Republic of China
| |
Collapse
|
10
|
Fernandes A, Pinto N, Tuna AR, Brardo FM, Pato MV. Pattern electroretinography response in amblyopic adults. Int Ophthalmol 2024; 44:86. [PMID: 38363441 PMCID: PMC10873232 DOI: 10.1007/s10792-024-03042-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 01/13/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION Amblyopia is generally a unilateral disorder, defined by at least a difference of two lines of visual acuity between both eyes with the best-corrected visual acuity, a decrease in contrast sensitivity, and a decrease in stereopsis. Pattern electroretinogram (PERG) is a noninvasive technique that provides a retinal biopotential and is a highly sensitive indicator of changes in the macular area. Our aim was to evaluate if there are differences in the retinal response of an amblyopic eye compared with a normal eye (NE). METHODS We evaluated twenty-four adult volunteers, twelve amblyopes (mean 43.42 ± 12.72 years old), and twelve subjects with NE (mean 35.58 ± 12.85 years old). None of the subjects in the two groups had comorbidities. A complete optometric examination was performed including parameters such as visual acuity (VA) by far and near with ETDRS chart, eye alignment with cover test, and evaluation of retinal cells response with PERG. RESULTS The refractive error found in the NE group of subjects had a mean of - 0.95 ± 1.65D, while the amblyopic group showed a mean of - 2.03 ± 4.29D. The VA in amblyopic eyes had a mean of 0.38 ± 0.20 logMAR. Analyzing PERG data, we observed significant differences in the P50-N95 amplitudes of the amblyopic group compared with the NE group (p < 0.0001-amblyopic eye vs. NE; p = 0.039-fellow eye vs. NE). DISCUSSION These findings suggest that amblyopic patients may also present other impairments beyond the visual cortex. PERGs seem to be an important complementary examination in the diagnosis of other impairments in amblyopia.
Collapse
Affiliation(s)
- Andresa Fernandes
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.
- Faculty of Health Sciences, Rua Marquês de Ávila E Bolama, CICS-Health Sciences Research Centre, University of Beira Interior, 6201-001, Covilhã, Portugal.
| | - Nuno Pinto
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- Faculty of Health Sciences, Rua Marquês de Ávila E Bolama, CICS-Health Sciences Research Centre, University of Beira Interior, 6201-001, Covilhã, Portugal
| | - Ana Rita Tuna
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- Faculty of Health Sciences, Rua Marquês de Ávila E Bolama, CICS-Health Sciences Research Centre, University of Beira Interior, 6201-001, Covilhã, Portugal
| | - Francisco Miguel Brardo
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- Faculty of Health Sciences, Rua Marquês de Ávila E Bolama, CICS-Health Sciences Research Centre, University of Beira Interior, 6201-001, Covilhã, Portugal
- Department of Physics, University of Beira Interior, Covilhã, Portugal
| | - Maria Vaz Pato
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- Faculty of Health Sciences, Rua Marquês de Ávila E Bolama, CICS-Health Sciences Research Centre, University of Beira Interior, 6201-001, Covilhã, Portugal
| |
Collapse
|
11
|
Huang Y, Qiu K, Li Y, Wang H, Zhang M. Temporal trend of anisometropia incidence in Chinese school-aged children before and during the COVID-19 pandemic. Front Med (Lausanne) 2024; 11:1322402. [PMID: 38410753 PMCID: PMC10894982 DOI: 10.3389/fmed.2024.1322402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/18/2024] [Indexed: 02/28/2024] Open
Abstract
Objective To analyze and compare the temporal trends in the incidence of anisometropia among Chinese school-aged children both before and during the COVID-19 pandemic, and to investigate the impact of the pandemic on the incidence of anisometropia. Methods We conducted a retrospective study comprising six distinct and independent longitudinal cohorts, each including children aged 6 to 13 years who visited the Joint Shantou International Eye Center between January 2010 and December 2021. Children were grouped into cohorts based on the year of their first eye clinic visit: 2010, 2012, 2014, 2016, 2018, or 2020. Only children without anisometropia at initial visits, followed for 18 ± 6 months, were included. The cumulative incidence and risk factors of anisometropia were analyzed using Kaplan-Meier estimation and Cox proportional hazards regression models. Subgroup analyses were performed based on sex, age groups, initial refractive error status, and initial interocular SE difference. Anisometropic children were further categorized into myopic and non-myopic, with subsequent subgroup analyses conducted. Results Of 11,235 children were recruited from six cohorts (2010: n = 1,366; 2012: n = 1,708; 2014: n = 1,896; 2016: n = 2,354; 2018: n = 2,514; 2020: n = 1,397), 869 children developed anisometropia during a mean follow-up of 17.5 ± 3.7 months. After adjustment of confounding factors, we found that the risk of anisometropia remained relatively stable before 2020 but significantly increased in the 2020 cohort (adjusted HR 2.93, 95% CI 2.23 to 3.86; p < 0.001). This trend persisted in studies of spherical anisometropia (adjusted HR 2.52, 95% CI 1.60 to 3.97; p < 0.001) and cylindrical anisometropia (adjusted HR 2.91, 95% CI 1.69 to 3.62; p < 0.001). Older age and a greater initial difference in SE between the two eyes were also significantly associated with a higher risk of developing anisometropia (p < 0.001). Subgroup analyses consistently showed increased risk in the 2020 cohort. Conclusion This study reveals a concerning rise in anisometropia incidence among Chinese school-aged children during the period of the COVID-19 pandemic. These findings highlight the worrisome rise in anisometropia risk during the COVID-19 pandemic and emphasize the importance of early detection and management to safeguard children's visual health.
Collapse
Affiliation(s)
- Yin Huang
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou University Medical College, Shantou, China
| | - Kunliang Qiu
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou University Medical College, Shantou, China
| | - Yuancun Li
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou University Medical College, Shantou, China
| | - Hongxi Wang
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou University Medical College, Shantou, China
| | - Mingzhi Zhang
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou University Medical College, Shantou, China
| |
Collapse
|
12
|
Jiang Y, Xiao X, Sun W, Wang Y, Li S, Jia X, Wang P, Hejtmancik JF, Zhang Q. Clinical and genetic risk factors underlying severe consequence identified in 75 families with unilateral high myopia. J Transl Med 2024; 22:75. [PMID: 38243264 PMCID: PMC10797748 DOI: 10.1186/s12967-024-04886-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/11/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUNDS Unilateral high myopia (uHM), commonly observed in patients with retinal diseases or only with high myopia, is frequently associated with amblyopia with poor prognosis. This study aims to reveal the clinical and genetic spectrum of uHM in a large Chinese cohort. METHODS A total of 75 probands with simplex uHM were included in our Pediatric and Genetic Eye Clinic. Patients with significant posterior anomalies other than myopic fundus changes were excluded. Variants were detected by exome sequencing and then analyzed through multiple-step bioinformatic and co-segregation analysis and finally confirmed by Sanger sequencing. Genetic findings were correlated with associated clinical data for analysis. RESULTS Among the 75 probands with a mean age of 6.21 ± 4.70 years at the presentation, myopic fundus of C1 and C2 was observed in 73 (97.3%) probands. Surprisingly, specific peripheral changes were identified in 63 eyes involving 36 (48.0%) probands after extensive examination, including peripheral retinal avascular zone (74.6%, 47/63 eyes), neovascularization (54.0%), fluorescein leakage (31.7%), peripheral pigmentary changes (31.7%), and others. Exome sequencing identified 21 potential pathogenic variants of 13 genes in 20 of 75 (26.7%) probands, including genes for Stickler syndrome (COL11A1 and COL2A1; 6/20), FEVR (FZD4, LRP5, and TSPAN12; 5/20), and others (FBN1, GPR179, ZEB2, PAX6, GPR143, OPN1LW, FRMD7, and CACNA1F; 9/20). For the peripheral retinal changes in the 20 probands, variants in Stickler syndrome-related genes were predominantly associated with retinal pigmentary changes, lattice degeneration, and retinal avascular region, while variants in genes related to FEVR were mainly associated with the avascular zone, neovascularization, and fluorescein leakage. CONCLUSIONS Genetic defects were identified in about one-fourth of simplex uHM patients in which significant consequences may be hidden under a classic myopic fundus in up to half. To our knowledge, this is the first systematic genetic study on simplex uHM to date. In addition to routine care of strabismus and amblyopia, careful examination of the peripheral retina and genetic screening is warranted for patients with uHM in order to identify signs of risk for retinal detachment and other complications and provide meaningful genetic counseling.
Collapse
Affiliation(s)
- Yi Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, 54 Xianlie Road, Guangzhou, 510060, China
| | - Xueshan Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, 54 Xianlie Road, Guangzhou, 510060, China
| | - Wenmin Sun
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, 54 Xianlie Road, Guangzhou, 510060, China
| | - Yingwei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, 54 Xianlie Road, Guangzhou, 510060, China
| | - Shiqiang Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, 54 Xianlie Road, Guangzhou, 510060, China
| | - Xiaoyun Jia
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, 54 Xianlie Road, Guangzhou, 510060, China
| | - Panfeng Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, 54 Xianlie Road, Guangzhou, 510060, China
| | - J Fielding Hejtmancik
- Ophthalmic Molecular Genetics Section, Ophthalmic Genetics and Visual Function Branch, National Eye Institute, Rockville, MD, 20852, USA
| | - Qingjiong Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, 54 Xianlie Road, Guangzhou, 510060, China.
| |
Collapse
|
13
|
Gong W, Zhu Z, Bulloch G, Wang J, Chen J, Du L, Yang J, Zhang B, He X, Zou H, Xu X, Deng J, Huang J. Anisometropia and its association with refraction development in highly myopic children. Clin Exp Optom 2024; 107:58-65. [PMID: 37078165 DOI: 10.1080/08164622.2023.2198635] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/30/2023] [Indexed: 04/21/2023] Open
Abstract
CLINICAL RELEVANCE Anisometropia can affect visual development in children. Investigations of anisometropia in high myopes would explore potential causes related to anisometropia, highlighting the management of anisometropia in high myopia. BACKGROUND The prevalence of anisometropia ranged from 0.6% to 4.3% in general paediatric population and from 7% to 14% in myopes. Anisometropia is regarded as an associated factor for myopia development, while myopia progression is a stimulus driving anisometropic development. The purpose of this study was to investigate the prevalence of anisometropia and its association with refraction development in Chinese children with high myopia. METHODS In the cohort study, a total of 1,577 highly myopic (spherical equivalent ≤-5.0D) children aged 4-18 years were included. Refractive parameters (dioptre of sphere, dioptre of cylinder, corneal curvature radius, and axial length) of both eyes were measured after cycloplegia. The prevalence and degree of anisometropia were compared among refractive groups (non-parametric tests or chi-square tests), and regression analyses were used to determine associated factors of anisometropia. The statistical significance was set to P < 0.05 (two-tailed). RESULTS In highly myopic children with a mean (standard deviation) age of 13.06 (2.80) years, the proportions of spherical equivalent anisometropia, cylindrical anisometropia and spherical anisometropia ≥1.00 D were 34.5%, 21.9% and 39.9%, respectively. There was more spherical equivalent anisometropia associated with more severe astigmatism (P for trend <0.001). In the multivariate regression analysis, more spherical equivalent anisometropia, cylindrical anisometropia and spherical anisometropia were associated with higher degrees of astigmatism (standard beta = -0.175, -0.148 and -0.191, respectively). More spherical anisometropia was associated with better spherical power (standard beta = 0.116). CONCLUSION The proportion of anisometropia in highly myopic children was high, compared with previously reported general population, and more severe anisometropia was associated with higher degree of cylindrical power, but not spherical power.
Collapse
Affiliation(s)
- Wei Gong
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Zhuoting Zhu
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Gabriella Bulloch
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Jingjing Wang
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Jun Chen
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Linlin Du
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Jinliuxing Yang
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Bo Zhang
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Xiangui He
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Haidong Zou
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xun Xu
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Junjie Deng
- Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jiannan Huang
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
14
|
Joseph E, Ck M, Kumar R, Sebastian M, Suttle CM, Congdon N, Sethu S, Murthy GV. Prevalence of refractive errors among school-going children in a multistate study in India. Br J Ophthalmol 2023; 108:143-151. [PMID: 36562766 PMCID: PMC10804007 DOI: 10.1136/bjo-2022-322123] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022]
Abstract
AIM Much existing data on childhood refractive error prevalence in India were gathered in local studies, many now dated. The aim of this study was to estimate the prevalence, severity and determinants of refractive errors among school-going children participating in a multistate vision screening programme across India. METHODS In this cross-sectional study, vision screening was conducted in children aged 5-18 years at schools in five states using a pocket vision screener. Refractive error was measured using retinoscopy, and subjective refraction and was defined both by spherical equivalent (SE) and spherical ametropia, as myopia ≤-0.5 diopters (D), hyperopia ≥+1.0 D and/or astigmatism as >0.5 D. Data from the eye with less refractive error were used to determine prevalence. RESULTS Among 2 240 804 children (50.9% boys, mean age 11.5 years, SD ±3.3), the prevalence of SE myopia was 1.57% (95% CI 1.54% to 1.60%) at 5-9 years, 3.13% (95% CI 3.09% to 3.16%) at 10-14 years and 4.8% (95% CI 4.73% to 4.86%) at 15-18 years. Hyperopia prevalence was 0.59% (95% CI 0.57% to 0.61%), 0.54% (95% CI 0.53% to 0.56%) and 0.39% (95% CI 0.37% to 0.41%), respectively. When defined by spherical ametropia, these values for myopia were 0.84%, 2.50% and 4.24%, and those for hyperopia were 2.11%, 2.41% and 2.07%, respectively.Myopia was associated with older age, female gender, private school attendance, urban location and state. The latter appeared to be driven by higher literacy rates. CONCLUSIONS Refractive error, especially myopia, is common in India. Differences in prevalence between states appear to be driven by literacy rates, suggesting that the burden of myopia may rise as literacy increases.
Collapse
Affiliation(s)
- Elizabeth Joseph
- Department of Ophthalmology, Little Flower Hospital and Research Centre, Angamaly, Kerala, India
| | - Meena Ck
- Department of Ophthalmology, Little Flower Hospital and Research Centre, Angamaly, Kerala, India
| | - Rahul Kumar
- Orbis India Country office, ORBIS International, Gurugram, Haryana, India
| | - Mary Sebastian
- Department of Ophthalmology, Little Flower Hospital and Research Centre, Angamaly, Kerala, India
| | | | | | - Sheeladevi Sethu
- Orbis India Country office, ORBIS International, Gurugram, Haryana, India
| | | |
Collapse
|
15
|
Qin J, Qing H, Ji N, Lyu T, Ma H, Shi M, Yu S, Ma C, Fu A. Changes in axial length in anisometropic children wearing orthokeratology lenses. Front Med (Lausanne) 2023; 10:1266354. [PMID: 38020088 PMCID: PMC10656815 DOI: 10.3389/fmed.2023.1266354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose There is a particular anisometropia occurring in one eye with myopia, while the other eye has very low myopia, emmetropia, or very low hyperopia. It is unclear how the binocular axial length changes when these children wear unilateral OK lenses only in the more myopic eyes. This study investigates the changes in the axial elongation of both eyes. Methods This is a 1-year retrospective study. In total, 148 children with myopic anisometropia were included. The more myopic eyes were wearing orthokeratology lenses (treated eyes), whereas the contralateral eyes were not indicated for visual correction (untreated eyes). The untreated eyes were classified into three subgroups based on the spherical equivalent refraction (SER): low myopia (≤ -0.50 D, n = 37), emmetropia (+0.49 to -0.49 D, n = 76), and low hyperopia (≥0.50 D, n = 35). Changes in the axial length (AL) were compared between the untreated and treated eyes and among the three subgroups. Results The axial elongation was 0.14 ± 0.18 mm and 0.39 ± 0.27 mm in all treated and untreated eyes, respectively (p < 0.001). The interocular AL difference decreased significantly from 1.09 ± 0.45 mm at the baseline to 0.84 ± 0.52 mm at 1 year (p < 0.001). The baseline median (Q1, Q3) SER of the untreated eyes were -0.75 D (-0.56, -0.88 D), 0.00 D (0.00, -0.25 D), and +0.75 D (+1.00, +0.62 D) in low myopia, emmetropia, and low hyperopia subgroups, respectively. The axial elongation was 0.14 ± 0.18 mm, 0.15 ± 0.17 mm, and 0.13 ± 0.21 mm (p = 0.92) in the treated eyes and 0.44 ± 0.25 mm, 0.35 ± 0.24 mm, and 0.41 ± 0.33 mm in the untreated eyes (p = 0.11) after 1 year. Multivariate linear regression analyses only showed significant differences in axial elongation between the emmetropia and low myopia subgroups of untreated eyes (p = 0.04; p > 0.05 between other subgroups). Conclusion Unilateral orthokeratology lenses effectively reduced axial elongation in the more myopic eyes and reduced interocular AL differences in children with myopic anisometropia. The refractive state of the untreated eyes did not affect the axial elongation of the more myopic eye wearing the orthokeratology lens. In the untreated eyes, AL increased faster in the low myopia subgroup than in the emmetropia subgroup.
Collapse
Affiliation(s)
- Jian Qin
- Department of Ophthalmology, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Huiling Qing
- Department of Ophthalmology, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Na Ji
- Department of Ophthalmology, The Affiliated Eye Hospital of Suzhou Vocational Health College, Suzhou, China
| | - Tianbin Lyu
- Department of Ophthalmology, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Ma
- Department of Ophthalmology, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Menghai Shi
- Department of Ophthalmology, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Shiao Yu
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Conghui Ma
- Department of Ophthalmology, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Aicun Fu
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
16
|
Lee CW, Chiang CC, Tsai DC, Tsai CY, Liou YM. Risk factors for anisometropia in schoolchildren: A population-based, longitudinal cohort study. Ophthalmic Physiol Opt 2023; 43:1500-1509. [PMID: 37565301 DOI: 10.1111/opo.13215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 08/12/2023]
Abstract
PURPOSE To investigate the incidence rate and risk factors for anisometropia among young schoolchildren. METHODS A population-based cohort study, the Myopia Investigation Study in Taipei, was conducted in primary schools in Taipei City. Children were recruited for biannual comprehensive eye examinations over 2 years. Cycloplegic autorefraction and slit lamp examinations were performed biannually. Data on demographic information, parental history, lifestyle and near-work activities were collected using parent-administered questionnaires at the first and final visits. Anisometropia was defined as ≥1 D difference in the spherical equivalent (SE) refractive error. RESULTS A total of 7035 8-year-old children completed the 2-year follow-up evaluations. The average annual incidence of anisometropia was 3.8%. Multivariable logistic regression analysis revealed that baseline SE (odds ratio [OR]: 0.87 95% CI: 0.80-0.95) and female sex (OR: 1.24, 95% confidence interval [CI]: 1.02-1.50) were significantly associated with incident anisometropia. Among lifestyle risk factors, spending <1 h per day in after-school outdoor activities on weekdays (OR: 1.38, 95% CI: 1.08-1.76) and performing near work at a distance <30 cm (OR: 1.33, 95% CI: 1.08-1.64) were significantly associated with an increased risk of incident anisometropia. In the multiple linear regression analysis, the inter-eye difference in SE increased significantly in children performing near work at distances <30 cm (adjusted β = 0.03; p = 0.02). CONCLUSIONS This study indicated the annual incidence of anisometropia in Taiwanese schoolchildren. Less time spent outdoors and shorter eye-to-object distances during near work increased the risk of incident anisometropia.
Collapse
Affiliation(s)
- Chia-Wei Lee
- Department of Ophthalmology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Chi-Chen Chiang
- Department of Nursing, School of Nursing, Fooyin University, Kaohsiung, Taiwan
| | - Der-Chong Tsai
- Department of Ophthalmology, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
- Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan
| | - Ching-Yao Tsai
- Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Business Administration, Fu Jen Catholic University, New Taipei City, Taiwan
- General Education Centre, University of Taipei, Taipei, Taiwan
| | - Yiing Mei Liou
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
- School Health Research Center, National Yang Ming Chiao Tung Univerty, Taipei, Taiwan
| |
Collapse
|
17
|
Abuallut II, Alameer KM, Abuageelah BM, Hurissi E, Alqahtani MM, Gosadi IM, Tubaigy FM, Alyami YM. Parents' Awareness, Knowledge, and Perception of Amblyopia in Children: A Study in Jazan Region, Saudi Arabia. Cureus 2023; 15:e48956. [PMID: 38106752 PMCID: PMC10725705 DOI: 10.7759/cureus.48956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2023] [Indexed: 12/19/2023] Open
Abstract
Background Amblyopia is a vision disorder that results from a development problem in the brain rather than a neurological disease in the eye. The condition causes reduced visual acuity in one or both eyes due to the brain's inability to process inputs, rather than a structural abnormality. This study aims to assess parents' awareness, knowledge, and perception of amblyopia in their children in the Jazan region, Saudi Arabia. Methods This is a cross-sectional study that used an electronic questionnaire consisting of five main sections to assess the level of awareness of amblyopia among parents in the Jazan region. The Statistical Package for Social Sciences (SPSS v.25, IBM Corp., Armonk, NY, USA) was utilized to input the data. The degree to which participants' level of awareness was related to variables such as age, gender, and educational level was assessed through the chi-square test (χ2), and any values that scored p-values under 0.05 were deemed statistically significant. Results The analysis included 572 participants, 395 mothers (69.0%) and 177 fathers (31.0%). The age groups of the participants were divided into 36-45 years (38.0%), 26-35 years (36.0%), and above 46 years (17.0%). Out of the total, 36 participants (6.0%) had a history of amblyopia, and 73 (13.0%) had a child who suffered from amblyopia. The findings showed that only 18 participants (3.1%) had a good awareness of amblyopia, while 242 (42.3%) had a fair level of awareness. Most participants, 312 (54.5%), were classified as having a poor awareness level of amblyopia. Parents with postgraduate degrees, those with prior awareness, and parents whose children had eye diseases demonstrated higher levels of good awareness. However, gender, age, and residency did not have significant associations with awareness levels. Conclusion While parents must be involved in managing amblyopia, our research found that more than half of the parents surveyed had a limited understanding of various aspects of the disease, which can cause permanent damage to their child's vision. Therefore, we recommend implementing health education programs to increase awareness and knowledge about amblyopia in Jazan.
Collapse
Affiliation(s)
- Ismail I Abuallut
- Department of Surgery, Ophthalmology Division, Jazan University, Jazan, SAU
| | | | | | - Eman Hurissi
- Department of Medicine and Surgery, Jazan University, Jazan, SAU
| | | | - Ibrahim M Gosadi
- Department of Family and Community Medicine, Jazan University, Jazan, SAU
| | - Faisal M Tubaigy
- Department of Ophthalmology, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Yousef M Alyami
- Department of Medicine and Surgery, Batterjee Medical College, Aseer, SAU
| |
Collapse
|
18
|
Neupane S, Sreenivasan V, Wu Y, Mestre C, Connolly K, Lyon DW, Candy TR. How Do Most Young Moderate Hyperopes Avoid Strabismus? Invest Ophthalmol Vis Sci 2023; 64:17. [PMID: 37962529 PMCID: PMC10655831 DOI: 10.1167/iovs.64.14.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 10/16/2023] [Indexed: 11/15/2023] Open
Abstract
Purpose Uncorrected hyperopic children must overcome an apparent conflict between accommodation and vergence demands to focus and align their retinal images. This study tested hypotheses about simultaneous accommodation and vergence performance of young hyperopes to gain insight into ocular motor strategies used to maintain eye alignment. Methods Simultaneous eccentric photorefraction and Purkinje image tracking were used to assess accommodative and vergence responses of 26 adult emmetropes (AE) and 94 children (0-13 years) viewing cartoons. Children were habitually uncorrected (CU) (spherical equivalent refractive error [SE] -0.5 to +4 D), corrected and aligned (CCA), or corrected with a history of refractive esotropia (CCS). Accommodative and vergence accuracy, dissociated heterophoria, and vergence/accommodation ratios in the absence of retinal disparity cues were measured for 33- and 80-cm viewing distances. Results In binocular viewing, median accommodative lags for 33 cm were 1.0 D (AE), 1.33 D (CU), 1.25 D (CCA), and 1.0 D (CCS). Median exophorias at 80 and 33 cm were 1.2 and 4.5 pd (AE), 0.8 and 2.5 pd (CU), and 0 and 1.2 pd (CCA), respectively. Without disparity cues, most response vergence/accommodation ratios were between 1 and 2 meter angle/D (∼5-10 pd/D) (69% of AE, 44% of CU, 60% of CCA, and 50% of CCS). Conclusions Despite apparent conflict in motor coupling, uncorrected hyperopes were typically exophoric and achieved adultlike accuracy of both vergence and accommodation simultaneously, indicating ability to compensate for conflicting demands rather than bias to accurate vergence while tolerating inaccurate accommodation. Large lags and esophoria are therefore atypical. This analysis provides normative guidelines for clinicians and a deeper mechanistic understanding of how hyperopes avoid strabismus.
Collapse
Affiliation(s)
- Sonisha Neupane
- Indiana University School of Optometry, Bloomington, Indiana, United States
| | | | - Yifei Wu
- Indiana University School of Optometry, Bloomington, Indiana, United States
| | - Clara Mestre
- Indiana University School of Optometry, Bloomington, Indiana, United States
| | - Katie Connolly
- Indiana University School of Optometry, Bloomington, Indiana, United States
| | - Don W. Lyon
- Indiana University School of Optometry, Bloomington, Indiana, United States
| | - T. Rowan Candy
- Indiana University School of Optometry, Bloomington, Indiana, United States
| |
Collapse
|
19
|
Hussain A, Gopalakrishnan A, Chowdhury S, Agarkar S. Progression pattern of non-amblyopic Anisomyopic eyes compared to Isomyopic eyes. Eur J Pediatr 2023; 182:4329-4339. [PMID: 37462797 DOI: 10.1007/s00431-023-05088-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/22/2023] [Accepted: 06/24/2023] [Indexed: 10/20/2023]
Abstract
This study aimed to determine the progression pattern of non-amblyopic anisomyopic children from ages 6 to 16 years. This retrospective study analyzed the electronic medical records of 8680 myopic children who visited Sankara Nethralaya, Chennai, India over eight years (2009 to 2017). A total of 711 records were retrieved based on inclusion criteria. In addition, 423 records out of 711 had consecutive follow-up for three years (baseline plus three follow-up visits) and were considered to determine the progression pattern. The cycloplegic sphero-cylindrical refraction was taken for analysis and converted to vector notation of M (SE), J0, and J45. Anisomyopia referred to the interocular difference of myopic SE of ≥ 1 D whereas isomyopia referred to the interocular difference of myopic SE of < 1 D. Based on the refraction of the less ametropic eye, anisomyopes were further categorized into bilateral anisometropic myopia (BAM) and unilateral anisometropic myopia (UAM). The isomyopic cohort showed a mean annual progression of -0.49 ± 0.54 D (median [IQR] -0.38 D [{-0.75}-0.00]). In BAM, the mean annual progression of the more myopic eye was -0.45 ± 0.55 D (median [IQR] -0.38 D [{-0.75}-0.00]), and the less myopic eye was -0.37 ± 0.55 D (median [IQR] -0.25 D [{-0.63}-0.00]). This difference was significant (t (212) = -2.14, p < 0.05). In UAM, the myopic eyes (-0.39 ± 0.51 D; median [IQR] -0.25 D [{-0.75}-0.00]) showed a statistically significant higher mean annual progression compared to emmetropic eyes (-0.22 ± 0.36 D; median [IQR] 0.00 D [{-0.44}-0.00]; t (96) = -3.30, p < 0.001). In terms of progression trend, in the BAM group, the rate of change of mean SE between the more myopic and the less myopic eyes were similar (-1.12 ± 1.20 D; median [IQR] -1.13 D [{-2.00}-{-0.38}] vs. -1.05 ± 1.25 D; median [IQR] -0.88 D [{-1.75}-{-0.13}]; t (138) = -0.64, p > 0.05). However, the more myopic eyes of UAM showed a higher myopic trend compared to the emmetropic eyes (-1.37 ± 1.06 D; median [IQR] -1.32 D [{-2.13}-{-0.50}] vs. -0.96 ± 1.11 D; median [IQR] -0.75 D [{-1.56}-{-0.25}]; t (61) = -2.74, p < 0.05). Conclusion: Children with BAM and UAM eyes exhibit different progression patterns from each other. While the rate of the refractive shift in myopic eyes of UAM is similar to isomyopic eyes, BAM eyes present a slower rate of progression than isomyopic eyes. What is Known: • The rate of change of refraction in anisomyopes is higher compared to isomyopic children. • Less myopic eyes tend to shift towards more myopia while more myopic eyes show stable refraction. What is New: • The progression pattern of bilateral anisometropic myopia and unilateral anisometropic myopia differ from one another. • While the rate of the refractive shift in myopic eyes of unilateral anisometropic myopia is similar to isomyopic eyes, bilateral anisometropic myopia eyes present a slower rate of progression than isomyopic eyes. • The pattern of change in the interocular difference of anisometropia depends on the laterality (bilateral or unilateral ametropia), and degree of spherical equivalent in the more ametropic eye.
Collapse
Affiliation(s)
- Azfira Hussain
- Myopia Clinic, Unit of Medical Research Foundation, Sankara Nethralaya, No.41, College Road, Nungambakkam, Chennai, India.
| | - Aparna Gopalakrishnan
- Myopia Clinic, Unit of Medical Research Foundation, Sankara Nethralaya, No.41, College Road, Nungambakkam, Chennai, India
| | - Saurav Chowdhury
- Myopia Clinic, Unit of Medical Research Foundation, Sankara Nethralaya, No.41, College Road, Nungambakkam, Chennai, India
| | - Sumita Agarkar
- Department of Pediatric Ophthalmology, Unit of Medical Research Foundation, Sankara Nethralaya, Chennai, India
| |
Collapse
|
20
|
Pe'er O, Gantz L, Gal E, Ofri R. A retinoscopic survey of donkeys and goats. Vet Ophthalmol 2023; 26:385-392. [PMID: 37386869 DOI: 10.1111/vop.13126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 07/01/2023]
Abstract
PURPOSE Assess the refractive states of donkeys and goats. METHODS Forty-two donkeys and 28 goats were enrolled. The mean ± SD ages were 7.68 ± 7.33 years for donkeys and 4.26 ± 2.33 years for goats. Seven donkeys and one goat were <6 months old. Retinoscopy was performed in alert animals, following cycloplegia in goats but not in donkeys. Normality was determined using the Kolmogorov-Smirnov test. The two primary meridians and two eyes were compared using Pearson's correlation and paired Student's t-tests. The association between refractive states and age was examined using one-way ANOVA in donkeys and a paired Student's t-test in goats. One-sample t-tests were conducted to assess if the refractive error distributions were significantly different from "0". RESULTS The mean ± SD spherical equivalent (SE) refractive errors of the right and left donkey eyes were -0.80 ± 1.03 D and -0.35 ± 0.95 D, respectively. The majority (86%) of the donkeys had an astigmatic refraction and eight (19%) had anisometropia. The mean SE refractive errors of the right and left goat eyes were -0.15 ± 1.1 D and -0.18 ± 1.2 D, respectively. The majority (54%) of the goat eyes had an astigmatic refraction and five (18%) had anisometropia. The right and left eye SE refractive errors were positively correlated in both species (both p = .9). Age was not correlated with refractive error in both donkeys (p = .09) and goats (p = .6). CONCLUSIONS Both goats and donkeys are emmetropic.
Collapse
Affiliation(s)
- Oren Pe'er
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Liat Gantz
- Department of Optometry and Vision Science, Hadassah Academic College, Jerusalem, Israel
| | - Eyal Gal
- Department of Optometry and Vision Science, Hadassah Academic College, Jerusalem, Israel
| | - Ron Ofri
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| |
Collapse
|
21
|
Lin HW, Young ML, Pu C, Huang CY, Lin KK, Lee JS, Hou CH. Changes in anisometropia by age in children with hyperopia, myopia, and antimetropia. Sci Rep 2023; 13:13643. [PMID: 37608064 PMCID: PMC10444756 DOI: 10.1038/s41598-023-40831-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/17/2023] [Indexed: 08/24/2023] Open
Abstract
Anisometropia is a unique condition of both eyes and it is associated with vision problems such as amblyopia and reduced stereoacuity. Previous studies have not reported its change pattern by age and its correlation with the refractive condition of both eyes. This study aims to compare the changes in anisometropia by age in children with hyperopia, myopia, and antimetropia. In total, 156 children were included. Children aged 3-11 years with anisometropia ≥ 1.00 D were followed up for ≥ 1 year with ≥ 2 visits at two medical centers in Taiwan. Refractive errors by cycloplegic autorefractometry, best-corrected visual acuity, eye position, and atropine use were recorded. The children were divided into hyperopic, myopic, and antimetropic groups. The results showed that anisometropia decreased in children aged < 6 years (3.34-2.96 D; P = 0.038) and increased in older children (2.16-2.55 D; P = 0.005). In children aged 3, 4, 5, and 6 years, the mean anisometropia was higher in children with myopia and antimetropia than in those with hyperopia (P = 0.005, 0.002, 0.001, and 0.011, respectively). The differences were not significant in children aged > 6 years (all P > 0.05). The factors associated with changes in anisometropia were age, refractive group, amblyopia, and strabismus. Anisometropia decreased with age in children younger than 6 years, and the changes in anisometropia was found in children with myopia and antimetropia.
Collapse
Affiliation(s)
- Han-Wen Lin
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Medicine, School of Medicine, Chang Gung University, Taoyüan, Taiwan
| | - Meng-Ling Young
- Department of Medicine, School of Medicine, Chang Gung University, Taoyüan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Christy Pu
- Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chung-Ying Huang
- Department of Medicine, School of Medicine, Chang Gung University, Taoyüan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ken-Kuo Lin
- Department of Medicine, School of Medicine, Chang Gung University, Taoyüan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Jiahn-Shing Lee
- Department of Medicine, School of Medicine, Chang Gung University, Taoyüan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chiun-Ho Hou
- Department of Medicine, School of Medicine, Chang Gung University, Taoyüan, Taiwan.
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.
- Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Department of Ophthalmology, National Taiwan University Hospital, 7, Chung Shan S. Rd., Zhongzheng Dist., Taipei, 100225, Taiwan (R.O.C.).
| |
Collapse
|
22
|
Ramírez-Ortiz MA, Amato-Almanza M, Romero-Bautista I, Klunder-Klunder M, Aguirre-Luna O, Kuzhda I, Resnikoff S, Eckert KA, Lansingh VC. A large-scale analysis of refractive errors in students attending public primary schools in Mexico. Sci Rep 2023; 13:13509. [PMID: 37598286 PMCID: PMC10439951 DOI: 10.1038/s41598-023-40810-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/16/2023] [Indexed: 08/21/2023] Open
Abstract
A cross-sectional, retrospective study was conducted from September 2013 through July 2014 to determine the prevalence of refractive errors among students attending public primary schools in Mexico. Among 3,861,156 students at 14,566 public primary schools in all 32 states of Mexico, teachers identified reduced visual acuity in 1,253,589 (32.5%) using visual acuity measurement. Optometrists confirmed 391,498 [31.2%, mean (SD) age: 8.8 (1.9) years; 204,110 girls (52.9%)] had refractive errors using visual acuity measurement and noncycloplegic static retinoscopy. Among 288,537 (72.4%) of children with previous eyeglasses usage data reported, 241,505 (83.7%) had uncorrected refractive errors. Before prescription eyeglasses were provided, 281,891 students (72%) had logMAR visual acuity ≤ 0.2; eyeglasses corrected vision loss in 85.6% (n = 241,352) of them. Simple myopic astigmatism was the most frequent refractive error (25.7%, n = 100,545). Astigmatism > - 1.00 diopters was present in 54.6% of all students with ametropia. The anisometropia rate based on spherical equivalent difference between right and left eye ≥ 1.50 diopters was 3.9% (n = 15,402). Uncorrected refractive errors are an important issue in primary school students in Mexico. An updated study is needed to analyze the evolving trends over the past decade.
Collapse
Affiliation(s)
| | - Mónica Amato-Almanza
- Ophthalmology Department, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | | | | | - Oswaldo Aguirre-Luna
- Ophthalmology Department, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Iryna Kuzhda
- Ophthalmology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Serge Resnikoff
- Brien Holden Vision Institute, Sydney, NSW, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia
| | | | - Van Charles Lansingh
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
- HelpMeSee, New York, NY, USA.
- See Better to Learn Better Foundation, Mexico City, Mexico.
- Instituto Mexicano de Oftalmología, Av. Armando Birlain Shaffler S/N, Centro Sur, 76090, Santiago de Querétaro, QRO, Mexico.
| |
Collapse
|
23
|
Meng C, Zhang Y, Wang S. Anisometropic amblyopia: A review of functional and structural changes and treatment. Eur J Ophthalmol 2023; 33:1529-1535. [PMID: 36448184 DOI: 10.1177/11206721221143164] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Amblyopia is the decreased best-corrected visual acuity (BCVA) in one or both eyes caused by the abnormal processing of visual input during development. One common cause of amblyopia is anisometropia, which has attracted widespread attention. Many structural changes occur in the primary and extrastriate visual areas of the cerebral cortex, as well as in the eyes, in patients with anisometropic amblyopia. Understanding these mechanisms has provided a favorable theoretical basis for treating anisometropic amblyopia. This article reviews the functional and anatomical changes and progress toward the treatment of anisometropic amblyopia.
Collapse
Affiliation(s)
- Can Meng
- Corneal Refraction Department, The Second Hospital of Jilin University, Changchun, China
| | - Yan Zhang
- Corneal Refraction Department, The Second Hospital of Jilin University, Changchun, China
| | - Shurong Wang
- Corneal Refraction Department, The Second Hospital of Jilin University, Changchun, China
| |
Collapse
|
24
|
Altinbay D, Sahli E, Bingol Kiziltunc P, Atilla H. Evaluation of fixation characteristics in amblyopia using microperimetry. Int Ophthalmol 2023:10.1007/s10792-023-02748-5. [PMID: 37184805 DOI: 10.1007/s10792-023-02748-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/06/2023] [Indexed: 05/16/2023]
Abstract
PURPOSE To evaluate fixation characteristics in amblyopia using macular analyzer integrity assessment (MAIA) microperimetry and to investigate the factors affecting fixation stability. METHODS This prospective, cross-sectional study enrolled a total of 58 amblyopic patients who were between 8 and 55 years old. Average threshold macular sensitivity (AT) and fixation characteristics were assessed using MAIA microperimetry. Two Bivariate contour ellipse area (BCEA) fixation indices (63% and 95% proportional values) and the percentage of fixation points within 1° and 2° from the fovea (P1 and P2) were used to assess fixation stability. Non-amblyopic fellow eyes were used as the control group for comparison. RESULTS AT and fixation stability indices (P1, P2, BCEA 63%, BCEA 95%) were worse in the amblyopic eyes than in the fellow eyes (p < 0.05, for all indices). There was a moderate positive correlation between best corrected visual acuity (BCVA), and AT, and P2, and a moderate negative correlation between BCVA, and BCEA indices. 48% of the eyes were eccentrically fixating (the percentage was 25% in the anisometropic group, 52% in the strabismic group, and 69% in the combined group) and 32% in the non-amblyopic eye (p = 0.052). The preferred fixation eccentricity in amblyopic eyes was significantly greater than the non-amblyopic eyes (p = 0.004), and there was a negative correlation between preferred fixation eccentricity and BCVA (p = 0.012, r = - 0.327). CONCLUSIONS Our data showed a decrease in fixation stability, a positive correlation between fixation stability and BCVA, and a negative correlation between preferred fixation eccentricity and BCVA in amblyopic eyes.
Collapse
Affiliation(s)
- Deniz Altinbay
- Niv Eye Center, Sumer 69023. Sk. No: 2/A, 01140, Adana, Turkey.
- Program of Opticianry, Vocational School, Toros University, Mersin, Turkey.
- Ankara University Graduate Faculty of Health Sciences, Ankara, Turkey.
| | - Esra Sahli
- Ankara University Graduate Faculty of Health Sciences, Ankara, Turkey
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Pinar Bingol Kiziltunc
- Ankara University Graduate Faculty of Health Sciences, Ankara, Turkey
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Huban Atilla
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
25
|
Zhi Y, Cai M, Du R, Qiao Y, Zheng X, Xu G, Yan L, Wu D. Quantitative evaluation of anisometropic amblyopia treatment efficacy by coupling multiple visual functions via CRITIC algorithm. BMC Ophthalmol 2023; 23:162. [PMID: 37072762 PMCID: PMC10114397 DOI: 10.1186/s12886-023-02898-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 04/02/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND The evaluation of amblyopia treatment efficacy is essential for amblyopia prevention, control, and rehabilitation. METHODS To evaluate the amblyopia treatment efficacy more precisely and quantitatively, this study recorded four visual function examination results, i.e., visual acuity, binocular rivalry balance point, perceptual eye position, and stereopsis before and after amblyopia treatment. RESULTS We found that all these four results had a significant difference between before and after treatment, and the relationship between visual acuity improvement and the difference of BRBP, PEP, and stereoacuity cannot show a fitting correlation regarding the widely used index of visual acuity as the standard of treatment efficacy. By using the Criteria Importance Through Inter-criteria Correlation (CRITIC) method, a more comprehensive and quantitative index by coupling the selected four indexes with objective weights was obtained for further training efficacy representation, and the validation dataset also showed a good performance. CONCLUSIONS This study proved that our proposed coupling method based on different visual function examination results via the CRITIC algorithm is a potential means to quantify the amblyopia treatment efficacy.
Collapse
Affiliation(s)
- Ying Zhi
- Department of Ophthalmology, First Affiliated Hospital of Northwest University, Xi'an, China
- Department of Ophthalmology, Xi'an No. 1 Hospital, Xi'an, China
| | - Min Cai
- Department of Ophthalmology, First Affiliated Hospital of Northwest University, Xi'an, China.
- Department of Ophthalmology, Xi'an No. 1 Hospital, Xi'an, China.
| | - Rui Du
- Department of Ophthalmology, First Affiliated Hospital of Northwest University, Xi'an, China
- Department of Ophthalmology, Xi'an No. 1 Hospital, Xi'an, China
| | - Ying Qiao
- Department of Ophthalmology, First Affiliated Hospital of Northwest University, Xi'an, China
- Department of Ophthalmology, Xi'an No. 1 Hospital, Xi'an, China
| | - Xiaowei Zheng
- School of Mathematics, Northwest University, Xi'an, China
| | - Guanghua Xu
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Li Yan
- National Engineering Research Center for Healthcare Devices, Guangzhou, China
| | - Dianpeng Wu
- National Engineering Research Center for Healthcare Devices, Guangzhou, China
| |
Collapse
|
26
|
Mutlu D, Bayram N. Morphological changes of the retinal layers in the central macula in children with anisometropic amblyopia. J Fr Ophtalmol 2023; 46:363-368. [PMID: 36759245 DOI: 10.1016/j.jfo.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 10/01/2022] [Accepted: 10/03/2022] [Indexed: 02/10/2023]
Abstract
PURPOSE The goal of this study was to evaluate the morphological characteristics of the retinal layers in the central macula in children with anisometropic amblyopia. METHODS This comparative, observational, prospective study included 28 patients who were diagnosed with anisometropic amblyopia and 30 age- and sex-matched healthy controls. All children were evaluated using the automatic calculation software system available on spectral-domain optical coherence tomography (SD-OCT) for automated segmentation of the macula. RESULTS Of the included patients, 18 (64.3%) were male and 10 (35.7%) were female, with a mean age of 10.3±3.4 years. Mean spherical equivalent and best-corrected visual acuity (BCVA) were 4.13±1.95 diopters and 0.707±0.36 logMAR, respectively. The mean axial length was significantly lower in amblyopic eyes compared to fellow eyes (22.1±0.34mm vs. 23.3±0.42mm, P<0.0001), and control eyes (22.1±0.34mm vs. 23.1±0.40mm, P<0.0001). The mean thickness of the outer nuclear layer was significantly lower in amblyopic eyes compared to fellow eyes (79.8±11.9μm vs. 86.8±7.9μm, P=0.007), and healthy controls (79.8±11.9μm vs. 87.4±10.5μm, P=0.012). CONCLUSION The results of this study showed that there are quantitative differences in retinal microstructures of the macula in eyes with anisometropic amblyopia compared to fellow eyes and healthy controls. These findings suggest that anisometropic amblyopia may result in abnormal development of macular structure in the inner retinal layer. A detailed analysis of retinal layers may be able to provide a guide to the depth of amblyopia and visual prognosis.
Collapse
Affiliation(s)
- D Mutlu
- Department of Ophthalmology, Kayseri City Training and Research Hospital, University of Health Science, 30080 Kocasinan Kayseri, Turkey.
| | - N Bayram
- Department of Ophthalmology, Kayseri City Training and Research Hospital, University of Health Science, 30080 Kocasinan Kayseri, Turkey
| |
Collapse
|
27
|
Liu F, Wang ZH, Huang W, Xu Y, Sang X, Liu R, Li ZY, Bi YL, Tang L, Peng JY, Wei JR, Miao ZC, Yan JH, Liu S, Yan JH, Liu S. Defects and asymmetries in the visual pathway of non-human primates with natural strabismus and amblyopia. Zool Res 2023; 44:153-168. [PMID: 36484227 PMCID: PMC9841183 DOI: 10.24272/j.issn.2095-8137.2022.254] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Strabismus and amblyopia are common ophthalmologic developmental diseases caused by abnormal visual experiences. However, the underlying pathogenesis and visual defects are still not fully understood. Most studies have used experimental interference to establish disease-associated animal models, while ignoring the natural pathophysiological mechanisms. This study was designed to investigate whether natural strabismus and amblyopia are associated with abnormal neurological defects. We screened one natural strabismic monkey ( Macaca fascicularis) and one natural amblyopic monkey from hundreds of monkeys, and retrospectively analyzed one human strabismus case. Neuroimaging, behavioral, neurophysiological, neurostructural, and genovariation features were systematically evaluated using magnetic resonance imaging (MRI), behavioral tasks, flash visual evoked potentials (FVEP), electroretinogram (ERG), optical coherence tomography (OCT), and whole-genome sequencing (WGS), respectively. Results showed that the strabismic patient and natural strabismic and amblyopic monkeys exhibited similar abnormal asymmetries in brain structure, i.e., ipsilateral impaired right hemisphere. Visual behavior, visual function, retinal structure, and fundus of the monkeys were impaired. Aberrant asymmetry in binocular visual function and structure between the strabismic and amblyopic monkeys was closely related, with greater impairment of the left visual pathway. Several similar known mutant genes for strabismus and amblyopia were also identified. In conclusion, natural strabismus and amblyopia are accompanied by abnormal asymmetries of the visual system, especially visual neurophysiological and neurostructural defects. Our results suggest that future therapeutic and mechanistic studies should consider defects and asymmetries throughout the entire visual system.
Collapse
Affiliation(s)
- Feng Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong 510060, China
| | - Zhong-Hao Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong 510060, China
| | - Wanjing Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong 510060, China
| | - Ying Xu
- Guangdong-Hongkong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou, Guangdong 510632, China
| | - Xuan Sang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong 510060, China
| | - Ruifeng Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong 510060, China
| | - Zhou-Yue Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong 510060, China
| | - Ya-Lan Bi
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Cambridge CB10 1SD, UK
| | - Lei Tang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong 510060, China
| | - Jing-Yi Peng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong 510060, China
| | - Jia-Ru Wei
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong 510060, China
| | - Zhi-Chao Miao
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Cambridge CB10 1SD, UK,Translational Research Institute of Brain and Brain-Like Intelligence and Department of Anesthesiology, Shanghai Fourth People’s Hospital Affiliated to Tongji University School of Medicine, Shanghai 200081, China
| | - Jian-Hua Yan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong 510060, China,E-mail:
| | - Sheng Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong 510060, China,Guangdong Province Key Laboratory of Brain Function and Disease, Guangzhou, Guangdong 510080, China,
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Liang X, Wei S, Li SM, An W, Du J, Sun Y, Gan J, Bai W, Cai Z, Song Q, Yin L, Wang N. Effect of Atropine 0.01% Eye Drops on the Difference in Refraction and Axial Length between Right and Left Eyes. Ophthalmic Res 2023; 66:496-505. [PMID: 36603556 DOI: 10.1159/000528878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/19/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION This study sought to determine whether the application of 0.01% atropine eye drops could impact the disparity in refraction and axial length (AL) between the right and left eyes in Chinese children. METHODS The study was designed as a double-blind, placebo-controlled randomized trial. A total of 220 children aged 6-12 years were recruited from the Beijing Tongren Hospital in Beijing, China. Participants were randomized in a 1:1 ratio and were prescribed 0.01% atropine or placebo eye drops to be administered once a night to both eyes for the duration of 1 year. The cycloplegic refraction and AL were recorded including baseline, 6 months, and again at the 12 months. RESULTS After 1-year follow-up period, 76 (69%) and 83 (75%) subjects of the initial 220 participants were identified as the 0.01% atropine and placebo groups, respectively. The inter-ocular difference in spherical equivalent refraction (SER) and AL demonstrated stable values in the 0.01% atropine treatment group (SER: p = 0.590; AL: p = 0.322) analyzed after 1 year, but found a significant increase (SER: p < 0.001; AL: p = 0.001) in the placebo group. Furthermore, over 1 year, eyes with greater myopia in the atropine group exhibited slower myopia progression (0.45 ± 0.44 D) than the lesser myopic eye (0.56 ± 0.44 D) (p = 0.003). CONCLUSION This study demonstrated that 0.01% atropine could maintain the inter-ocular SER and AL difference. And 0.01% atropine appeared to be more effective in delaying the progression of myopia in eyes with more myopia than in the less myopic eyes.
Collapse
Affiliation(s)
- Xintong Liang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Shifei Wei
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Shi-Ming Li
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Wenzai An
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Jialing Du
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Yunyun Sun
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Jiahe Gan
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
- Department of Ophthalmology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Weiling Bai
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Zhining Cai
- Department of Clinical Medicine, Capital Medical University, Beijing, China
| | - Qianqian Song
- Department of Clinical Medicine, Capital Medical University, Beijing, China
| | - Lei Yin
- Department of Ophthalmology, Zhengzhou First People's Hospital, Zhengzhou, China
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| |
Collapse
|
29
|
Wang S, Ji Y, Bai W, Ji Y, Li J, Yao Y, Zhang Z, Jiang Q, Li K. Advances in artificial intelligence models and algorithms in the field of optometry. Front Cell Dev Biol 2023; 11:1170068. [PMID: 37187617 PMCID: PMC10175695 DOI: 10.3389/fcell.2023.1170068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/17/2023] [Indexed: 05/17/2023] Open
Abstract
The rapid development of computer science over the past few decades has led to unprecedented progress in the field of artificial intelligence (AI). Its wide application in ophthalmology, especially image processing and data analysis, is particularly extensive and its performance excellent. In recent years, AI has been increasingly applied in optometry with remarkable results. This review is a summary of the application progress of different AI models and algorithms used in optometry (for problems such as myopia, strabismus, amblyopia, keratoconus, and intraocular lens) and includes a discussion of the limitations and challenges associated with its application in this field.
Collapse
Affiliation(s)
- Suyu Wang
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Yuke Ji
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Wen Bai
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Yun Ji
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Jiajun Li
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Yujia Yao
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Ziran Zhang
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Qin Jiang
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
- *Correspondence: Qin Jiang, ; Keran Li,
| | - Keran Li
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
- *Correspondence: Qin Jiang, ; Keran Li,
| |
Collapse
|
30
|
Kulikova IL, Aleksandrova KA. [Changes in accommodation in children with hyperopic anisometropia and unilateral amblyopia after laser refractive surgery and pleoptic treatment]. Vestn Oftalmol 2023; 139:33-40. [PMID: 38235628 DOI: 10.17116/oftalma202313906133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
PURPOSE This study comparatively analyzes the state of accommodation in children with hyperopic anisometropia and amblyopia after femtosecond laser-assisted in situ keratomileusis (Femto-LASIK) combined with pleoptic treatment, and after conventional pleoptic treatment. MATERIAL AND METHODS The first group consisted of 30 children with medium and high hyperopia, high and medium amblyopia, and anisometropia greater than 3.0 diopters, who underwent Femto-LASIK in the amblyopic eye. The second group consisted of 28 children with similar local status, who were prescribed traditional correction and received conservative treatment. The follow-up period was 1.5 years. RESULTS After 1.5 years, higher visual acuity (p<0.05) was achieved in the first group. A significant increase in the coefficient of accommodative response (CAR) was observed in the operated amblyopic eyes in group 1 - by 0.1±0.02 c.u. compared to the control group (p<0.05). In both groups there was an upwards trend for the coefficient of microfluctuations (CMF) in the amblyopic eye, but in the first group CMF increased more significantly (p<0.05). The objective accommodative response (OAR) and positive relative accommodation (PRA) of the amblyopic eye showed a double increase - by 1.0±0.23 and 0.9±0.38 diopters, respectively, at the end of treatment in the first group. The increase in similar indicators in the second group was insignificant (p<0.05). In children of the first group the difference in ciliary muscle thickness (CMT) of the amblyopic eye with disabled and enabled accommodation increased by 0.04±0.01 mm (p<0.05) in the anterior part of the ciliary muscle at the levels of CMTmax and CMT1. CONCLUSION The data obtained in this study indicate the strong effect of refractive laser surgery in combination with pleoptic treatment on improving the visual acuity and the state of accommodation of the amblyopic and paired dominant eyes in children with hyperopic anisometropia, in contrast to conventional methods of treatment.
Collapse
Affiliation(s)
- I L Kulikova
- Cheboksary branch of the S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", Cheboksary, Russia
| | - K A Aleksandrova
- Cheboksary branch of the S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", Cheboksary, Russia
| |
Collapse
|
31
|
Hashem O, Sheha H. Ten-Year Outcomes of LASIK for Pediatric Myopic Anisometropia. Clin Ophthalmol 2022; 16:4293-4301. [PMID: 36578667 PMCID: PMC9792104 DOI: 10.2147/opth.s387302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose To evaluate long-term safety, effectiveness, and stability of unilateral LASIK in pediatric myopic anisometropic amblyopia. Methods This retrospective study included children who received unilateral LASIK for myopic anisometropia of >6 D, after mandatory 6-month occlusion/penalization therapy. They were evaluated at 6 months, 1 year, 2 years and biannually until 10 years. Outcome measures included visual acuity, refraction, ocular alignment, stereopsis, corneal clarity, and corneal topography. Results 32 patients (16 girls) with mean age of 8.6 ± 2.3 years completed 10 years of follow up after unilateral LASIK. Mean preoperative spherical equivalent refraction (SER) was -10.3D ±2.0D in the affected eye, with anisometropic difference of -9.5D ±1.7D. Mean post-LASIK SER was -1.3D±0.8D (p<0.001). Anisometropia significantly decreased to 0.3D±0.8D, 0.4D±1.0D, and 1.0±2.5D at 6 months, 1 year and 10 years respectively (p<0.001). 11 patients (34%) who had preoperative intermittent exotropia (< 15°) regained orthophoria in all gazes, while 5 of 10 who had constant exotropia with large angle (>30°) required strabismus surgery for ocular alignment. BCVA improved from 0.04±0.6 Decimal at baseline to 0.6 ±0.2 after LASIK and occlusion therapy (p< 0.001). Despite insignificant refractive regression in both eyes, patients have maintained orthophoria, improved stereopsis, clear cornea, and the topography showed no evidence of post-LASIK ectasia. Conclusion LASIK appears safe, effective, and stable for correcting refractory pediatric myopic anisometropia, in which conventional measures fail or endanger normal visual development. Eliminating anisometropic aniseikonia consequently restores binocular vision and stereopsis which, along with amblyopia therapy, would reverse amblyopia and prevent recurrence.
Collapse
Affiliation(s)
- Omar Hashem
- Cornea and Refractive Department, Research Institute of Ophthalmology, Giza, Cairo, Egypt,Correspondence: Omar Hashem, Research Institute of Ophthalmology, 2 Al Ahram Street, Giza, Cairo, Egypt, Tel +201222422032, Email
| | - Hosam Sheha
- Department of Ophthalmology, Florida International University, Herbert Wertheim College of Medicine & Glaucoma Research Organization, Miami, FL, USA,Department of Ophthalmology, Manhattan Eye, Ear and Throat Hospital, Hofstra Northwell School of Medicine, New York, NY, USA
| |
Collapse
|
32
|
Xu Z, Wu Z, Wen Y, Ding M, Sun W, Wang Y, Shao Z, Liu Y, Yu M, Liu G, Hu Y, Bi H. Prevalence of anisometropia and associated factors in Shandong school-aged children. Front Public Health 2022; 10:1072574. [PMID: 36620276 PMCID: PMC9815018 DOI: 10.3389/fpubh.2022.1072574] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
Objective To investigate anisometropia's prevalence and associated factors in school-aged children. Methods A cross-sectional school-based study was conducted in Shandong Province, China, including children aged 4 to 17 from 9 schools. Anisometropia was defined as the differences between the two eyes in spherical equivalent (SE) or cylinder degree of 1.00 diopter (D) or more [SE or cylindrical (CYL) difference ≥ 1.00 D] after cycloplegic autorefraction. The Generalized Linear Model (GLM) was used to analyze the effects of ocular parameters [the differences between eyes in axial length (AL), habitual visual acuity (HVA), and corneal astigmatism (CA)] and lifestyle parameters (time spent indoor near work and outdoor activities) on anisometropia. Results Total 4,198 (93.4%) of the 4,494 children were included in the statistical analysis. The mean difference in inter-eye SE was 0.42 ± 0.61 D. The prevalence of anisometropia was 13.2% (95%CI: 12.1 to 14.2%) (SE anisometropia's prevalence:10.3%; CYL anisometropia's prevalence: 4.1%), increased with older age (OR = 1.10, P = 0.002), the worse myopic eye (myopia vs. premyopia, OR = 1.87, P = 0.002), the worse hyperopic eye (hyperopia vs. premyopia, OR = 1.77, P = 0.013), larger difference in inter-eye AL (0.1-0.3 vs. ≤ 0.1, OR = 1.67, P = 0.008; >0.3 vs. ≤ 0.1, OR = 28.61, P < 0.001), HVA (>0.2 vs. ≤ 0.2, OR = 3.01, P < 0.001), CA (OR = 6.24, P < 0.001), the worse stereoacuity (>100 vs. ≤ 100, OR = 1.59, P = 0.001), longer indoor near work time per day on weekends (4-8 vs. <4, OR = 1.41, P = 0.038; ≥8 vs. <4, OR = 1.40, P = 0.131), and shorter outdoor activity time per day on weekdays (≥1 vs. <1, OR = 0.75, P = 0.046) in multivariable analysis. In the SE anisometropia group, the difference in inter-eye AL (>0.3 vs. ≤ 0.1, β: 0.556, 95%CI: 0.050 to 1.063), HVA (>0.2 vs. ≤ 0.2, β: 0.511, 95%CI: 0.312 to 0.710), and CA (β: 0.488, 95%CI: 0.289 to 0.688), stereoacuity (>100 vs. ≤ 100, β: 0.299, 95%CI: 0.110 to 0.488) had a positive impact on the difference in inter-eye SE. Conclusions Ocular parameters and lifestyle parameters are associated with the occurrence of anisometropia in children aged 4 to 17 years, including the difference in inter-eye AL, HVA, CA, stereoacuity, indoor near work time, and outdoor activity time. Preventing myopia and early treating anisometropic amblyopia may be effective ways to reduce the prevalence of anisometropia.
Collapse
Affiliation(s)
- Zihang Xu
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Jinan, China,Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China
| | - Ziyun Wu
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Jinan, China,Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China
| | - Ying Wen
- Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Meihua Ding
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Wei Sun
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Jinan, China,Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yirong Wang
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhen Shao
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yi Liu
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Mingkun Yu
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Jinan, China,Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China
| | - Guoyong Liu
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Jinan, China,Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China
| | - Yuanyuan Hu
- Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China,Yuanyuan Hu ✉
| | - Hongsheng Bi
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Jinan, China,Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China,*Correspondence: Hongsheng Bi ✉
| |
Collapse
|
33
|
Leet MP, Bear MF, Gaier ED. Metaplasticity: a key to visual recovery from amblyopia in adulthood? Curr Opin Ophthalmol 2022; 33:512-518. [PMID: 36094025 PMCID: PMC9547850 DOI: 10.1097/icu.0000000000000901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE OF REVIEW We examine the development of amblyopia and the effectiveness of conventional and emerging therapies through the lens of the Bienenstock, Cooper, and Munro (BCM) theory of synaptic modification. RECENT FINDINGS The BCM theory posits metaplastic adjustment in the threshold for synaptic potentiation, governed by prior neuronal activity. Viewing established clinical principles of amblyopia treatment from the perspective of the BCM theory, occlusion, blur, or release of interocular suppression reduce visual cortical activity in the amblyopic state to lower the modification threshold and enable amblyopic eye strengthening. Although efficacy of these treatment approaches declines with age, significant loss of vision in the fellow eye by damage or disease can trigger visual acuity improvements in the amblyopic eye of adults. Likewise, reversible retinal inactivation stimulates recovery of amblyopic eye visual function in adult mice and cats. SUMMARY Conventional and emerging amblyopia treatment responses abide by the framework of BCM theory. Preclinical studies support that the dramatic reduction in cortical activity accompanying temporary retinal silencing can promote recovery from amblyopia even in adulthood, highlighting a promising therapeutic avenue.
Collapse
Affiliation(s)
- Madison P Leet
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge
| | - Mark F Bear
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge
| | - Eric D Gaier
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge
- Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
34
|
Jaber BAD. Clinical Practice and the Attitude of Ophthalmologists Regarding Amblyopia in the Population of Jordan: A Cross-Sectional Study. Cureus 2022; 14:e30114. [PMID: 36381876 PMCID: PMC9643014 DOI: 10.7759/cureus.30114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2022] [Indexed: 06/16/2023] Open
Abstract
Aim The study was aimed at finding out the knowledge and attitude among ophthalmologists regarding amblyopia in the population of Jordan. Methodology This was an observational cross-sectional study conducted in 2021 among ophthalmologists who live and work in the local society of Jordan and were aged between 30 and 50 years. The survey was conducted using an online questionnaire administered through email and various social media platforms. The level of knowledge and awareness of amblyopia, its causes, methods of treatment, and the best age for treating amblyopia was assessed. Results Out of 200 participants, the majority were in the age group of 30-34 years (47.5%). The male:female ratio was 1:1. The average better age for examination and treatment of amblyopia was three to five years (46%). The most common cause of amblyopia was strabismic amblyopia (50%). Children's and parents' cooperation most significantly influenced the treatment's success (49%). The preferred assessment was cycloplegic refraction (56%), and the preferred patching treatment was a direct cover placed over the eye (77%). The average time to treat amblyopia was less than three years in the majority (53.5%). The most critical factor determining the success of treatment was when the treatment began (57.5%). Conclusions Our study found that although the majority of the participants were less experienced overall, they had a good knowledge of the amblyopia age group and the method of examination. Still, there was a mixed response regarding the treatment. Hence there is a need to increase awareness regarding amblyopia by Jordanian ophthalmologists, social organizations, and educational institutes.
Collapse
|
35
|
Guler Alis M, Alis A. Features of the Choroidal Structure in Children With Anisometropic Amblyopia. J Pediatr Ophthalmol Strabismus 2022; 59:320-325. [PMID: 35192385 DOI: 10.3928/01913913-20220103-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To examine the choroidal structure in children with anisometropic amblyopia using the binarization method. METHODS Thirty children with unilateral anisometropic amblyopia and 30 healthy age- and sex-matched controls were included in the study. Choroidal thickness was measured with optical coherence tomography. The choroidal layer was examined with the binarization method using ImageJ software (National Institutes of Health). The total choroidal area, stromal area, luminal area, luminal area to stromal area ratio, and choroidal vascular index were calculated. The values were compared by correlating the spherical equivalent (SE) (determined by an autorefractometer) with anterior chamber depth, axial length, central corneal thickness (measured by optical biometry), and choroidal thickness values. RESULTS Mean SE values were 3.75 ± 2.16 diopters (D) in the amblyopic eyes, 2.39 ± 2.09 D in the fellow eyes, and -0.27 ± 0.53 D in the control eyes. Best corrected visual acuity (BCVA) was 0.29 ± 0.11 logarithm of the minimum angle of resolution (logMAR) in the amblyopic eyes, 0.02 ± 0.04 logMAR in the fellow eyes, and 0 ± 0 logMAR in the control eyes. Choroidal thickness values were 351 ± 47 µm in the amblyopic eyes, 333 ± 55 µm in the fellow eyes, and 324 ± 51 µm in the control eyes. Luminal area to stromal area ratio values were 1.73 ± 0.13 in the amblyopic eyes, 1.76 ± 0.15 in the fellow eyes, and 2.02 ± 0.25 in the control eyes. Choroidal vascular index values were 63% ± 0.02 in the amblyopic eyes, 64% ± 0.02 in the fellow eyes, and 66% ± 0.03 in the control eyes. BCVA, SE, choroidal thickness, luminal area to stromal area ratio, and choroidal vascular index were significantly different in each group. The total choroidal area, luminal area, and stromal area were similar in all eyes. No correlation was found between choroidal vascular index and choroidal thickness, anterior chamber depth, axial length, and central corneal thickness. CONCLUSIONS In children with anisometropic amblyopia, the total choroidal area was relatively larger in both the amblyopic and the fellow eyes compared to the control eyes. Due to the higher stromal area and lower luminal area, both the amblyopic and the fellow eyes also had lower choroidal vascular index values than control eyes. [J Pediatr Ophthalmol Strabismus. 2022;59(5):320-325.].
Collapse
|
36
|
Lin D, Wang Z, Chen W, Shen T, Qiu X, Wei K, Li J, Yang D, Wang P, Li X, Yan J, Tang Z. Regional Downregulation of Dopamine Receptor D1 in Bilateral Dorsal Lateral Geniculate Nucleus of Monocular Form-Deprived Amblyopia Models. Front Neurosci 2022; 16:861529. [PMID: 35757538 PMCID: PMC9213678 DOI: 10.3389/fnins.2022.861529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/29/2022] [Indexed: 11/13/2022] Open
Abstract
Amblyopia is a common eye disease characterized by impaired best-corrected visual acuity. It starts in early childhood and leads to permanent vision reduction if left untreated. Even though many young patients with amblyopia are well treated in clinical practice, the underlying mechanism remains to be elucidated, which limits not only our understanding of this disease but also the therapeutic approach. To investigate the molecular mechanism of amblyopia, primate and rodent models of monocular-deprived amblyopia were created for mRNA screening and confirmation. We obtained 818 differentially expressed genes from the dorsal lateral geniculate nucleus (dLGN) of a primate model of amblyopia. After Gene Ontology and kyoto encyclopedia of genes and genomes (KEGG) enrichment analyses, the main enriched pathways were related to neural development. Interestingly, a particular neurotransmitter pathway, the dopaminergic pathway, was identified. The downregulation of dopamine receptor D1 (DRD1) was confirmed in both monkey and mouse samples. Furthermore, the immunofluorescence staining indicated that DRD1 expression was downregulated in both ventrolateral region of the contralateral dLGN and the dorsomedial region of the ipsilateral dLGN in the mouse model. The regions with downregulated expression of DRD1 were the downstream targets of the visual projection from the amblyopic eye. This study suggested that the downregulation of DRD1 in the LGN may be a cause for amblyopia. This may also be a reason for the failure of some clinical cases of levodopa combined with carbidopa applied to amblyopes.
Collapse
Affiliation(s)
- Dongyue Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, China
| | - Zhonghao Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, China
| | - Wei Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, China
| | - Tao Shen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, China
| | - Xuan Qiu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, China
| | - Kun Wei
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, China
| | - Jiahui Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, China
| | - Dongsheng Yang
- Jinan Purui Eye Hospital, Children's Eye Disease and Ocular Motor Institute of Purui Jinan, Jinan, China
| | - Ping Wang
- Jinan Purui Eye Hospital, Children's Eye Disease and Ocular Motor Institute of Purui Jinan, Jinan, China
| | - Xuri Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, China
| | - Jianhua Yan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, China
| | - Zhongshu Tang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, China.,Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
37
|
Oladiwura D, shweikh Y, Roberts C, Theodorou M. Nystagmus in Down Syndrome – a Retrospective Notes Review. BRITISH AND IRISH ORTHOPTIC JOURNAL 2022; 18:48-56. [PMID: 35837367 PMCID: PMC9231581 DOI: 10.22599/bioj.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 04/27/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction: Nystagmus has been reported in up to 30% of people with Down Syndrome (DS), and yet is still not well understood. Our study aims to characterise the clinical features of patients with DS and nystagmus. Methods: A retrospective medical-records review was conducted of all patients with a diagnosis of DS and nystagmus seen at Moorfields Eye Hospital over a ten-year period. Results: Fifty-one subjects were identified, with complete data in 48. The mean age at presentation was 5.1 years (range 0–26 years). The mean binocular LogMAR visual acuity was 0.55(95%CI 0.53–0.57), mean refractive error was –1.8 Dioptre Sphere, DS (95% CI – 5.251.63) with –1.2 Dioptre Cylinder, DC (95% CI – 1.6–0.7). Ocular misalignment was found in 50% of patients. A diagnosis of Fusion Maldevelopment Nystagmus Syndrome (FMNS) was made in 6.3%, Infantile Nystagmus Syndrome (INS) in 8.4% and ABducting nystagmus/Inter-Nuclear Ophthalmoplegia (INO) in 2.1%. The descriptive term ‘Manifest Horizontal Nystagmus’(MNH) was used in the majority, highlighting the difficulties in clinically differentiating the subtypes of nystagmus in DS. Eleven patients had associated cataract. Additional diagnoses unrelated to DS were made in 10.4%. Conclusions: The most frequent type of nystagmus in our cohort was ‘presumed’ INS. This study highlights the importance of differentiating between FMNS and INS (with a latent component), so that further investigations can be performed as appropriate. Almost 25% had associated cataract, and a further 10% other diagnoses un-associated to DS. Despite INS being known to be associated with DS, further investigations may be required in a small subset with true INS after careful clinical assessment and use of eye movement recordings (where available).
Collapse
|
38
|
South J, Gao T, Calderwood M, Turuwhenua J, Roberts P, Lee A, Collins A, Black J. Measuring aniseikonia and investigating neuroplasticity and image factors in amblyopia (MAGNIFY): study protocol for a randomised clinical trial. Trials 2022; 23:358. [PMID: 35478070 PMCID: PMC9044861 DOI: 10.1186/s13063-022-06159-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 03/07/2022] [Indexed: 11/26/2022] Open
Abstract
Background Aniseikonia represents a potential barrier to neuroplasticity which may limit visual outcomes in children with anisometropic amblyopia. Full correction of refractive error is the first step in standard amblyopia treatment, which corrects for image focus but neglects image size differences. Methods The MAGNIFY study is a double-masked, randomised clinical trial investigating the effectiveness of aniseikonia correcting lenses in children at first diagnosis of significant anisometropia. We hypothesis that aniseikonia correction lenses will improve image clarity and reduce the retinal size differences producing better visual acuity and stereoacuity improvements after 15 weeks of optical treatment for children with anisometropia. Eligible children will be randomly allocated to the treatment group (aniseikonia-correcting spectacle lenses) or control group (standard spectacle lenses). Visual acuity and binocular functions will be assessed every 5 weeks during the 15-week optical treatment phase according to standard amblyopia treatment protocol. Discussion It is possible that correcting aniseikonia along with anisometropia at first diagnosis will promote binocularity as well as increase spectacle adherence by reducing visual discomfort, improving optical treatment outcomes. This could then reduce the need for additional amblyopia treatment such as patching or atropine, reducing the burden on hospital eye departments and potentially improving visual outcomes for children with amblyopia. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000061932. Registered on 24 January 2020. Protocol 15th November 2019, version one. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06159-2.
Collapse
Affiliation(s)
- Jayshree South
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand.
| | - Tina Gao
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Melinda Calderwood
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Jason Turuwhenua
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand.,School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Paul Roberts
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand.,Medlink Innovation Limited, Auckland, New Zealand
| | - Arier Lee
- Section of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
| | - Andrew Collins
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Joanna Black
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
39
|
Etezad-Razavi M, Tafaghodi-Yousefi B, Eslampour A, Kiarudi MY, Najjaran M, Momeni-Moghaddam H, Alio JL. Visual outcomes of photorefractive keratectomy in non-children with anisometropic amblyopia: One-year Follow-up Outcomes. Eur J Ophthalmol 2022; 32:2615-2621. [PMID: 35156869 DOI: 10.1177/11206721211073033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the safety, efficiency, short term stability, and sensory results of photorefractive keratectomy (PRK) in anisometropic in non-compliant children with correction. METHODS Twelve eyes of 12 children with an age range: 6-17 years and anisometropic amblyopia who underwent PRK under general anesthesia to correct the dioptric difference between the eyes were included in this study. A complete ophthalmic assessment including refractive status, uncorrected and corrected distance visual acuity (UDVA & CDVA), and binocular vision status using the Worth 4-dot test and stereopsis were performed before and 1, 3, 6, and 12 months after PRK. RESULTS The mean preoperative CDVA was 0.34 ± 0.24 LogMAR which showed a statistically significant improvement at 12 months (0.20 ± 0.19, p = 0.024) after surgery compared to the preoperative assessment. (p = 0.003) The mean preoperative UDVA was 0.63 ± 0.24 LogMAR that increased to 0.44 ± 0.24, 0.32 ± 0.16, 0.25 ± 0.19, and 0.25 ± 0.19 LogMAR at 1, 3, 6, and 12 months after PRK, respectively. One to three lines improvement in UDVA and CDVA was seen in 10 (83.4%) and 8 eyes (66.7%); while one line UDVA and CDVA loss was seen in one (8.3%) and one (8.3%) eye and unchanged UDVA and CDVA was seen in 1 (8.3%) and 3 eyes (25%), respectively. The mean preoperative stereoacuity was 341.9 ± 245.7 s of arc, which significantly improved to 166.6 ± 87.5 s of arc 12 months after PRK. (p = 0.012). CONCLUSION PRK was an effective surgical alternative to improve visual acuity and stereopsis in anisometropic children who did not cooperate with conventional methods of amblyopia therapy.
Collapse
Affiliation(s)
| | | | - Alireza Eslampour
- Eye Research Center, 37552Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Y Kiarudi
- Eye Research Center, 37552Mashhad University of Medical Sciences, Mashhad, Iran
| | - Marzieh Najjaran
- Department of Optometry, School of Paramedical Sciences, 37552Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamed Momeni-Moghaddam
- Health Promotion Research Center, 48538Zahedan University of Medical Sciences, Zahedan, Iran
| | - Jorge L Alio
- Miguel Hernandez University, Alicante, Spain and Vissum Miranza, Alicante, Spain
| |
Collapse
|
40
|
Zhang KY, Lyu HB, Yang JR, Qiu WQ. Efficacy of long-term orthokeratology treatment in children with anisometropic myopia. Int J Ophthalmol 2022; 15:113-118. [PMID: 35047365 DOI: 10.18240/ijo.2022.01.17] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/10/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To explore the efficacy of the orthokeratology lens for anisometropic myopia progression. METHODS A retrospective study was performed. Cycloplegic refraction and axial length (AL) were collected from 50 children (10.52±1.72y) who visited Peking University Third Hospital from July 2015 to August 2020. These children's one eyes (Group A) received monocular orthokeratology lenses at first, after different durations (12.20±6.94mo), their contralateral eyes (Group B) developed myopia and receive orthokeratology as well. The data in 1-year of binocular period were recorded. AL growth rate (difference of follow-up and baseline per month) were compared between two groups by paired t test. Interocular differences of AL were compared by Wilcoxon test. RESULTS During monocular period, the AL growth rate of the Group A (0.008±0.022 mm/mo) was significantly slower than that of the Group B (0.038±0.018 mm/mo; P<0.0001). However, during binocular period, the AL growth rate of the Group A (0.026±0.014 mm/mo) was significantly faster than that of the Group B (0.016±0.015 mm/mo; P<0.0001). The AL difference between both eyes was 0.6 (0.46) mm, then significantly decreased to 0.22 (0.39) mm when started binocular treatment (P<0.0001). However, it was significantly increased to 0.30 (0.32) mm after a year (P<0.0001), but still significantly lower than baseline (P<0.0001). CONCLUSION The orthokeratology lens is efficient for control the AL elongation of monocular myopia eyes and reduce anisometropia. For the condition that the contralateral eyes develop myopia and receive orthokeratology lens later, there is no efficiency observed on control interocular difference of AL during binocular treatment.
Collapse
Affiliation(s)
- Kai-Yun Zhang
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.,College of Optometry, Peking University Health Science Center, Beijing 100191, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| | - Hui-Bin Lyu
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| | - Jia-Rui Yang
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| | - Wei-Qiang Qiu
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| |
Collapse
|
41
|
Su T, Zhu PW, Li B, Shi WQ, Lin Q, Yuan Q, Jiang N, Pei CG, Shao Y. Gray matter volume alterations in patients with strabismus and amblyopia: voxel-based morphometry study. Sci Rep 2022; 12:458. [PMID: 35013442 PMCID: PMC8748957 DOI: 10.1038/s41598-021-04184-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 12/16/2021] [Indexed: 11/21/2022] Open
Abstract
This study proposes the use of the voxel-based morphometry (VBM) technique to investigate structural alterations of the cerebral cortex in patients with strabismus and amblyopia (SA). Sixteen patients with SA and sixteen healthy controls (HCs) underwent magnetic resonance imaging. Original whole brain images were analyzed using the VBM method. Pearson correlation analysis was performed to evaluate the relationship between mean gray matter volume (GMV) and clinical manifestations. Receiver operating characteristic (ROC) curve analysis was applied to classify the mean GMV values of the SA group and HCs. Compared with the HCs, GMV values in the SA group showed a significant difference in the right superior temporal gyrus, posterior and anterior lobes of the cerebellum, bilateral parahippocampal gyrus, and left anterior cingulate cortex. The mean GMV value in the right superior temporal gyrus, posterior and anterior lobes of the cerebellum, and bilateral parahippocampal gyrus were negatively correlated with the angle of strabismus. The ROC curve analysis of each cerebral region confirmed the accuracy of the area under the curve. Patients with SA have reduced GMV values in some brain regions. These findings might help to reveal the potential pathogenesis of SA and its relationship with the atrophy of specific regions of the brain.
Collapse
Affiliation(s)
- Ting Su
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Eye Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, People's Republic of China.,Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA
| | - Pei-Wen Zhu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People's Republic of China
| | - Biao Li
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People's Republic of China
| | - Wen-Qing Shi
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People's Republic of China
| | - Qi Lin
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People's Republic of China
| | - Qing Yuan
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People's Republic of China
| | - Nan Jiang
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Eye Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, People's Republic of China
| | - Chong-Gang Pei
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People's Republic of China.
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People's Republic of China.
| |
Collapse
|
42
|
Hui W, Xiaofeng H, Hua X, Yihan D, Yong T. Assessment of choroidal vascularity and choriocapillaris blood perfusion in Chinese preschool-age anisometropic hyperopic amblyopia children. Front Pediatr 2022; 10:1056888. [PMID: 36467467 PMCID: PMC9713412 DOI: 10.3389/fped.2022.1056888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 10/24/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To determine the macular and peripapillary area choroid microstructure parameters of hyperopic anisometropic amblyopia eyes and compare to fellow and age-matched control eyes. To assess the correlation between the axial length (AL), choroidal thickness (CT) and choroid microstructure parameters. METHODS This cross-sectional comparative, non-interventional study involved 52 hyperopic anisometropic amblyopia children and 48 age-matched heathy controls. 52 eyes with hyperopic anisometropic amblyopia and 48 age-matched control eyes were studied. The peripapillary and subfoveal CT were determined. The total choroidal area (TCA), luminal area (LA), and stromal area (SA) of the subfoveal and peripapillary choroid were measured. In addition, the correlation between the AL, CT and choroid microstructure parameters were calculated. RESULTS The peripapillary and subfoveal CT of the amblyopic eyes was significantly thicker than the fellow and control eyes (all P < 0.05). The subfoveal and peripapillary choroidal SA, LA and TCA of the amblyopic eyes were significantly increased than that of the fellow and control eyes (all P < 0.05). The choroidal vascularity index (CVI) values of the amblyopic eye were significantly different among the three groups (P < 0.05). There was a statistically significant negative correlation between AL and subfoveal CT (SFCT), LA and TCA levels (P < 0.001, P = 0.039, P = 0.027, respectively). Spherical equivalent (SE) was positive correlated with SFCT, LA and TCA levels (P = 0.456, 0.229 and 0.240, respectively; all P < 0.05). There was a statistically significant positive correlation between SFCT, SE, LA, SA, TCA and CVI levels (all P < 0.05). CONCLUSION The subfoveal and peripapillary CT of amblyopic children abnormally increased and correlated with shorter AL and higher SE. The choroidal structure of the amblyopic eyes was different from the fellow and control eyes, the hyperopic anisometropic amblyopic eyes had significantly thicker sub-foveal choroid, higher LA, SA, and TCA. AL and CT affect choroidal structure and vascular density. Choroidal blood flow may be increased in amblyopic eyes. The larger LA, SA, TCA, and lower CVI were characteristic of the amblyopic eye.
Collapse
Affiliation(s)
- Wang Hui
- Department of Ophthalmology, Beijing Chaoyang Hospital, The Third Clinical Medical College of Capital Medical University, Beijing, China
| | - Hu Xiaofeng
- Department of Ophthalmology, Beijing Chaoyang Hospital, The Third Clinical Medical College of Capital Medical University, Beijing, China
| | - Xin Hua
- Department of Ophthalmology, Beijing Chaoyang Hospital, The Third Clinical Medical College of Capital Medical University, Beijing, China
| | - Dong Yihan
- Department of Ophthalmology, Beijing Chaoyang Hospital, The Third Clinical Medical College of Capital Medical University, Beijing, China
| | - Tao Yong
- Department of Ophthalmology, Beijing Chaoyang Hospital, The Third Clinical Medical College of Capital Medical University, Beijing, China
| |
Collapse
|
43
|
Alis MG, Alis A, Acikalin B. How do the amblyopic and fellow eyes differ in adults? J Fr Ophtalmol 2021; 45:74-80. [PMID: 34801272 DOI: 10.1016/j.jfo.2021.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/26/2021] [Accepted: 06/04/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To investigate the differences between the amblyopic eye and the fellow eye in adults with anisometropic amblyopia. MATERIALS AND METHODS Measurements of the central macular thickness [CMT], subfoveal choroidal thickness [SFCT], and retinal nerve fiber layer [RNFL] in patients with anisometropic amblyopia were obtained using optical coherence tomography [OCT]. Axial length [AL], anterior chamber depth [ACD], and central corneal thickness [CCT] were measured with optical biometry. All 12 parameters were compared between the amblyopic eye [Group 1] and the fellow eye [Group 2]. RESULTS A total of 110 eyes of 55 patients [9 myopic, 46 hypermetropic] were analyzed retrospectively. The ages of the patients ranged from 17 to 55 years, with a mean of 30.8±10.7 years. 56.4% [n=31] of the patients were female, and 43.6% [n=24] were male. The mean spherical equivalent [SE] was 1.96±3.79 in Group 1 and 1.28±2.45 in Group 2. SFCT was 312.00±53.03 in Group 1 and 283.47±51.91 in Group 2. AL was 22.53±1.40 in Group 1 and 22.79±1.18 in Group 2. SE, SFCT, and AL were statistically significantly different between the two groups. There was no difference between the two groups in terms of CMT, RNFL, ACD and CCT values. CONCLUSION In adults with anisometric amblyopia, the SFCT of the amblyopic eye is greater than that of the fellow eye. The choroid plays an important role in the nutrition of the retinal layers, the development of ocular function and refractive error, and its development may be affected by the refractive error. Since the majority of our patients were hyperopic, the AL was found to be shorter in the amblyopic eye. CMT, RNFL, ACD and CCT values were the similar in both groups. There was no clinically significant relationship between biometric parameters and OCT parameters.
Collapse
Affiliation(s)
- M G Alis
- Fatih Sultan Mehmet Training and Research Hospital, Atasehir, Istanbul, Turkey.
| | - A Alis
- Fatih Sultan Mehmet Training and Research Hospital, Atasehir, Istanbul, Turkey.
| | - B Acikalin
- Fatih Sultan Mehmet Training and Research Hospital, Atasehir, Istanbul, Turkey.
| |
Collapse
|
44
|
Candy TR, Cormack LK. Recent understanding of binocular vision in the natural environment with clinical implications. Prog Retin Eye Res 2021; 88:101014. [PMID: 34624515 PMCID: PMC8983798 DOI: 10.1016/j.preteyeres.2021.101014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/26/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
Technological advances in recent decades have allowed us to measure both the information available to the visual system in the natural environment and the rich array of behaviors that the visual system supports. This review highlights the tasks undertaken by the binocular visual system in particular and how, for much of human activity, these tasks differ from those considered when an observer fixates a static target on the midline. The everyday motor and perceptual challenges involved in generating a stable, useful binocular percept of the environment are discussed, together with how these challenges are but minimally addressed by much of current clinical interpretation of binocular function. The implications for new technology, such as virtual reality, are also highlighted in terms of clinical and basic research application.
Collapse
Affiliation(s)
- T Rowan Candy
- School of Optometry, Programs in Vision Science, Neuroscience and Cognitive Science, Indiana University, 800 East Atwater Avenue, Bloomington, IN, 47405, USA.
| | - Lawrence K Cormack
- Department of Psychology, Institute for Neuroscience, and Center for Perceptual Systems, The University of Texas at Austin, Austin, TX, 78712, USA.
| |
Collapse
|
45
|
Malaika R, Raffa L, Algethami M, Alessa S. Pediatric spectacle prescription: Understanding practice patterns among ophthalmologists and optometrists in Saudi Arabia. Saudi J Ophthalmol 2021; 34:278-283. [PMID: 34527872 PMCID: PMC8409352 DOI: 10.4103/1319-4534.322608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 08/22/2020] [Accepted: 10/05/2020] [Indexed: 11/04/2022] Open
Abstract
PURPOSE This study aims to understand the approach to prescribing spectacles for children and the interpretation of refractive errors among ophthalmologists/optometrists in Saudi Arabia. METHODS A cross-sectional survey was conducted between September and November 2018 using a database of online registrants for ophthalmologists and optometrists practicing in Saudi Arabia. The survey included 10 multiple-choice questions designed to elicit information about how ophthalmologists and optometrists deal with commonly encountered case scenarios covering different practical aspects of pediatric refraction. The responses were compared using the proportion of pediatric clientele received in the respondents' practices (Group A: <25%, Group B: 25%) and drawing upon concepts from the published literature. RESULTS One hundred and three participants, including ophthalmologists, specialists/registrars, and optometrists from across Saudi Arabia, participated in this survey. Approximately 25% were classified as Group A. Large discrepancies were observed between the participants' responses and actual practices based on guideline recommendations. Responses varied significantly between Groups A and B on certain issues pertaining to pseudomyopia (P < 0.001), anisometropia (P = 0.033), and high astigmatism (P = 0.023). CONCLUSION Practice patterns regarding pediatric spectacle prescription varied among ophthalmologists and optometrists in Saudi Arabia. The approach to managing refractive errors in children was better among ophthalmologists/optometrists servicing a larger pediatric clientele, suggesting the need to increase awareness among all groups of ophthalmologists/optometrists.
Collapse
Affiliation(s)
- Rawan Malaika
- Department of Ophthalmology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Lina Raffa
- Department of Ophthalmology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | | | - Sara Alessa
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
46
|
Lee YJ, Yoo YJ, Han SB. Outcomes after Cataract Surgery in High Myopes with Axial Length Differences of ≥2 mm. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.8.1036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To evaluate the visual outcome after cataract operations in high myopia patients, whose axial length differences are longer than 2 mm.Methods: A retrospective study was conducted on patients who had received phacoemulsification cataract surgery from January 2014 to June 2020. The patients whose axial lengths and inter-eye axial lengths exceeded 26 and 2 mm, respectively, were selected. Demographic data, axial lengths, central subfield macular thickness, retinal nerve fiber layer, and best-corrected visual acuities (BCVAs) before and at 6 months postoperatively were collected. The factors related to visual outcome were analyzed using univariate, multivariate linear regression.Results: Twelve patients had an inter-eye axial length difference longer than 2 mm. The average axial lengths of longer and shorter eyes were 29.17 ± 1.94 and 26.66 ± 2.51 mm, respectively (p = 0.02, Mann-Whitney U-test). The BCVAs (logarithm of minimal angle of resolution, logMAR) of the longer and shorter eyes before the surgery were 1.09 ± 0.62 and 0.19 ± 0.16, respectively (p = 0.03, Mann-Whitney U-test). The BCVAs (logMAR) of the longer and shorter eyes 6 months after surgery were 0.19 ± 0.16 and 0.08 ± 0.10, respectively (p = 0.11, Mann-Whitney U-test). In univariate linear regression analysis, the BCVAs 6 months after the surgery showed better preoperative BCVAs (p < 0.001) and a thinner central subfield macular thickness (p = 0.001). In multivariate linear regression analysis, the BCVA at 6 months after the surgery showed significant improvement compared with preoperative BCVA values (p < 0.001).Conclusions: High myopia patients whose axial length differences exceeded 2 mm showed improved VA after cataract surgery.
Collapse
|
47
|
Maneschg OA, Barboni MTS, Nagy ZZ, Németh J. Fixation stability after surgical treatment of strabismus and biofeedback fixation training in amblyopic eyes. BMC Ophthalmol 2021; 21:264. [PMID: 34167504 PMCID: PMC8229382 DOI: 10.1186/s12886-021-02020-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 06/01/2021] [Indexed: 01/06/2023] Open
Abstract
Background Visual fixation may be affected in amblyopic patients and, moreover, its stability may be associated with the effects of amblyopic treatments on visual performance in patients with strabismus. Therefore, fixation stability is a relevant biomarker that might predict the recurrence of amblyopia after a therapeutic intervention. Microperimetric biofeedback fixation training (BFT) can stabilize visual fixation in adult patients with central vision loss. It was the purpose of the present study to evaluate the effects of BFT on fixation stability in adult amblyopic patients after surgical intervention to treat strabismus. Methods Participants were 12 patients with strabismus (mean age = 29.6 ± 8.5 years; 6 females) and 12 healthy volunteers (mean age = 23.8 ± 1.5 years; 9 females). The protocol included ophthalmological and microperimetric follow-ups to measure fixation stability and macular sensitivity. BFT was applied monocularly to four amblyopic eyes either on the spontaneous preferential retinal locus or to a fixation area closer to the anatomical fovea after surgical treatment of strabismus. Results Baseline measurements showed significantly altered microperimetric average threshold in amblyopic eyes compared to fellow eyes (p = 0.024) and compared to control eyes (p < 0.001). Fixation was unstable in amblyopic eyes compared to control eyes (p < 0.001). Fixation stability did not significantly change after surgical alignment of strabismus (p = 0.805). BFT applied to operated eyes resulted in a more stable fixation with improvements of about 50% after three months of training. Conclusions Fixation stability improvements following BFT highlight its potential use in adult amblyopic eyes after the surgical alignment of the strabismus. Future investigations may also consider applying this method in combination with standard treatments to improve vision in amblyopic patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-02020-3.
Collapse
Affiliation(s)
- Otto Alexander Maneschg
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary. .,Bionic Innovation Center, Budapest, Hungary.
| | | | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - János Németh
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary.,Bionic Innovation Center, Budapest, Hungary
| |
Collapse
|
48
|
Boniquet-Sanchez S, Sabater-Cruz N. Current Management of Amblyopia with New Technologies for Binocular Treatment. Vision (Basel) 2021; 5:31. [PMID: 34200969 PMCID: PMC8293449 DOI: 10.3390/vision5020031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/03/2021] [Accepted: 06/03/2021] [Indexed: 12/19/2022] Open
Abstract
Amblyopia is the most common cause of monocular poor vision affecting up to 3.7% of the global population. Classically, the first step in treatment has been optical correction, followed by patching and/or pharmacological treatment. However, this is an evolving scenario, since researchers and clinicians are interested in new binocular treatments due to the increasing development of new technologies. In this article main, current binocular treatments as Dig Rush, falling blocks, I-BiT, Occlu-tab, Vivid Vision, and movies are reviewed for binocular amblyopia management.
Collapse
Affiliation(s)
- Sandra Boniquet-Sanchez
- Anterior Segment Department, Institut Clinic d’Oftalmologia, Hospital Clinic of Barcelona, 08036 Barcelona, Spain;
| | | |
Collapse
|
49
|
Tsai HR, Wang JH, Chiu CJ. Effect of orthokeratology on anisometropia control: A meta-analysis. J Formos Med Assoc 2021; 120:2120-2127. [PMID: 34119394 DOI: 10.1016/j.jfma.2021.05.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 03/08/2021] [Accepted: 05/21/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The effectiveness of orthokeratology in retarding anisometropic progression has been investigated in several small-sample studies. This quantitative analysis aimed to elucidate the efficacy of orthokeratology for anisometropia control. METHODS We searched PubMed, Embase, and Cochrane databases for relevant studies through September 2020. Axial length (AL) data at baseline and final follow-up were extracted, and AL elongation and difference were calculated. Methodological quality was evaluated using the risk of bias in non-randomized studies of interventions (ROBINS-I) tool. Meta-analyses were performed using a fixed-effect model based on the heterogeneity. RESULTS A total of 10 cohort studies (nine retrospective studies; one prospective study) were included. The pooled results for the unilateral myopia group showed that the mean AL elongation difference between myopic and emmetropic eyes was -0.27 mm (95% CI, -0.31 to -0.22; p < 0.01) at the one-year follow-up (four studies) and -0.17 mm (95% CI, -0.33 to -0.02; p = 0.03) at the two-year follow-up (two studies). In the bilateral anisomyopic group, mean AL elongation difference between high and low myopic eyes was -0.06 mm (95% CI, -0.09 to -0.04; p < 0.01) at the one-year follow-up (seven studies) and -0.13 mm (95% CI, -0.21 to -0.06; p < 0.01) at the two-year followup (three studies). CONCLUSION This study demonstrated that orthokeratology can effectively retard myopic progression and reduce anisomyopic values. However, additional wellstructured randomized controlled trials or prospective studies with longer follow-up periods are warranted to address this topic in more detail.
Collapse
Affiliation(s)
- Hou-Ren Tsai
- Department of Medical Administration Office, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan.
| | - Jen-Hung Wang
- Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
| | - Cheng-Jen Chiu
- Department of Ophthalmology and Visual Science, Tzu Chi University, Hualien, Taiwan; Department of Ophthalmology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan.
| |
Collapse
|
50
|
Vincent SJ, Collins MJ, Read SA, Carney LG. Myopic anisometropia: ocular characteristics and aetiological considerations. Clin Exp Optom 2021; 97:291-307. [DOI: 10.1111/cxo.12171] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 02/14/2014] [Indexed: 12/20/2022] Open
Affiliation(s)
- Stephen J Vincent
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Leo G Carney
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| |
Collapse
|