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ObjectiveTo explore the efficacy of acupuncture intervention for children with monocular refractive-parallax amblyopia and the possible mechanisms of brain function based on resting-state functional magnetic resonance （rs-fMRI）. MethodsSeventy-six children with anisometropic amblyopia were randomly divided into routine treatment group （38 cases） and acupuncture treatment group （38 cases）. In the conventional group， the children were given three regular treatments of red flash， grating and visual stimulation for 5 mins each time； in the acupuncture group， on the basis of the conventional treatment， the children were given acupuncture for 20 mins each time on bilateral Jingming （BL 1）， Cuanzhu （BL 2）， Guangming （GB 37） and Fengchi （GB 20）； the children in both groups were treated once every other day and three times a week for 4 weeks. The corrected visual acuity was compared between groups before and after treatment. Fifteen children with left-sided refractive amblyopia were randomly selected from each of the above two groups and underwent brain rs-fMRI scans before and after treatment， and 10 healthy children with normal visual acuity of the matched gender and age were included in the normal group and underwent brain rs-fMRI scans. Based on the activation likelihood estimation （ALE） method， we constructed the what visual pathway network， and compared and analyzed the spherical regions of interest （ROIs） of the children with normal children， and both groups of children with differences in functional connectivity （FC values） within the what pathway in the brain before and after treatment. ResultsTwo cases dropout in the acupuncture group， and finally 36 cases in the acupuncture group and 38 cases in the conventional group were included in the analysis. Compared with before treatment， the best corrected visual acuity of amblyopia in both groups was significantly improved after treatment （P＜0.05）， and the improvement of vision in the acupuncture group was significantly better than that in the conventional group （P＜0.05）. The results of rs-fMRI showed that the FC values of the primary optic cortex and the right fusiform gyrus， the left lingual gyrus and the right fusiform gyrus， and the right infraoccipital gyrus and the right middle temporal gyrus were significantly elevated in the brain of the refractive amblyopia children with the whitepathic amblyopia， compared with that of the normal children （P＜0.05）. The FC values of the left lingual gyrus， the right suboccipital gyrus with the right fusiform gyrus， the left lingual gyrus with the right middle temporal gyrus， the right and left lateral middle occipital gyrus， and the right and left lateral middle occipital gyrus with the right suboccipital gyrus were significantly （P＜0.05） lower in the conventional group compared with those in the conventional group before treatment. Compared with that before acupuncture treatment， the FC values of the right lingual gyrus and the right fusiform gyrus， the primary visual cortex and the right middle temporal gyrus increased significantly after acupuncture treatment （P＜0.05）， and the FC values of the left inferior occipital gyrus and the right middle temporal gyrus， the FC values of the left lingual gyrus and the right middle occipital gyrus decreased significantly （P＜0.05）. Compared between groups after treatment， the FC between the left suboccipital gyrus and the right fusiform gyrus in the acupuncture group was significantly higher than that in the conventional group （P＜0.05）， and the FC between the left middle occipital gyrus and the right and left suboccipital gyrus was significantly lower than that in the conventional group （P＜0.05）. ConclusionAcupuncture can significantly improve the corrected vision of anisometropic amblyopic children， and its effect mechanism may focus on regulating the occipito-temporal interlobular functional connectivity within the what pathway， thus improving the children's visual function of shape and color vision and visual learning and memory ability.
ABSTRACT
@#AIM: To explore the effects of red light flashing therapeutic instrument combined with distance visual training through reading red visual acuity chart on myopic amblyopia in children.<p>METHODS: Totally 112 cases of children patients with myopic amblyopia treated in our hospital were assigned to the control group and the observation group. The control group was given short covering method and short-range visual function training, and the observation group was given red light flashing therapeutic instrument combined with distance visual training through reading red visual acuity chart on the basis of the above treatment. The clinical efficacy, refractive dynamic changes, the BCVA and amblyopia recurrence rate were compared between the two groups. <p>RESULTS: The total clinical effective rate in the observation group was significantly higher than that in the control group(<i>P</i><0.05). Before and after treatment, the myopic diopter was no significant difference in the observation group(<i>P</i>>0.05), the control group gradually increased myopic diopter with time(<i>P</i><0.05). The myopic refraction, the change value of average annual refraction and the recurrence rate of amblyopia after 1y of treatment in the observation group was lower than that in the control group(<i>P</i><0.05). The BCVA after 1y of treatment was significantly higher than that after 6mo of treatment(<i>P</i><0.05).<p>CONCLUSION: Red light flashing therapeutic instrument combined with distance visual training through reading red visual acuity chart for children patients with myopic amblyopia can effectively reduce the change value of average annual refraction, correct the best visual acuity, and reduce the risk of amblyopia recurrence.
ABSTRACT
Abstract?AIM: To discuss clinical efficacy and safety of 10g/L atropine with short covering for children with amblyopia.?METHODS: Eighty -eight children ( 88 eyes ) with amblyopia, staying in hospital from February 2011 to February 2014 for treatment, were divided into control group ( n =44 ) and observation group ( n =44 ) . The control group only given short covering therapy was observed.Observation group was given 10g/L atropine treatment besides covering.Clinical efficacy, treatment compliance, visual acuity, corrected spherical degree of amblyopia eye and adverse events were observed and compared.?RESULTS:1) After treatment, total effective rate of the observation group was 95% ( 42/44 ) , significantly higher than that of control group ( 80%, 35/44, P0.05), but increased number of lines of vision and corrected spherical degree of amblyopia eye in the observation group were significantly higher (P<0.05);4) in the observation group total rate of adverse events was 9% ( 4/44 ) , significantly lower than that in the control group (23%, 10/44, P<0.05).?CONCLUSION: The combined therapy, 1% atropine with short covering, is effective and safe for amblyopia in children.