Perception of first-order grating acuity and second-order spatial contrast sensitivity in anisometropia amblyopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To study the perception of first-order grating acuity and second-order spatial contrast sensitivity in patients with monocular anisometropia amblyopia.METHODS:A total of 715 children(715 eyes)diagnosed as monocular anisometropia amblyopia in our hospital from January 2018 to December 2022 were collected as amblyopia group, and 745 children(745 eyes)with normal corrected visual acuity were collected. The best corrected visual acuity(BCVA), first-order grating acuity and/or second-order spatial contrast sensitivity were measured, repectively. The perception ability of amblyopia patients to first-order grating acuity and second-order spatial contrast sensitivity were analyzed.RESULTS:There were significant differences between amblyopia group and normal control group in the perception of first-order grating acuity(11.58±6.10 vs. 20.27±3.47, P<0.001)and second-order spatial contrast sensitivity(0.33±0.16 vs 0.12±0.04, P<0.001). And there were significant differences between mild-to-moderate amblyopia and severe amblyopia patients in first-order grating acuity(12.10±6.23 vs. 8.13±3.70, P<0.001)and second-order spatial contrast sensitivity(0.32±0.16 vs. 0.37±0.17, P<0.05).CONCLUSION: The first-order and second-order visual pathway of the cerebral cortex in children with monocular anisometropia amblyopia have different degrees of damage. The injury of severe amblyopia is more serious than that of mild-to-moderate amblyopia.

A clinical trial on phakic intraocular lens for the treatment of refractive amblyopia in children and adolescents

Purpose: To analyze the demographics and clinical outcomes of posterior chamber phakic intraocular (IOL) implantation for refractive amblyopia in children and adolescents. Methods: A prospective interventional study was performed on children and adolescents with amblyopia at a tertiary eye care center from January 2021 to August 2022. Twenty?three eyes of 21 anisomyopic and isomyopic amblyopia patients operated for posterior chamber phakic IOL (Eyecryl phakic IOL) as a treatment for amblyopia were included in the study. Patient demographics, pre? and postoperative visual acuity, cycloplegic refraction, anterior and posterior segment examination, intraocular pressure, pachymetry, contrast sensitivity, endothelial count, and patient satisfaction scores were evaluated. Patients were followed up at day 1, 6 weeks, 3 months, and 1 year after surgery, and visual outcomes and complications were documented. Results: The mean age of patients was 14.16 ± 3.49 years (range: 10–19 years). The mean intraocular lens power was ? 12.20 diopter spherical (DS) in 23 eyes and ? 2.25 diopter cylindrical (DC) in four patients. The mean unaided distant visual acuity (UDVA) and best?corrected visual acuity (BCVA) were 1.39 ± 0.25 and 0.40 ± 0.21 preoperatively on the log of minimum angle of resolution (logMAR) chart. Postoperatively, the visual acuity improved by 2.6 lines in 3 months period and maintained till 1 year. Postsurgery, contrast sensitivity in the amblyopic eyes significantly improved, and the average endothelial loss recorded was 5.78% at 1 year, which was statistically insignificant. Patient satisfaction score was statistically significant, with 4.736/5 recorded on the Likert scale. Conclusion: Posterior chamber phakic IOL is a safe, effective, and alternative method for treating amblyopia patients who are noncompliant with glasses, contact lenses, and keratorefractive procedures.

Biometric investigation of ocular components in various types of anisometropia in school-age children / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the differences and correlations between different types of anisometropia, binocular visual acuity and biological parameters in school-age children.METHODS: A total of 128 school-age children(6-12 years)with mild-to-moderate anisometropia were retrospectively analyzed. Subjects were divided into five groups according to anisometropia type. All participants underwent cycloplegic refraction, A-scan ultrasound biometry, and corneal topography. Refractive status, best-corrected visual acuity(BCVA), anterior chamber depth(ACD), lens thickness(LT), vitreous chamber depth(VCD), axial length(AL), corneal radius(CR), and ratio of AL and CR(AL/CR)were recorded. Kruskal-Wallis and Spearman rank correlation tests were then used for statistical analysis.RESULTS: Hyperopic anisometropia had the greatest binocular vision difference(0.14±0.20). Myopic anisometropia had the greatest asymmetry in AL and VCD(0.56±0.41 and 0.56±0.39 mm, respectively). Anisometropia was positively correlated with BCVA, VCD, AL, and AL/CR(r=0.266, 0.379, 0.350, 0.263, respectively; P<0.05), and it was not significantly correlated with LT and CR(r=-0.019,-0.069, respectively; P>0.05), while no parameters had a statistically significant correlation with anisometropia in each group.CONCLUSION: School-age children with hyperopic anisometropia showed the greatest difference of binocular acuity in the four types of anisometropia. The inter-ocular differences of biometric parameters in simple hyperopic or myopic anisometropia were mainly attributed to the asymmetry of VCD and AL, while the differences in ocular parameters were not statistically significant in school-age children with astigmatic anisometropia.

Comparison of spectral-domain optical coherence tomography parameters between the eyes of anisometropic amblyopia children and normal eyes / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the thickness of retina in macular area and retinal nerve fiber layer(RNFL)around optic disc between the eyes of monocular anisometropic amblyopia children and normal eyes.METHODS: A total of 62 children(124 eyes)with monocular anisometropic amblyopia who were treated in Chengdu Women's and Children's Central Hospital from January 2021 to October 2022 were selected as the experimental group, and 60 children(60 eyes; right eye)with normal vision who were treated in the same period were selected as the control group. Spectral-domain optical coherence tomography(SD-OCT)was used to detect the retinal thickness in macular region and the RNFL thickness around optic disc in the two groups, and comparative analysis was performed.RESULTS: The retinal thickness and perioptic RNFL thickness of amblyopic children in experimental group were thicker than those in control group, and most of them had significant differences(P<0.05). The retinal thickness and perioptic RNFL thickness of contralateral non-amblyopic children in experimental group were thinner than those in control group, but there were no significant differences in most of them(P>0.05).CONCLUSIONS: There are differences in the retinal thickness of the macula and perioptic RNFL in the amblyopic eye and the contralateral non-amblyopic eye of monocular anisometropic amblyopic children compared with normal eyes, and the contralateral non-amblyopic eye is not completely equal to the normal eye.

Comparison of stereoacuity in patients of anisometropia, isometropia and emmetropia

Purpose: To compare the stereoacuity in patients with anisometropia, isometropia, and emmetropia. Methods: A cross?sectional study was conducted on 1403 subjects (range: 5–45 years) divided into anisometropes (n = 403), isometropes (n = 500), and emmetropes (n = 500). There were 258 amblyopic eyes among anisometropes and 156 amblyopic eyes among isometropes. Stereoacuity was measured using the Titmus stereo test consisting of a combination of contour targets. Results: There were 675 males and 728 females. A significant (P < 0.001) reduction in stereoacuity was found in anisometropes as compared to isometropes and emmetropes. The stereoacuity was even worse in amblyopes as compared to non?amblyopes. Most patients with anisometropia of <3.0 D had fair stereoacuity. However, as the degree of anisometropia increased to >3.0 D, stereoacuity deteriorated gradually. Marked reduction of stereoacuity was observed in severe degree of anisometropia (>6.0 D). Overall, an anisometropia of ?2.12 D was associated with reduced stereoacuity. Among the anisometropes, it was found to be the poorest in myopia, followed by myopia with astigmatism, hypermetropia with astigmatism, and hypermetropia. Conclusion: The level of stereoacuity was worse in anisometropes as compared to isometropes and emmetropes. Amblyopes had a greater reduction in stereoacuity than non?amblyopes. Stereoacuity decreased as the degree of anisometropia increased. Among the anisometropes, myopes had worst stereoacuity than hypermetropes.

How does anisometropia affect the choroidal vascularity index?

Purpose: To investigate the choroidal vascularity index (CVI) and morphological features of the choroid in anisometropic amblyopia. Methods: In this prospective cross?sectional study, 39 patients with unilateral anisometropic amblyopic patients and 33 eyes of 33 healthy control participants were involved. These participants were examined in terms of axial length (AL), spherical equivalent (SE), central macular thickness (CMT), choroidal thickness (CT), total choroidal area (TCA), luminal area (LA), stromal area (SA), LA/SA ratio, and CVI. All parameters were compared between amblyopic eyes, healthy fellow eyes, and healthy control eyes. The Shapiro–Wilk tests, Chi?square test, the paired t?test, Wilcoxon signed?rank test, Mann–Whitney U test, Kruskal–Wallis test, and Pearson/Spearman correlation tests were used. Results: In the hyperopic patients; SE, subfoveal CT, nasal CT, temporal CT, TCA, LA, SA, and CMT were greater in amblyopic eyes than in healthy fellow eyes and control eyes (P < 0.001, P < 0.001, P < 0.001, P < 0.001, P < 0.001, P < 0.001, and P < 0.001, respectively), and CVI, LA/SA ratio, and AL were smaller in amblyopic eyes than in healthy fellow eyes and control eyes ([P < 0.001, P = 0.006], P < 0.001, and P < 0.001, respectively). In the myopic patients, subfoveal CT, nasal CT, temporal CT, TCA, LA, SA values were statistically smaller in amblyopic eyes than in healthy eyes and control eyes ([P < 0.001, P = 0.002), [P = 0.004, P = 0.012], [P = 0.012, P = 0.032], [P < 0.001, P = 0.013], [P < 0.001, P = 0.024], and [P < 0.001, P = 0.047], respectively). The differences in the AL and choroidal parameters were due to myopia and hyperopia. Conclusion: The choroidal structural parameters of the amblyopic eyes were different from that of the healthy eyes.

Anisometropía y estereopsis en cirugía fotoablativa en pacientes miopes / Anisometropia and Stereopsis in Myopic Patients Treated with Photoablative Surgery

Objetivo: Relacionar la anisometropía con la estereopsis en pacientes miopes con o sin astigmatismo asociado poscirugía refractiva corneal con láser de excímero (LASEK-MMC o PRK-MMC). Método: Se realizó un estudio preexperimental del tipo antes y después, en el que fueron incluidos 81 pacientes (162 ojos) tratados con LASEK-MMC (65 pacientes) o PRK-MMC (16 pacientes) seguidos por tres meses, en el servicio de Cirugía Refractiva del Instituto Cubano de Oftalmología Ramón Pando Ferrer (ICORPF), en el periodo comprendido entre enero de 2018 a enero del 2019. Las variables estudiadas fueron anisometropía, diferencia de longitudes axiles, así como la estereopsis. Resultados: La edad promedio fue de 24,7 ± 3,7 años en el grupo tratados con LASEK-MMC y 24,1 ± 3,1 años en los tratados con PRK-MMC. El 100 por ciento de los pacientes tenían un astigmatismo miópico compuesto, en ambos ojos. El 47,7 por ciento de los pacientes operados con LASEK-MMC, presentaba anisometropía previo a la operación, mientras que 4 pacientes la presentaron después (6,2 por ciento) (p = 0,000). El 31,3 por ciento de los pacientes tratados con PRK-MMC, estaba afectado previo a la cirugía y ese porcentaje disminuyó más de 5 veces después de la cirugía (p = 0,000). Con la cirugía la estereopsis mejoró en particular cuando no existieron antecedentes de anisometropía. Conclusiones: Los pacientes tratados con PRK-MMC y con LASEK-MMC experimentan una disminución d la anisometropía y una mejoría de estereopsis(AU)

Objective: To relate anisometropia to stereopsis in myopic patients with or without associated astigmatism after excimer laser corneal refractive surgery (laser-assisted subepithelial keratectomy [LASEK] or photorefractive keratectomy [PRK], with intraoperative application of mitomycin-C [MMC]). Methods: A preexperimental, before-and-after study was carried out with 81 patients (162 eyes) treated with LASEK-MMC (65 patients) or PRK-MMC (16 patients) and followed for three months, in the refractive surgery service of Ramón Pando Ferrer Cuban Institute of Ophthalmology, in the period from January 2018 to January 2019. The variables studied were anisometropia, axial length difference, apart from stereopsis. Results: The average age was 24.7±3.7 years in the group treated with LASEKMMC and 24.1±3.1 years among the patients treated with PRK-MMC. 100 percent of the patients had compound myopic astigmatism in both eyes. Anisometropia was present in 47.7 percent of LASEK-MMC patients before the surgery, while four patients had anisometropia after the surgery (6.2 percent) (P=0.000). Of the patients treated with PRK-MMC, 31.3 percent were affected before surgery; this percentage decreased more than five times after surgery (P=0.000). Surgery improved stereopsis, particularly when there was no history of anisometropia. Conclusions: Patients treated with PRK-MMC and LASEK-MMC experience decreased anisometropia and improved stereopsis(AU)

Ocular dominance switches after small incision lenticule extraction and its influencing factors / 中华实验眼科杂志

Objective:To investigate the changes, distribution and influencing factors of ocular dominance after small incision lenticule extraction (SMILE).Methods:A retrospective observational case series study was conducted.One hundred and twelve patients (224 eyes) with an average age of 25.1±5.4 years who underwent SMILE surgery at Tianjin Eye Hospital from November 2017 to February 2018 were enrolled.There were 42 male and 70 female patients.The dominant eye was determined using the hole-in-the-card test before and after the surgery.Subjective and objective refraction and uncorrected visual acuity examination were performed before operation, and 1 day, 1 week, 1 month and 3 months after operation.The subjects were divided into switch group and non-switch group based on whether the dominant eye changed after surgery.Binary logistic regression was used to analyze the main influencing factors of dominant eye switches.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Tianjin Eye Hospital (No.201905). Written informed consent was obtained from each patient before any medical examination.Results:There were 18 patients (16.1%) in the switch group including 7 males (38.9%) and 11 females (61.1%), and 94 patients (83.9%) in the non-switch group including 35 males (37.2%) and 59 females (62.8%). No statistically significant difference was found in sex between the two groups ( χ2=0.02, P=0.89). At 1 month and 3 months after the surgery, there was a statistically significant difference in the cylindrical power between the dominant and non-dominant eye ( t=2.31, 1.95; both at P<0.05). Binary logistic regression equation showed that spherical equivalent[odds ratio ( OR)=0.47, 95%confidence interval ( CI): 0.35-0.66]and refractive error difference ( OR=3.04, 95% CI: 2.12-4.36) were significantly related to the eye dominance switches. Conclusions:There were 16.1% of patients having eye dominance switches after SMILE.The dominant eye transfomation is associated with higher spherical equivalent and anisometropia difference before surgery.

Study on the influencing factors in pupils' disequilibrium refractive development / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the influencing factors of disequilibrium refractive development in children aged 6-12 years old.METHODS: A total of 607 children with a mean age of 8.2±1.8 years old from two primary schools in Binhai New Area of Tianjin in December 2019 were selected by cluster sampling for optical biometry measurement(axial length and equivalent corneal power), cycloplegia refractive examination and questionnaire survey.RESULTS: The childrens'spherical equivalent was -0.11±1.63D, binocular spherical equivalent difference was -0.08±0.64D and absolute value of spherical equivalent difference was 0.41±0.49D. There were 56 children with anisometropia and 551 children without anisometropia. There was no difference in the absolute value of binocular corneal power difference between anisometropia and non-anisometropia group(0.30±0.34D vs 0.27±0.24D, P=0.430). But the absolute value of axial difference was significantly different(0.67±0.39mm vs 0.13±0.13mm, P=0.005). Multivariate linear regression analysis showed that weekly usage time of phones/computers, weekly close work hours, weekly visual fatigue times and habitual reading distance were the influencing factors of refractive imbalance development(the absolute value of binocular spherical equivalent difference). Habitual reading distance and handedness in writing are the influencing factors of the developmental bias of refractive imbalance(binocular spherical equivalent difference).CONCLUSION: Children aged 6-12 years old who spend more time on phones/computers, and have prolonged close work, more times of visual fatigue and close habitual reading distance may increase the degree of refractive imbalance. Children with right-handed handwriting and severe left or right head deviation have a deeper degree of myopia in the right eye than in the left eye.

Comparison of clinical efficacy effect between anisometropia amblyopia and strabismus amblyopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To compare the effect of comprehensive treatment in children with anisometropia and strabismus amblyopia.<p>METHODS: Prospective study. Forty-six individuals(mean age 9±3 years old, 26 males, 20 females)with previously untreated monocular amblyopia were recruited in our hospital from July 2018 to January 2020. There were 23 patients with strabismus monocular amblyopia(mean age 9±3 years old, 12 males, 11 females)and 23 patients with anisometropia monocular amblyopia(mean age 9±3 years old, 14 males, 9 females). The best corrected visual acuity(Tumbling E Chart)and stereopsis(Titmus)were measured before and after a 6mo period of comprehensive treatment(refractive correction, patching and precision eyesight training). The differences of monocular visual benefits(visual acuity)and binocular visual benefits(stereopsis)between two groups before and after treatment were compared. <p>RESULTS: Before treatment, there was no significant difference of best corrected visual acuity between anisometropia amblyopia and strabismus amblyopia(<i>t</i>= -0.475, <i>P</i>>0.05), but the stereopsis of strabismus amblyopia was significantly lower than that of anisometropia amblyopia(<i>t</i>= -3.919, <i>P</i><0.001). After 2mo treatment, there was a significant difference in best corrected visual acuity benefits between anisometropia amblyopia and strabismus amblyopia(<i>t</i>= -2.946, <i>P</i><0.01), but there was no significant difference in stereopsis benefits between anisometropia amblyopia and strabismus amblyopia(<i>t</i>=1.305, <i>P</i>>0.05). After 6mo treatment, there was a significant difference in visual acuity benefits between anisometropia amblyopia and strabismus amblyopia(<i>t</i>= -2.353, <i>P</i><0.05), and there was also a significant difference in stereopsis benefits between anisometropia amblyopia and strabismus amblyopia(<i>t</i>=2.218, <i>P</i><0.05). However, the stereopsis of strabismus amblyopia was still lower than that of anisometropia amblyopia at 6mo(<i>t</i>=-2.760, <i>P</i><0.01).<p>CONCLUSION: We conclude that the stereopsis of patients with strabismus amblyopia is more severe than those with anisometropic amblyopia before treatment under the same visual acuity. The visual acuity of patients with anisometropic amblyopia recovers faster than patients with strabismus amblyopia through treatment. While the stereopsis of patients with strabismus amblyopia recovers faster than patients with anisometropic amblyopia, but the level of stereopsis with strabismus amblyopia is still lower than that of patients with anisometropic amblyopia.

Analysis on visual screening result of children aged 0-6 years old by using the SureSight automatic screening refractor in Binhu District, Wuxi City / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To provide a scientific basis for the development of children's eye health measures in Binhu District of Wuxi City by understanding the visual development status of children aged 0-6 years old in the region.<p>METHODS: A total of 3 695 children of 0-6 years old from preschool children in Binhu District received quickly check of eye's refractive status by using the SureSight automatic screening refractor, and determine the results by referring to the refractive screening referral standard norm for each age groups offered by the US Welch Allyn company. All participating preschool children have completed a vision screening and a comprehensive eye examination. <p>RESULTS: The total of abnormal rate was 9.76%, suspicious rate was 5.40% in vision screened children, along with the age increase, the abnormal and suspicious detection rates had a tendency to rise, differences in vision screening results of each age group were statistically significant(χ²=15.913, <i>P</i>=0.014), and differences between boys and girls had no statistical significance(χ²=7.200, <i>P</i>=0.066). The highest proportion of abnormal vision was astigmatism(13.89%, 17.96%, 17.62%, 11.50%), followed by hyperopia(0.35%, 1.91%, 3.60%, 8.86%)and anisometropia(0.69%, 0.67%, 1.64%, 2.07%)in different age groups. Hyperopia(4.38%), myopia(0.82%), astigmatism(15.65%), anisometropia(1.42%)and any refractive(0.466%), these five types in the distribution of various age groups. The prevalence of astigmatism in preschool children in 0-3 years old were 6.94%(95%<i>CI</i>: 4.90%-9.00%)and the 3-4 years old were 8.98%(95%<i>CI</i>: 7.80%-10.20%), the 4-5 years old were 8.81%(95%<i>CI</i>: 7.70%-9.90%), the 5-6 years old were 5.75%(95%<i>CI</i>: 4.80%-6.70%). The prevalence of astigmatism in different age groups had no statistical difference(χ²=0.872, <i>P</i>=0.929).<p>CONCLUSION: Astigmatism was the most common type of ametropia in preschool children, followed by hyperopia and anisometropia. Although no myopia was found, it confirmed the previous research that myopia was not formed at early age. Preschool children vision screening and eye care should be implemented regularly.

Advances in orthokeratology for myopic anisometropia control / 国际眼科杂志(Guoji Yanke Zazhi)

Myopic anisometropia is a special type of refractive error. As the prevalence of myopia has rapidly increased worldwide in recent years, the prevalence of myopic anisometropia is also growing year by year. Anisometropia can cause aniseikonia of the retinal and fusion impairment, leading the problems such as asthenopia, monocular suppression, amblyopia, and stereopsis disorder, which results in negative effects on patients' work and life. Therefore, it is crucial for children to discover myopic anisometropia in early stage and take effective measures in time to delay the progression of it. At present, a wide range of research has been conducted to study the methods that control the progression of myopia among children. It has been found that orthokeratology lens(OK lens)can effectively slow the progression of myopic anisometropia. This article mainly reviews the mechanism of how orthokeratology control myopic anisometropia, its effect on delaying the progression of myopic anisometropia, and its impact on stereopsis among children with myopic anisometropia, aiming to provide a theoretical basis for the prevention and control of myopic anisometropia in the future.

Changes in choroidal thickness and axial length in adolescents with myopic anisometropia after orthokeratology treatment / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To observe the changes of choroidal thickness(CT)and axial length(AL)in adolescents with myopic anisometropia before and after orthokeratology(OK lenses)treatment.METHODS: In this retrospective case-control study, 71 myopic participants who insisted on using OK lenses more than 6mo at night from June 2020 to September 2021 in Second People's Hospital of Shenzhen were enrolled. They were divided into three groups, including group A consisted of 31 myopic participants with non-anisometropic myopia with binocular lenses(A1 group: the right eyes, A2 group: the left eyes), group B consisted of 18 bilateral myopic anisometropes(B1 group: the eyes with high degree, B2: the eyes with low degree)and group C consisted of 22 unilateral myopic anisometropes(C1: the eyes with high degree, C2: the eyes with low degree). The length of axis, the CT values of subfoveal(SF)and the superior(S0.5, S1.0, S1.5), inferior(I0.5, I1.0, I1.5), temporal(T0.5, T1.0, T1.5)and nasal(N0.5, N1.0, N1.5)at 0.5, 1.0 and 1.5mm from the fovea before and after wearing lenses at 6mo were measured.RESULTS: After wearing lenses at 6mo, CT of all sites in group A1 was all thickening compared with that before wearing lenses(all P&#x003C;0.05), CT of all sites in group A2 was all thickening compared with that before wearing lenses, there was no difference compared with that before wearing lenses except for the SF, S1.5, T0.5 and T1.5 sites of the CT, the rest of the sites were different before and after wearing lenses(all P&#x003C;0.05), CT of T1.0, N1.5 and S1.5 sites in B1 group was thicker than that before wearing lenses(all P&#x003C;0.05), there was no difference in CT of all sites of the patients in group B2 before and after wearing lenses(all P&#x003E;0.05). Among them, the CT at SF, S0.5, S1.0, S1.5, I0.5, I1.0, I1.5, N0.5, N1.0 and N1.5 was thinner than before wearing lenses, but it was not statistically significant. There were differences in all sites of CT in group C1 compared with that before and after wearing lenses(all P&#x003C;0.05), for the CT of group C2, all the other sites except the points T1.5 and S1.5 was significantly thickened compared with that before wearing lenses(P&#x003C;0.05). The axis of patients in group B2 increased by 0.12±0.14mm after wearing lenses at 6mo compared with that before wearing lenses(all P&#x003C;0.001). The axis of group C2 increased by 0.20±0.17mm after wearing lenses at 6mo compared with that before wearing lenses(all P&#x003C;0.001). The interocular axial difference in group B and C decreased from 0.54±0.27, 0.88±0.39mm before wearing lenses to 0.47±0.20, 0.62±0.39mm after wearing lenses at 6mo(all P&#x003C;0.05). There was no significant in the interocular axis difference of group A1 and A2 before and after wearing lenses(P&#x003E;0.05).CONCLUSION: For adolescents with myopic anisometropia patients after long-term wearing OK lenses have CT thickening in high degree eyes, but no thickening in low-degree eyes, and even thinning. At the same time, wearing OK lenses can slow axis elongation and reduce interocular anisometropia difference in axis, which is an effective clinical method to control the development of anisometropia.

Comparison of myopia progression in anisometropic children on the effect of orthokeratology with different degrees of unilateral myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the progress of binocular myopia with orthokeratology lens in different degrees of unilateral myopia in anisometropic children for 1a.METHODS:Retrospective case-control study. The data of 60 unilateral myopic anisometropia children, 8-12-year-old patients who fitted with orthokeratology lens in Xi'an No.1 Hospital from June 2018 to June 2019 were collected. The binocular spherical equivalent(SE)difference ≥2.5D was found in 30 cases in the high anisometropia group, and 1.0D≤ binocular SE difference &#x003C;2.5D was found in 30 cases of the low anisometropia group. The patients in the two groups were observed and compared after wearing lens for 6mo and 1a of the changes of binocular axial length(AL)and SE without-lens eyes.RESULTS: At the follow-up at 6mo and 1a, the growth of AL in the high anisometropia group with orthokeratology lens was less than that in the low anisometropia group(P&#x003C;0.001). The amount of growth of AL without-lens eyes and the growth of SE were greater than that in the low anisometropia group(all P&#x003C;0.001), and the shortening range of the binocular AL in the high anisometropia group was greater than that in the low-degree anisometropia group(P&#x003C;0.05). The correlation analysis showed that the anisometropia and the shortening of axial difference were correlated(F=0.293, 0.458, all P&#x003C;0.001).CONCLUSION: In anisometropia children with unilateral myopia, after wearing the orthokeratology lens, the progression in high anisometropia group was slower than low anisometropia after wearing the orthokeratology lens, but the progression of AL without-lens eyes and SE was faster than low anisometropia. Wearing orthokeratology lens can effectively reduce anisometropia, and the greater degree of the anisometropia the more binocular axial difference was narrowed, the more binocular axial difference was narrowed.

Comparison of the efficacy in adolescents with myopic anisometropia corrected by spectacles versus orthokeratology / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To observe the near stereoscopic visual function of adolescents with different degrees of myopic anisometropia after being corrected by spectacles and orthokeratology.METHODS:In this prospective clinical research,220 patients aged 10-20 years old with myopic anisometropia were recruited between March 2017 and December 2018. All the patients were divided into four groups according to the difference of cycloplegic spherical equivalent refractive(SER)error between the two eyes: group of 76 cases without anisometropia(SER error difference less than 1.00D), group of 60 cases with mild anisometropia(SER error difference of 1.00-<1.75D), group of 51 cases with moderate anisometropia(SER error difference of 2.00-<2.75D), and group of 33 cases with severe anisometropia(SER error difference of 3.00D or more). With regards the different optical correction approaches for myopia, 88 cases were categorized into the orthokeratology group and 132 cases into the spectacle group, the stereoacuity values at 3mo after correction were compared between the orthokeratology group and the spectacle group to see whether statistically significant difference existed.RESULTS:In the group of spectacle correction, there was significant statistical difference existed between the four sub-groups for the near stereoscopic visual function(<i>P</i><0.001). In the group of orthokeratology correction, there was no statistical difference existed between the four sub-groups for the near stereoscopic visual function(<i>P</i>=0.765). In both non-anisometropia and mild anisometropia groups, there was no statistical difference between the orthokeratology correction and spectacle correction sub-groups for the near stereoacuity values(<i>P</i>=0.109,<i>P</i>=0.052). However, in the moderate and severe anisometropia groups, orthokeratology group had better near stereoscopic vision than spectacle group(<i>P</i><0.001).CONCLUSION: Adolescents with myopic anisometropia corrected by orthokeratology lens were better at near stereoscopic visual function than corrected by spectacles, especially in the moderate and severe anisometropia groups.

Relationship between solar greenhouse working and anisometropia / 环境与职业医学

Background Due to long working time and complex and changeable lighting conditions, greenhouse workers' anisometropia is an issue of concern. Objective This study is conducted to evaluate the relationship between solar greenhouse working and anisometropia of workers. Methods Subjects of a solar greenhouse group and a non-greenhouse group in northwest area of China were selected. Questionnaire survey was used to collect general demographicinformation. Standard Logarithmic Visual Acuity Chart (GB 11533—2011) was used to measure naked eye vision before working, the absolute value of binocular visual acuity difference was calculated and converted into classification variables, and both anisometropia absolute value and classification variables of anisometropia were used as indicators to compare the difference of the two groups. A cumulative exposure index that multiplies exposure time and number of greenhouses was further introduced to evaluate cumulative exposure levels of the greenhouse workers and was used to divide them into low, medium, and high cumulative exposure subgroups. Generalized linear model and logistic regression model were used to analyze possible risk factors associated with anisometropia. Results A total of 1002 subjects were enrolled in this study, including 739 workers in the greenhouse group and 263 workers in the non-greenhouse group. The medians (interquartile intervals) of anisometropia of the greenhouse group and non-greenhouse group were 0.1 (0, 0.2) and 0 (0, 0.1) respectively, and the difference was statistically significant (P<0.05). The proportions of anisometropia=0, ≤0.2, and >0.2 in the greenhouse group were 34.2%, 55.2%, and 10.6%, respectively, and those in the non-greenhouse group were 58.2%, 34.6%, and 7.2%, respectively. The difference of anisometropia distribution between the two groups was statistically significant (P<0.05). According to the cumulative exposure index, the greenhouse group was divided into low, medium, and high cumulative exposure subgroups, with 154 (21.0%), 188 (25.6%), and 392 (53.4%) workers, respectively. There was no statistical significance in anisometropia among workers with different cumulative exposure levels (P>0.05). The results of multiple generalized linear analysis showed that greenhouse working was a risk factor of anisometropia (b=0.053, P<0.05), and the results of multiple logistic regression analysis showed that greenhouse working was associated with an increased risk of anisometropia (OR=2.586, 95%CI: 1.473-4.539). The results of multiple generalized linear analysis showed that medium exposure level increased the degree of anisometropia after adjusting age, gender, and other factors (b=0.054, P<0.05). Conclusion Solar greenhouse working may be a risk factor for increasing anisometropia in workers.

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.

Effect of S4D computer treatment in children with hyperopic anisometropia and hyperopic anisometropia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the effect of stereoscopic 4D(S4D)technology as a visual training system in children with hyperopic amblyopia and hyperopic anisometropic amblyopia.<p>METHODS: Totally 48 patients aged 3-9 years with hyperopic amblyopia and hyperopic anisometropic amblyopia were recruited, including 18 hyperopic amblyopia(36 eyes)and 30 hyperopic anisometropic amblyopia(30 eyes). All patients excluded other eye diseases and received S4D technology training on the basis of refractive correction and reasonable covering. The initial training was mainly to improve visual acuity. Those with visual acuity above 0.6 were treated with disinhibition training and binocular visual function training. The changes of visual acuity and binocular stereopsis before and after training were compared.<p>RESULTS: The 18 patients(36 eyes)with hyperopic amblyopia were divided into mild amblyopia group(<i>n</i>=13), moderate amblyopia group(<i>n</i>=19)and severe amblyopia group(<i>n</i>=4). 30 patients(30 eyes)with hyperopic anisometropic amblyopia were divided into mild amblyopia group(<i>n</i>=5), moderate amblyopia group(<i>n</i>=13)and severe amblyopia group(<i>n</i>=12). The visual acuity was significantly improved after 60 times of treatment. After 60 times of treatment, stereopsis was significantly improved, which had nothing to do with the initial diopter(<i>P</i>>0.05), but positively correlated with the visual acuity initially and finally(<i>P</i><0.05), and positively correlated with the amount of anisometropia(<i>P</i><0.05). <p>CONCLUSION: S4D technology training combined with traditional treatment can effectively improve the visual acuity and binocular function of 3-9 years old children with anisometropic amblyopia and hyperopic anisometropic amblyopia.

Study of the accommodative difference between wearing orthokeratology lens and frame lens in low myopic anisometropia children / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the monocular and binocular accommodative difference between wearing orthokeratology lens and frame lens in low myopic anisometropia children.<p>METHODS: Totally 47 children(94 eyes)with low degree myopic anisometropia(1.0D≤binocular equivalent spherical lens difference <2.5D)were involved between November 2019 and April 2020 in the retrospective clinical study. Twenty-seven cases(54 eyes)wore frame lens were used as group A and 20 cases(40 eyes)wore orthokeratology lens were used as group B. The corrected visual acuity and the accommodative parameters \〖the accommodative response(AR), the accommodative facility(AF), the accommodative amplitude(AMP)\〗 at 1mo after treatment were recorded and compared. <p>RESULTS:In two groups the results of AR were positive, and it meant accommodative lag(AL). AL of the higher myopic eyes was higher than the lower eyes in group A(0.63±0.21D <i>vs</i> 0.25±0.34D, <i>P</i><0.001), but there was no significant difference of AL in group B(<i>P</i>=0.104). Between two eyes, the difference of the corrected visual acuity and the monocular AMP in two groups were no significant(<i>P</i>>0.05). The binocular AR difference in group A was significantly higher than group B(0.38±0.36D <i>vs</i> 0.10±0.26D, <i>P</i>=0.005), and the binocular AF was lower(8.22±1.15c/min <i>vs</i> 9.95±0.89c/min, <i>P</i><0.001). There was no statistical difference in binocular AMP(<i>P</i>=0.280).<p>CONCLUSION: Low myopic anisometropia children with orthokeratology lens can obtain higher binocular AF and lower binocular AR difference than that with frame lens, so as to maintain more coordinated binocular accommodation.

Straatsma syndrome / Síndrome de Straatsma

Abstract The presence of retinal myelinated nerve fibers is not a rare finding during routine examinations, and it is usually a benign and isolated finding. However, in some rare cases, it can be associated with other ophthalmological conditions. We describe a case of a patient with the triad myelin nerve fibers, myopia and ambliopia, which configures the Straatsma Syndrome.

Resumo A presença de fibras de mielina é um achado comum durante exames oftalmológicos de rotina. Na maior parte das vezes, tem caráter beningno e é um achado isolado. No entanto, em alguns raros casos, a presença de mielinização pode estar associada a outras condições oftalmológicas. Descrevemos um caso de paciente com a tríade presença de fibras nervosas retinianas mielinizadas, miopia, e ambliopia, configurando a síndrome de Straatsma.