Características visuales en el albinismo: Revisión sistemática

El albinismo es una condición compleja, en muchos casos incapacitante, afectando a muchas personas alrededor del mundo, incluso puede conducir a la muerte. Los problemas visuales más comunes que pueden existir en el albinismo con fotofobia son defectos refractivos con medidas considerables, problemas a nivel de fondo de ojo, fotofobia y translucencia de iris. La realidad actual estima que 1 de cada 10.000 personas tienen albinismo y pueden presentar estos problemas visuales. Objetivo. Identificar las características visuales en cada tipo de albinismo presentados en los estudios de Latinoamérica durante el periodo 2014-2022. Metodología. Se realizó una revisión sistemática. Como criterios de inclusión se tomó en cuenta el año de publicación de las fuentes. Se utilizaron los siguientes descriptores de búsqueda en español y en inglés: "albinismo", "tipos de albinismo" y "complicaciones albinismo", "albinism", "albinism types", "albinism issues". Resultados. Fueron seleccionados 22 artículos obtenidos de Google Académico, revistas como pubmed, scielo, Elsevier, tesis, de los cuales y basado en controles de calidad se analizaron 12 fuentes. Conclusión. La mayoría de estudios describen tratamientos posibles para el albinismo. Se resaltan hallazgos clínicos que destacan las características en los tipos de albinismo como lo son problemas a nivel del nervio óptico como la hipoplasia, y disminución de la agudeza visual, nistagmus y en ocasiones el problema de posición compensatoria de cabeza.

Albinism is a complex condition, in many cases disabling, affecting many people around the world, and can even lead to death. The most common visual problems that may exist in albinism with photophobia are refractive defects with considerable measurements, problems at the fundus level, photophobia and iris translucency. Current reality estimates that 1 in 10,000 people have albinism and may present with these visual problems. Objective. To identify the visual characteristics in each type of albinism presented in studies in Latin America during the period 2014-2022. Methodology. A systematic review was performed. The year of publication of the sources was taken into account as inclusion criteria. The following search descriptors were used in Spanish and English: "albinism", "types of albinism" and "albinism complications", "albinism", "albinism types", "albinism issues". Results. Twenty-two articles obtained from Google Scholar, journals such as pubmed, scielo, Elsevier, theses were selected, from which and based on quality controls 12 sources were analyzed. Conclusion. Most studies describe possible treatments for albinism. Clinical findings that highlight the characteristics in the types of albinism such as problems at the level of the optic nerve as hypoplasia, and decreased visual acuity, nystagmus and sometimes the problem of compensatory head position are highlighted.

O albinismo é uma condição complexa e, em muitos casos, incapacitante, que afeta muitas pessoas em todo o mundo e pode até levar à morte. Os problemas visuais mais comuns que podem existir no albinismo com fotofobia são defeitos de refração de tamanho considerável, problemas no nível do fundo do olho, fotofobia e translucidez da íris. A realidade atual estima que 1 em cada 10.000 pessoas tem albinismo e pode apresentar esses problemas visuais. Objetivo. Identificar as características visuais em cada tipo de albinismo apresentado em estudos na América Latina durante o período de 2014 a 2022. Metodologia. Foi realizada uma revisão sistemática. O ano de publicação das fontes foi levado em consideração como critério de inclusão. Foram usados os seguintes descritores de busca em espanhol e inglês: "albinismo", "tipos de albinismo" e "complicações do albinismo", "albinismo", "tipos de albinismo", "questões de albinismo". Resultados. Foram selecionados 22 artigos do Google Scholar, revistas como pubmed, scielo, Elsevier, teses, dos quais 12 fontes foram analisadas com base em controles de qualidade. Conclusão. A maioria dos estudos descreve possíveis tratamentos para o albinismo. Os achados clínicos destacam as características dos diferentes tipos de albinismo, como problemas no nervo óptico, como hipoplasia, diminuição da acuidade visual, nistagmo e, às vezes, problemas compensatórios na posição da cabeça.

Factores asociados a baja agudeza visual en una población escolar de la ciudad de Bucaramanga, Colombia / Factors Associated with Low Visual Acuity in a School Population in the City of Bucaramanga, Colombia / Fatores associados à baixa acuidade visual em uma população escolar da cidade de Bucaramanga, Colômbia

Introducción. La baja agudeza es un problema de salud pública en el mundo, que aumenta año tras año, relacionada con factores comportamentales poco saludables como el sedentarismo. La baja agudeza afecta especialmente a escolares, en quienes la visión representa uno de los sistemas más importantes para su desarrollo, tanto para el aprendizaje como para las relaciones sociales. El objetivo es establecer asociación entre baja agudeza visual y características sociodemográficas y comportamentales en una población escolar de la ciudad de Bucaramanga, Colombia. Metodología. Estudio observacional de corte transversal basado en datos recolectados de encuestas a estudiantes de una institución educativa de Bucaramanga entre los años 2006 y 2017, sobre las cuales se realizó un análisis bivariado entre características sociodemográficas y comportamentales con baja agudeza visual. Resultados. La prevalencia de baja agudeza visual fue de 33.57%, con mayor prevalencia de baja agudeza visual en mujeres y aquellos con mayor índice de masa corporal. La agudeza visual baja no tuvo asociación estadísticamente significativa con las otras variables estudiadas. Discusión. Las mujeres tienen una mayor prevalencia de baja agudeza visual. Parece existir una relación entre la actividad física y la agudeza visual. Conclusiones. Las diferencias encontradas según el sexo pueden deberse a patrones comportamentales diferentes entre hombres y mujeres, como la actividad física y el sedentarismo. Hacen falta estudios que evalúen la causalidad de la asociación entre los problemas de agudeza visual y los hábitos de vida poco saludables. Palabras clave: Agudeza Visual; Adolescente; Conducta Sedentaria; Visión Ocular; Baja Visión.

Introduction. Low visual acuity is a public health problem worldwide, which is increasing year by year, and it is associated with unhealthy behavioral factors such as sedentary lifestyle. Low visual acuity particularly affects schoolchildren, whom eyesight is one of the most important abilities for their development, both in terms of learning and social interactions. The objective of this study is to establish an association between low visual acuity, sociodemographic, and behavioral characteristics of a student population in Bucaramanga, Colombia. Methodology. This was a cross-sectional observational study based on data collected from surveys of students within an educational institution sited in Bucaramanga between 2006 and 2017. A bivariate analysis was conducted between sociodemographic and behavioral characteristics and low visual acuity. Results. The prevalence of low visual acuity was 33.57%, with a higher prevalence of low visual acuity in women and those with a higher body mass index. However, low visual acuity didn't have a statistically significant association with the other variables studied. Discussion. Women have a higher prevalence of low visual acuity. There appears to be an association between physical activity and visual acuity. Conclusions. The encountered differences according to sex may be due to different behavioral patterns between males and females, such as physical activity and sedentary lifestyle. Further studies are needed to assess the causality of the association. Keywords: Visual Acuity; Adolescent; Sedentary Behavior; Vision, Ocular; Vision, Low.

Introdução. A baixa acuidade é um problema de saúde pública no mundo, que aumenta a cada ano, relacionada a fatores comportamentais pouco saudáveis, como o sedentarismo. A baixa acuidade atinge especialmente as crianças em idade escolar, para as quais a visão representa um dos sistemas mais importantes para o seu desenvolvimento, tanto para a aprendizagem quanto para as relações sociais. O objetivo é estabelecer uma associação entre baixa acuidade visual e características sociodemográficas e comportamentais em uma população escolar na cidade de Bucaramanga, Colômbia. Metodologia. Estudo observacional transversal baseado em dados coletados em pesquisas com estudantes de uma instituição de ensino de Bucaramanga entre 2006 e 2017, nos quais foi realizada uma análise bivariada entre características sociodemográficas e comportamentais com baixa acuidade visual. Resultados. A prevalência de baixa acuidade visual foi de 33.57%, com maior prevalência de baixa acuidade visual em mulheres e naqueles com maior índice de massa corporal. A baixa acuidade visual não teve associação estatisticamente significativa com as demais variáveis estudadas. Discussão. As mulheres apresentam maior prevalência de baixa acuidade visual. Parece haver uma relação entre atividade física e acuidade visual. Conclusões. As diferenças encontradas segundo o sexo podem ser decorrentes de diferentes padrões comportamentais entre homens e mulheres, como atividade física e sedentarismo. Estudos são necessários para avaliar a causalidade da associação entre problemas de acuidade visual e hábitos de vida pouco saudáveis. Palavras-chave: Acuidade Visual; Adolescente; Comportamento Sedentário; Visão Ocular; Baixa Visão.

Visão funcional e sua importância na autonomia do paciente / Functional vision and its importance in patient autonomy

RESUMO A oftalmologia tem atribuído importância crescente à visão funcional na preservação da autonomia do paciente e no aumento da sua qualidade de vida. Estudos nas áreas da geriatria e psiquiatria demonstram que a deficiência visual adquirida tem impactos negativos ao nível da saúde mental dos pacientes e na diminuição de sua autonomia, e a prevenção da deficiência visual adquirida e o tratamento precoce, sempre que indicado, terão impactos positivos na manutenção de um estilo de vida saudável e ativo.

ABSTRACT Ophthalmology has attributed increasing importance to Functional Vision in preserving patient autonomy and increasing their quality of life. Studies in the areas of geriatrics and psychiatry demonstrate that acquired visual impairment has negative impacts on the mental health of users and on the reduction of their autonomy, so that prevention of acquired visual impairment and early treatment, whenever indicated, will have positive impacts on maintaining a healthy and active lifestyle.

Charles Bonnet syndrome in age-related macular degeneration - prevalence and clinical features in a Portuguese population / Síndrome de Charles Bonnet na degeneração macular relacionada à idade - prevalência e características clínicas numa população portuguesa

ABSTRACT Objective: Age-related macular degeneration (AMD) is the most prevalent cause of irreversible visual loss in the developed world. In late stages, it may lead to extremely low visual acuities, especially when associated with geographic atrophy or choroidal neovascularization. According to recent literature, Charles Bonnet syndrome (CBS) may be a rather common feature of late AMD. Methods: One hundred patients with late-stage age-related macular degeneration were actively asked whether they had symptoms of Charles Bonnet syndrome. Those that answered positively underwent a comprehensive questionnaire about the details of the visual hallucinations. Results: The following factors were significantly associated with Charles Bonnet syndrome: older age (+6.3 years; p=0.003), lower visual acuity in the better eye (Charles Bonnet Syndrome Group: 0.11; Non-Charles Bonnet Syndrome Group: 0.42; p=0.005) and female sex (Charles Bonnet Syndrome Group: 88%; Non-Charles Bonnet Syndrome Group: 43%; p=0.02). The visual hallucinations occurred mainly straight ahead (n=5), once per day (n=4), at no particular time (n=6), lasted some minutes (n=5), and disappeared after blinking (n=3) or looking away (n=3). The majority of patients lived alone (n=7), had not told anyone about the hallucinations (n=6), and associated the episodes with severe distress (n=5). Conclusion: Charles Bonnet syndrome was fairly prevalent in this late-stage age-related macular degeneration population. Our sample shows the importance of directly asking subjects about Charles Bonnet syndrome since they are often reluctant to admit to having visual hallucinations. Reassurance about its benignity is crucial to improve their quality of life.

RESUMO Objetivo: A doença macular ligada à idade (DMI) é a causa mais prevalente de perda visual irreversível nos países desenvolvidos. Em estadios avançados, esta doença pode levar a acuidades visuais extremamente baixas. De acordo com literatura recente, a Síndrome de Charles Bonnet (SCB) pode acontecer de forma relativamente comum na DMI tardia. Métodos: Cem doentes com degeneração macular da idade avançada foram interrogados ativamente sobre terem sintomas da síndrome de Charles Bonnet. Os que responderam de forma positiva foram submetidos a um questionário oral detalhado sobre os pormenores das alucinações visuais. Resultados: Os seguintes fatores foram significativamente associados à síndrome de Charles Bonnet: idade avançada (+6,3 anos; p=0,003), menor melhor acuidade visual corrigida no melhor olho (Grupo com Síndrome de Charles Bonnet: 0,11; Grupo sem Síndrome de Charles Bonnet: 0,42; p=0,005) e sexo feminino (Grupo com Síndrome de Charles Bonnet: 88%; Grupo sem Síndrome de Charles Bonnet: 43%; p=0,02). As alucinações visuais ocorriam principalmente em frente (n=5), uma vez por dia (n=4), em qualquer altura do dia (n=6), duravam alguns minutos (n=5) e desapareciam após pestanejo (n=3) ou desvio do olhar (n=3). A maioria dos doentes vivia sozinha (n=7), não tinha partilhado sua condição com ninguém (n=6) e associava os episódios a uma sensação angustiante (n=5). Conclusão: A síndrome de Charles Bonnet teve prevalência relativamente alta nessa população de degeneração macular da idade. Nossa amostra sublinha a importância de questionar diretamente sobre síndrome de Charles Bonnet, uma vez que os doentes se sentem muitas vezes relutantes em admitir alucinações visuais. A reafirmação da benignidade da situação é crucial para aumentar a qualidade de vida desses indivíduos.

Avaliação dos alunos deficientes visuais e videntes do Instituto de Cegos Padre Chico / Evaluation of the visually impaired and sighted students at the Instituto de Cegos Padre Chico

RESUMO Objetivo Avaliar o perfil dos alunos concluintes, deficientes visuais e videntes do Instituto de Cegos Padre Chico entre os anos 2011 e 2020. Métodos Entre janeiro e março de 2021, foi realizada uma análise documental dos alunos concluintes entre os anos de 2011 e 2020. Foram coletados dados relacionados à situação social, educacional, socioeconômica e oftalmológica. Os dados foram tratados no programa Microsoft Excel 2013 da Microsoft e analisados no software livre Bioestat, versão 5.0. Resultados Foram coletados os dados de 110 concluintes cegos, com baixa visão e videntes. Mais de 90% dos alunos declararam rendimento familiar equivalente a um salário-mínimo e meio. Do total da amostra, 52 alunos eram cegos; 38 tinham baixa visão, e 20 eram videntes. Dentre as 36 patologias identificadas entre os alunos, 57,78% levaram à cegueira e 42,22%, à baixa visão. Em alunos cegos, as patologias mais frequentes foram glaucoma congênito (32,69%) e amaurose congênita de Leber (11,53%); em alunos com baixa visão, foram glaucoma congênito e distrofias de retina (ambas em 10,53% da amostra). Conclusão É de suma importância a avaliação da saúde ocular para que o professor realize de forma mais rápida as práticas de ensino e alcance resultados satisfatórios na alfabetização de crianças com deficiência visual.

ABSTRACT Objective To evaluate the profile of visually impaired and sighted students at the Instituto de Cegos Padre Chico (ICPC) between 2011 and 2020. Methods Between January and March 2021, a document analysis of the students who completed the undergraduate course between 2011 and 2020. Data related to social, educational, socioeconomic, and ophthalmological situation were collected. The data were treated in Microsoft Excel 2013 and analyzed in the free software Bioestat, version 5.0. Results Retrospective data were collected from 110 blind, low-vision and sighted students who were graduating. More than 90% of the students declared family income equivalent to one and a half minimum wages. Of the total sample, 52 students were blind; 38 had low vision, and 20 were sighted students. Among the 36 pathologies identified among the students, 57.78% led to blindness, and 42.22%, to low vision. In blind students, the most frequent diagnosis was congenital glaucoma (32.69%) and Leber congenital amaurosis (11.53%); in low vision students, congenital glaucoma and retinal dystrophies (both in 11.53% of the population of this study). Conclusion The evaluation of the eye health is of vital importance for the teacher to perform teaching practices faster and achieve satisfactory results in the literacy of visually impaired children.

Cross sectional, surveillance and longitudinal study of poor visual acuity in Gui an New Distinct of Guizhou Province / 中国学校卫生

Objective@#To understand the development trend of poor vision among primary students through cross sectional, surveillance and longitudinal analysis, so as to put forward some suggestions on adolescents growth and health.@*Methods@#Visual data of 3 753 pupils were inclucled for analysis from Gui an New Distinct, Guizhou Province in autumn semester 2021, and were compared with data collected during the year of 2016-2021. The curve, increment and contribution rate of poor vision from each grade of the three designs were contrasted.@*Results@#In 2021, poor vision rate among pupils in this town was 25.6%. The curve of poor vision rate in cross sectional data was U shaped with significant rise followed by decline which was different from monitoring and longitudinal tracking data, and the trend of poor vision rate of monitoring and longitudinal tracking data were linear with continued increases. The cross sectional data in 2021 showed that the highest contribution rate of poor vision rate of pupils was in grade 1(87.0% ), while other data showed that those were both in grade 4(45.0%, 33.9%).@*Conclusion@#The accuracy of the development trend of poor vision is lowest in cross sectional analysis and highest in longitudinal analysis. However, data acquisition and preservation is easy in cross sectional study and difficult in longitudinal study. It is necessary to improve the electronic information system based on cross sectional data to gradually form a complete monitoring and longitudinal tracking data, and combine different data to provide more accurate information.

An empirical study on the effect of tennis sports on visual health of primary school students / 中国学校卫生

Objective@#To explore the impact of tennis on the visual health of primary school students, so as to provide a basis for myopia prevention.@*Methods@#In September 2021, a total of 202 third grade students from Fengtai Affiliated School of Renmin University of China in Beijing were recruited, with 75 students in the intervention group and 127 students in the control group. In addition to attending the same cultural and physical education courses, the intervention group added a tennis course twice a week and tested their vision before the intervention (September 2021), middle (January 2022) and later (June 2022). Data collected at different time points in the two groups were analyzed by using independent sample t-test for comparison between blocks, and single factor repeated measurement ANOVA for analysis of time point factors.@*Results@#After intervention, among male subjects, the average visual acuity of the left and right eyes in the intervention group were higher than that in the control group at the third visual acuity test (left eye:5.00±0.13,4.88±0.29, right eye:5.00±0.12,4.88±0.30, t =2.33, 2.36, P <0.05). Among female subjects, the second visual acuity test (left eye:5.03±0.17, 4.86±0.21, right eye:5.03±0.15, 4.85±0.23) and the third visual acuity test (left eye:4.97±0.13, 4.81±0.23, right eye:4.97±0.14, 4.82±0.24) showed that the average visual acuity of the left and right eyes in the intervention group were higher than that in the control group among females (second: t =3.84, 3.87, third: t =3.70, 3.46, P < 0.01 ). After intervention, the detection rate of visual impairment in both males and females control groups increased at three tests, with statistically significant differences ( χ 2=17.86, 34.77, P <0.01). In the first visual acuity test, there was no statistically significant difference in the detection rate of visual impairment between the control group and the intervention group for both males and females ( χ 2=0.01, 0.10, P >0.05). The third visual impairment detection rate of males in the intervention group was lower than that of the control group (20.00% vs 45.45%), while the second and third visual impairment detection rates of female students in the intervention group were lower than those of the control group (22.86% vs 54.00%; 28.57% vs 70.00%) ( χ 2=7.34, 8.24, 14.18, P < 0.01).@*Conclusions@#Tennis can alleviate and prevent the occurrence of myopia in primary school students to a certain extent. Sports such as tennis should be actively promoted to protect the visual health of primary school students.

Visual loss after aesthetic facial filler injection: a literature review on an ophthalmologic issue / Perda visual após preenchimento facial estético: uma revisão da literatura sobre complicações oftalmológicas

ABSTRACT Dermal filler injection is among facial rejuvenation treatments that have been increasingly used. Despite being a minimally invasive procedure, it can lead to severe complications such as blindness. A review of all cases of filler- -induced visual loss in the world literature was conducted to summarize the mechanisms, anatomical considerations, and clinical ophthalmologic course, current strategies of prevention and management, and trends over the years. We identified 233 cases of filler-induced visual loss, and 172 patients had a severe visual impairment in at least one eye. The typical patients are young women who received injections of hyaluronic acid or autologous fat in the glabella or nose, and the typical presentations were sudden ocular pain, ptosis, and ophthalmoplegia due to vascular occlusion. The findings of this study also suggest an increase in the number of unlicensed professionals performing the procedure. Even though the continued development of dermal fillers has improved the treatment options available, further studies and strategies are necessary to reduce the incidence and minimize the consequences of filler-induced visual loss.

RESUMO O uso de preenchedores dérmicos é uma prática bem estabelecida de rejuvenescimento facial. Embora seja um procedimento minimamente invasivo, pode levar a complicações graves como cegueira. Uma revisão de casos de perda visual pós preenchimento facial estético foi conduzida para descrever os mecanismos, considerações anatômicas, quadro oftalmológico, atuais estratégias de prevenção e manejo, e tendências ao longo dos anos. Foram identificados 233 casos, e 172 pacientes tiveram ao menos um olho com baixa visão ao final do seguimento. O paciente típico é uma mulher jovem submetida a preenchimento de ácido hialurônico na glabela ou nariz, apresentando dor ocular súbita, ptose e oftalmoplegia devido à oclusão vascular. Este estudo também destaca um possível aumento de profissionais não habilitados realizando este procedimento. Apesar do contínuo desenvolvimento dos preenchedores dérmicos e aprimoramento das opções de tratamento disponíveis, mais estudos e estratégias são necessários para reduzir a incidência de complicações e minimizar suas consequências.

Feasibility and reliability of the Brockport physical fitness test among visually impaired adolescents in China / 中国学校卫生

Objective@#To investigate the feasibility and reliability of the Brockport physical fitness test in visually impaired adolescents in China to determine its applicability in clinical practice and research.@*Methods@#A total of 41 visually impaired adolescents 10-17 years of age were included. Body mass index (BMI), dominant grip strength, modified curl up, trunk lift, shoulder stretch, back saver sit and reach and PACER were tested twice with a 1 week interval by the same tester using the same instrument.@*Results@#Each item in the Brockport physical fitness test was completed. The intraclass correlation coefficients for height, weight, BMI, dominant grip strength, modified curl up, trunk lift, back saver sit and reach (left/right leg straight), and PACER in all subjects were 1.00, 1.00, 1.00, 0.94, 0.75, 0.78, 0.90, 0.87, 0.89, respectively. In blind subjects, the corresponding values were 1.00, 1.00, 1.00, 0.97, 0.80, 0.92, 0.89, 0.87, 0.87, respectively. In low vision subjects, the corresponding values were 1.00 , 1.00, 1.00, 0.90, 0.71, 0.40, 0.89, 0.85, 0.85, respectively. The Cohen kappa values for shoulder stretch (left/right hand on top) were 0.79 and 0.78 in all subjects, 0.72 and 0.64 in blind subjects, and 0.87 and 1.00 in low vision subjects.@*Conclusion@#The Brockport physical fitness test is a feasible and reliable physical fitness test for visually impaired adolescents in China, however, trunk lift is not recommended for adolescents with low vision.

Feasibility and reliability of the Brockport physical fitness test among visually impaired adolescents in China / 中国学校卫生

Objective@#To investigate the feasibility and reliability of the Brockport physical fitness test in visually impaired adolescents in China to determine its applicability in clinical practice and research.@*Methods@#A total of 41 visually impaired adolescents 10-17 years of age were included. Body mass index (BMI), dominant grip strength, modified curl up, trunk lift, shoulder stretch, back saver sit and reach and PACER were tested twice with a 1 week interval by the same tester using the same instrument.@*Results@#Each item in the Brockport physical fitness test was completed. The intraclass correlation coefficients for height, weight, BMI, dominant grip strength, modified curl up, trunk lift, back saver sit and reach (left/right leg straight), and PACER in all subjects were 1.00, 1.00, 1.00, 0.94, 0.75, 0.78, 0.90, 0.87, 0.89, respectively. In blind subjects, the corresponding values were 1.00, 1.00, 1.00, 0.97, 0.80, 0.92, 0.89, 0.87, 0.87, respectively. In low vision subjects, the corresponding values were 1.00 , 1.00, 1.00, 0.90, 0.71, 0.40, 0.89, 0.85, 0.85, respectively. The Cohen kappa values for shoulder stretch (left/right hand on top) were 0.79 and 0.78 in all subjects, 0.72 and 0.64 in blind subjects, and 0.87 and 1.00 in low vision subjects.@*Conclusion@#The Brockport physical fitness test is a feasible and reliable physical fitness test for visually impaired adolescents in China, however, trunk lift is not recommended for adolescents with low vision.

Evaluation and reconstruction of visual function based on virtual reality technology / 中华实验眼科杂志

Virtual reality (VR) is a computer simulation system that can create and let users experience three-dimensional virtual scenes, and can provide users with multi-sensory information.In recent years, with the rapid development of 5G, artificial intelligence, big data and cloud computing, the application of VR technology in the field of ophthalmology has ushered in new opportunities and challenges.In terms of visual function assessment such as visual acuity, accommodative function, stereoscopic vision, VR combined with infrared eye tracking, binocular dichoptic vision and human-computer interaction can fully control the content presented to user, and provide the possibility to achieve personalized and automated diagnosis, which can effectively reduce labor costs.In the diagnosis and treatment of strabismus and amblyopia, VR combined with the above technologies and environmental immersion, three-dimensional imaging can provide users with rich images, reducing the difficulty of eye position measurement in strabismus and inhibition quantification in amblyopia.VR improves the fun and compliance of strabismus training, amblyopia training and stereoscopic training by imitating training paradigms such as convergence insufficiency training and visual perception training.The combination of augmented reality technology and computer-generated visual enhancement, holographic imaging, three-dimensional audio prompts and adaptive optics can effectively compensate for the visual defects of people with low vision and improve their quality of life.In the field of myopia prevention and control, the pros and cons of VR are still controversial, but it still has potential application value.In this article, the application status of virtual (augmented) reality technology in the assessment and reconstruction of visual function were reviewed, and the challenges it may face were analyzed, with a view to promoting the combination of medicine and engineering in ophthalmology diagnosis and treatment.

Epidemiologia e prevalência da maculopatia miópica em centro de referência em oftalmologia / Epidemiology and prevalence of myopic maculopathy in an ophthalmology reference center

RESUMO Objetivo: Determinar a epidemiologia e a prevalência da maculopatia miópica e da miopia patológica e os fatores de risco associados. Métodos: Trata-se de estudo observacional transversal retrospectivo realizado em um serviço de oftalmologia, com 59 pacientes com idade entre 7 e 70 anos e equivalente esférico maior que -6 dioptrias. Suas retinografias foram laudadas segundo a classificação META-PM, por dois oftalmologistas e um retinólogo experiente. A análise estatística foi realizada conforme o Matlab R2010, com o Excel 2010 e o Statistical Package for the Social Sciences , versão 20.0, sendo utilizado o resultado da análise de regressão logística binária múltipla. Resultados: De acordo com a META-PM, a prevalência da maculopatia miópica nos cem olhos analisados foi de 19% para C0, 53% para C1,18% para C2,2% para C3 e 8% para C4. A prevalência da miopia patológica foi de 39%, sendo que 37% desses olhos possuíam maculopatia miópica C1 com lesões plus , C2 ou pior ou estafiloma posterior, e 2% apresentavam categoria menor que C2, sem lesões plus , porém com estafiloma posterior. A análise de regressão logística binária múltipla revelou associação entre idade e equivalente esférico com a presença da miopia patológica (p<0,05), evidenciando que o aumento de 1 ano na idade implicou em 1,05 vez (razão de chance de 1,05) mais chance de apresentar miopia patológica (p<0,001; intervalo de confiança de 95% de 1,02-1,08). O aumento de 1 dioptria no equivalente esférico maior que -6 dioptrias acarretou 1,19 vez (razão de chance de 1,19) maior risco de apresentar miopia patológica (p=0,001; intervalo de confiança de 95% de1,08-1,32). Por fim, não houve associação entre sexo e presença da miopia patológica (p=0,784). Conclusão: A classificação META-PM é uma ferramenta importante na padronização do estadiamento da lesão miópica, permitindo comparação entre estudos e normatização de condutas. O avançar da idade e o equivalente esféricomiópico estão relacionados à severidade da maculopatia miópica e à presença da miopia patológica.

ABSTRACT Objective: To determine the epidemiology and prevalence of myopic maculopathy and pathologic myopia and associated risk factors. Methods: This is a retrospective cross-sectional observational study performed at an ophthalmology center, including 59 patients aged 7 to 70 years, and spherical equivalent higher than -6 diopters. Their retinographies were assessed by two ophthalmologists and an experienced retina specialist, using the META-PM study classification. Statistical analysis was performed using Matlab R2010, Excel 2010 and Statistical Package for the Social Sciences version 20.0, based on the result of multiple binary logistic regression analysis. Results: According to META-PM, the prevalence of myopic maculopathy in 100 eyes analyzed was 19% C0; 53% C1; 18% C2; 2% C3; 8% C4. The prevalence of pathologic myopia was 39%, and 37% of these eyes having myopic maculopathy category C1 with lesions plus, C2 or worse, or posterior staphyloma, and 2% in category smaller than C2, without lesions plus, but with posterior staphyloma. Multiple binary logistic regression analysis revealed an association between age and spherical equivalent inpathologic myopia (p<0.05), demonstrating the increase by 1 year in age implied in 1.05-fold (odds ratio=1.05) more likelyto present pathologic myopia (p<0.001; 95%CI 1.02-1.08). The increase by 1 diopter in the spherical equivalent higherthan -6 diopters, led to 1.19-fold (odds ratio=1.19) greater risk of presenting pathologic myopia (p=0.001; 95%CI 1.08-1.32). Finally, there was no association between sex and pathologic myopia (p=0.784). Conclusion: The META-PM study classification is an important tool to standardize myopic lesion staging, allowing comparison between studies and establishing management. Advanced age and myopic spherical equivalent are related to severity of myopic maculopathy and pathologic myopia.

Low vision among children and adolescents in Tujia inhabited areas / 中国学校卫生

Objective@#To understand the prevalence of low vision among Tujia and Han children and adolescents in Tujia inhabited areas, and to provide reference for the prevention and control of myopia in children and adolescents in minority areas.@*Methods@#A cluster sampling of Tujia and Han primary school students from two primary schools in Lichuan City, Enshi Tujia and Miao Autonomous Prefecture, Hubei Province (2 466 Tujia and 971 Han) were selected for visual acuity assessment. Univariate χ 2 test and multivariate Logistic analysis were used. Low vision and associated factors between Tujia and Han nationality were compared.@*Results@#The overall detection rate of low vision among children and adolescents in Tujia inhabited areas was 44.9%. There were differences in the degree of low vision in the left and right eyes of individuals, and the detection rate of low vision varied significantly by ethnic, gender and grade ( χ 2=22.10, 18.43, 19.06, 17.97 for the left eye, 17.52, 20.44, 21.49, 18.61 for the right eye, P < 0.05). There were many factors affecting low vision among children and adolescents in Tujia inhabited areas, overweight and obesity were negatively associated with low vision ( OR=1.81, 1.70, 95%CI=1.76-1.92, 1.66-1.82, P <0.01).@*Conclusion@#Low vision is highly prevalent in Tujia children and adolescents. Effective intervention measures should be taken to treat and prevent myopia in children and adolescents.

Changes and health equity of low vision among children and adolescents in Chongqing during 2018 to 2021 / 中国学校卫生

Objective@#To understand changes and health equity of low vision in children and adolescents in Chongqing, and to provide reference for student myopia prevention and control.@*Methods@#Using longitudinal studies, all school students in grades 1 to grade 12 in Chongqing were examined for visual acuity during 2018 to 2021, and the prevalence as well as changes of low vision were analyzed. In 2021, stratified random sampling was used to evaluate the health equity of uncorrected visual acuity and diopter(spherical equivalent, SE).@*Results@#The prevalence of low vision for children and adolescents in Chongqing from 2018 to 2021 was 54.12%, 58.17%, 60.03% and 58.20% respectively. Low vision showed an increasing trend in the first three years and decreased by 1.83% in 2021 as compared with 2020( χ 2 trend =13 870.45, P <0.01). The difference in the detection rate of poor vision among students in different grades was statistically significant( χ 2=17 396.36, 2 093.95, 771.87, P <0.01). From 2018 to 2021, the detection rate of low vision in girls was higher than that of boys( P <0.01). The Gini coefficient was 0.054 57 for uncorrected visual acuity in urban area, higher than in rural areas (0.035 94). Meanwhile, the Gini coefficient of urban and rural SE was 0.065 82, higher than the country (0.049 30). The results showed that myopia in children and adolescents was more uneven in urban areas.@*Conclusion@#The adjustment of myopia prevention and control strategies in the late stage of the novel coronavirus pneumonia epidemic is related to the reduction of the detection rate of poor vision in children and adolescents in Chongqing. Low vision varied by grade and gender, suggesting tailored myopia prevention and control strategy. The detection rate of poor vision in cities is more uneven than in rural areas, and different myopia prevention and control measures need to be implemented according to regional characteristics.

Deficiencia visual y neurológica posterior a la disfunción del sistema de derivación ventrículoperitoneal: reporte de caso / Visual and neurological impairment post-dysfunction in the ventricle-peritoneal shunt system: A case report

Resumen | Las alteraciones visuales de origen neurológico en los niños tienen diversas causas, algunas reversibles y otras no. La hidrocefalia es una de las más comunes e importantes, ya que puede producir deficiencias permanentes. Las causas de la hidrocefalia son variadas; entre las principales está la hemorragia intraventricular, generalmente debida al sangrado de la matriz germinal, el cual es muy común en recién nacidos prematuros. Se presenta el caso clínico de una paciente prematura con parálisis cerebral infantil, hemorragia intraventricular e hidrocefalia, producto de un embarazo múltiple, que presentó atrofia óptica en la infancia secundaria a la disfunción del sistema de derivación ventrículo-peritoneal. Durante su rehabilitación y tratamiento, ha recibido sesiones de neurorrehabilitación que le han permitido mejorar su agudeza y capacidad visual. Se comparó el caso de la paciente con algunos similares para establecer las semejanzas y las diferencias entre los cuadros clínicos presentados y la importancia del tipo de tratamiento médico utilizado en el curso de recuperación de la capacidad visual.

Abstract | Neurological visual impairments in children have multiple causes, some of them reversible while others are not. Hydrocephalus is one of the most important and common ones as it can result in permanent impairment. There are multiple causes of hydrocephalus, intraventricular hemorrhage being the main one. This generally occurs when the germinal matrix bleeds and is very common in preterm newborns. We present the clinical case of a patient with cerebral palsy, intraventricular hemorrhage, and hydrocephalus as a result of a preterm multiple pregnancy who developed optic atrophy during childhood secondary to ventricle-peritoneal shunt dysfunction. During the rehabilitation and treatment period, she received neurorehabilitation sessions, which improved her visual acuity and capacity. We found similarities and differences with other cases and we confirmed the importance of the treatment chosen for the recovery of visual capacity.

Investigation of ametropia in primary school students from first to third grade in Kashgar city / 中华实验眼科杂志

Objective:To investigate the differences in ametropia among school-age children and between Han and Uygur ethnic groups in the main urban area of Kashgar, and to understand the epidemiological characteristics of myopia among children in Kashgar.Methods:A cross-sectional study was conducted.Random stratified sampling method was used to select the first to third grade students from 6 primary schools in the main urban areas of Kashgar, Xinjiang, from April to June 2018.Visual acuity was examined by the international standard visual acuity chart and refraction was detected by the automatic computer refractometer without cycloplegia.The subjects were classified into low vision (uncorrected visual acuity<0.8 in either eye), hyperopia≥2.00 D, myopia≥-1.00 D, astigmatism≥1.00 D and anisometropia≥1.00 D according to examination results.The percentage of different refraction states and percentage of different ethnic groups among myopic students in the three grades were analyzed.The study protocol was approved by an Ethics Committee of The First People's Hospital in Kashgar ([2021] QSY No.81).Results:A total of 6 108 students were enrolled, among which, there were 3 119 males and 2 989 females, 3 395 Uygur and 2 713 Han people, 2 016 first grade, 2 155 second grade and 1 937 third grade students.The detection rate of low vision was 13.5% (825/6 108) in the whole, 21.5% (584/2 713) in the Han people and 7.1% (241/3 395) in the Uygur people, 8.8% (176/2 016) in the first grade, 11.8% (254/2 155) in the second grade and 20.4% (395/1 937) in the third grade.The detection rate of myopia was 9.9% (606/6 108) in the whole, 17.6% (477/2 713) in the Han people and 3.8% (129/3 395) in the Uygur people, 4.4% (89/2 016) in the first grade, 8.1% (174/2 155) in the second grade and 17.7% (343/1 937) in the third grade.There were significant differences in percentage of low vision, myopia, astigmatism and anisometropia among different grades and between the two nationalities (all at P<0.001), and no significant difference in the percentage of hyperopia was found (P>0.05).Conclusions:The percentage of visual abnormalities and myopia in the first to third grade children in Kashgar is lower than the national average, but the percentage is gradually increasing with age.The percentage of visual abnormalities and myopia among Han pupils is close to the national average, and far higher than that of Uygur pupils.

Eyeglass prescription and refractive examination of grade 4-6 primary school students in Henan / 中国学校卫生

Objective@#To analyze the prevalence of poor vision and eyeglass prescription, refractive examination among primary school students of grade 4-6 in Henan, so as to provide scientific basis for precise interventions for student vision health.@*Methods@#A stratified cluster random sampling method was used to investigate a total of 29 187 students of grade 4-6 from 17 cities in Henan Province. Distant vision examination and questionnaire survey were conducted.@*Results@#The overall prevalence of poor vision for grade 4-6 students in Henan was 63.6%, with girls (69.0%) higher than boys (59.0%),urban students (65.3%) higher than suburban students (62.5%)( χ 2=312.6, 23.6, P <0.01). The prevalence of severe poor vision was 28.5%.With the increase of grade, the detection rate of poor vision and severe poor vision increased( χ 2 trend =278.7, 775.4, P <0.01). Totally 13.2% of pupil did not have a visual examination in the past year. The rate of wearing glasses was 27.0% for students with poor eyesight and 3.2% for students with poor monocular eyesight. Totally 46.8% of the students wearing glasses received mydriatic optometry before wearing glasses.@*Conclusion@#The problem of poor vision among students of grade 4-6 in Henan is prominent, so it is necessary to strengthen eyesight monitoring and eye health education.

The Wuhan model of visual health management for students: a referential framework for the public-school health system / 中国学校卫生

Abstract@#According to the Healthy China Action Plan, Wuhan gives full play to the role of preventing and controlling student myopia by promoting student health. The primary focus is placed on education in schools, and Wuhan has integrated educational resources to develop a multi-level myopia prevention and control system and service network for school students. The network contains educational adminstrative, schools, families, and professional technical service organizations. By integrating multiple disciplines, Wuhan has built a comprehensive vision health management service system for all students. The Internet and cloud intelligent monitoring facilitated the establishment of a smart vision health management platform for students, which thoroughly and efficiently implemented myopia prevention and control to safeguard students visual health by engaging in education, monitoring, and supervision. The prevention and control of student myopia is a breakthrough for comprehensive healthy development of students. A comparison of the standard myopia rate in Wuhan in 2019 and 2018 revealed that the standard myopia rate at different learning stages of primary school, junior high school, and high school dropped by 3.31, 2.50, and 2.26 percentage points, respectively, and the rate of myopia in primary school was significantly lower than the national level. Post-epidemic surveys showed that the compliance rate and the awareness rate of the visual environment and visual behaviors of primary and secondary school students in Wuhan reached more than 80%, and prevalence of newly onset myopia or decreased vision was 30%, which was lower than the national average. The "Wuhan Model" provides an important referential framework for public health services for school students.

Prevalence and trend of low vision among primary and secondary school students in Wuhan from 2019 to 2020 / 中国学校卫生

Objective@#To provide a largescale assessment the prevalence of poor vision in 2020 among children and adolescents in Wuhan City, Hubei province and to provide basis for healthy vision promotion.@*Methods@#This crosssectional epidemiological study was conducted among 156 783 students, who lived in Wuhan during the COVID-19 period participated the vision screening through the online applet designed by Wuhan Center for Adolescent Poor Vision Prevetion and Control under the guidance of their guardians between June 19 and July 6, 2020. The demographic information and daily hours spent on various activities in the past week were investigated. The corresponding visual acuity data of students in 2019 before the COVID-19 outbreak was extracted from school vision monitoring records for each semester, which was measured by the experienced eye care professionals.@*Results@#The detection rate of poor vision (51.04%) in 2020 was significantly higher than that in 2019(43.04%)( χ 2=68 944.95, P <0.01). After adjustment for covariates, the odds ratio and 95% confidence interval for poor vision were 1.17(1.13-1.20), 1.07(1.04-1.10), 0.67 (0.65-0.69) and 0.62(0.60-0.64) in students with online class time, recreational screen time, indoor and outdoor activity time in the highest tertile, compared with the lowest tertile groups.@*Conclusion@#Increased rate of poor vision among primary and secondary schoool students deserves further concern. It is necessary to strengthen intervention of eyesight protection. Policies and programs aimed at improving opportunities for physical activities and decreasing multiple screen behaviors should be given priority.

Relationship between classroom lighting and poor vision of students in primary and secondary schools in Tianjin / 中国学校卫生

Objective@#To investigate the relationship between classroom lighting and poor vision of students in primary and secondary schools in Tianjin, and to provide reference for targeted prevention measures for comprehensive school eye health programmes.@*Methods@#A total of 623 classrooms and 24 713 students in 89 primary and secondary schools in Tianjin were selected using stratified cluster sampling method in Sep.to Oct. of 2020. The illuminometer was used to monitor the lighting environment of the classroom, and the standard logarithmic vision light box was used to detect the naked eye vision of students. Chisquare test, variance analysis and binary Logistic regression were used in SPSS software.@*Results@#Rate of low vision among primary and secondary school students in Tianjin was 67.86%. The qualification rate of blackboard reflectance, blackboard average illumination, blackboard illumination uniformity, desk average illumination and desk illumination uniformity were 58.11%, 53.13%, 73.19%, 66.61% and 75.12%, respectively. Univariate analyses showed that the blackboard reflectance, blackboard average illumination, desk average illumination, and desk illumination uniformity were associated with low vision among students(χ 2=311.29, 62.54, 61.71, 6.59, P<0.05). Multivariable Logistic regression analysis showed that blackboard reflectance, average illumination of blackboard and desk were associated with higher risk of poor vision[OR(95%CI)=1.19(1.11-1.27),1.27(1.17-1.37),1.11(1.02-1.20), P<0.05].@*Conclusion@#Prevalence of low vision among primary and secondary school students in Tianjin is relatively high. Blackboard reflectance, average illumination of blackboard and desk are the important determinants for poor vision of primary and secondary school students. Creating effective classroom lighting scheme is crucial for vision health among students.