Terapias de estimulación visual y rendimiento académico de niños de primer año de Educación Básica / Visual stimulation therapies and academic performance of children in the first year of Elementary School / Terapias de estimulação visual e desempenho acadêmico de crianças no primeiro ano do Ensino Fundamental

La terapia visual como tratamiento de estimulación neurofisiológica, permite el desarrollo y mejoría de las habilidades visuales; mismas que inciden de manera directa en el aprendizaje y la lectura. Objetivo. Evaluar el impacto de las terapias de estimulación visual en el rendimiento académico en niños de primer año de básica de una unidad educativa privada en Quito-Ecuador. Materiales y métodos. La investigación fue descriptiva, modalidad de intervención educativa, con alcance explicativo causal y longitudinal. Se trabajó con una muestra intencional conformada por 32 estudiantes de 5 años cumplidos, ambos sexos biológicos, que asistían a clases presenciales, no recibían terapias visuales y, contaban con el consentimiento de los padres. Un profesional especialista en salud visual ejecutó la investigación en tres fases: 1) diagnóstica: medición de las variables como pre-test; 2) aplicación de estrategias: con el despliegue del programa por seis meses para trabajar la estimulación de habilidades visuo-perceptuales y; 3) evaluación del programa tras la intervención de las variables como post - test. Resultados. Tras las terapias, el 97% de la población tuvo un impacto positivo de +60, el porcentaje de agudeza visual inferior se redujo al 0%, incrementó la agudeza visual óptima en OD (43%) y OI (47%), la estereopsis mejoró en un 84% de sujetos, las habilidades visuo-perceptuales fueron aceptables y se mejoró el rendimiento escolar. Conclusiones. Se pudo evidenciar que la estimulación de habilidades visuales a través de terapias específicas, en edades tempranas, es importante y necesaria para evitar problemas futuros en el aprendizaje.

Visual therapy as a treatment of neurophysiological stimulation, allows the development and improvement of visual skills, which have a direct impact on learning and reading. Objective. To evaluate the impact of visual stimulation therapies on the academic performance of children in the first year of elementary school in a private educational unit in Quito-Ecuador. Materials and methods. The research was descriptive, educational intervention modality, with causal and longitudinal explanatory scope. We worked with an intentional sample of 32 students of 5 years of age, both biological sexes, who attended presential classes, did not receive visual therapies and had parental consent. A professional specialist in visual health carried out the research in three phases: 1) diagnostic: measurement of the variables as a pre-test; 2) application of strategies: with the deployment of the program for six months to work on the stimulation of visual-perceptual skills and; 3) evaluation of the program after the intervention of the variables as a post-test. Results. After the therapies, 97% of the population had a positive impact of +60, the percentage of inferior visual acuity was reduced to 0%, optimal visual acuity increased in OD (43%) and OI (47%), stereopsis improved in 84% of subjects, visuo-perceptual skills were acceptable and school performance was improved. Conclusions. It could be evidenced that the stimulation of visual skills through specific therapies, at early ages, is important and necessary to avoid future learning problems.

A terapia visual como um tratamento de estimulação neurofisiológica permite o desenvolvimento e a melhoria das habilidades visuais, que têm um impacto direto no aprendizado e na leitura. Objetivo. Avaliar o impacto das terapias de estimulação visual no desempenho acadêmico de crianças no primeiro ano do ensino fundamental em uma unidade educacional privada em Quito-Equador. Materiais e métodos. A pesquisa foi descritiva, na modalidade de intervenção educacional, com um escopo explicativo causal e longitudinal. Trabalhamos com uma amostra intencional de 32 alunos de 5 anos de idade, de ambos os sexos biológicos, que frequentavam as aulas presenciais, não recebiam terapia visual e tinham o consentimento dos pais. Um profissional especialista em saúde visual realizou a pesquisa em três fases: 1) diagnóstico: mensuração das variáveis como pré-teste; 2) aplicação de estratégias: com a implantação do programa durante seis meses para trabalhar a estimulação das habilidades perceptivo-visuais e; 3) avaliação do programa após a intervenção das variáveis como pós-teste. Resultados. Após as terapias, 97% da população teve um impacto positivo de +60, a porcentagem de acuidade visual inferior foi reduzida para 0%, a acuidade visual ótima aumentou em OD (43%) e OI (47%), a estereopsia melhorou em 84% dos indivíduos, as habilidades visuo-perceptuais foram aceitáveis e o desempenho escolar melhorou. Conclusões. Foi possível demonstrar que a estimulação das habilidades visuais por meio de terapias específicas em uma idade precoce é importante e necessária para evitar futuros problemas de aprendizagem.

Multifocal versus modified monovision corrections: A non-dispensing comparison of visual assessment in presbyopic neophytes

Purpose: To compare the visual performance of two simultaneous?vision soft multifocal contact lenses and to compare multifocal contact lens and its modified monovision counterpart in presbyopic neophytes. Methods: A double?masked, prospective, comparative study was conducted on 19 participants fitted with soft PureVision2 multifocal (PVMF) and clariti multifocal (CMF) lenses in random order. High? and low?contrast distance visual acuity, near visual acuity, stereopsis, contrast sensitivity, and glare acuity were measured. The measurements were conducted using multifocal and modified monovision design with one brand and then repeated with another brand of lens. Results: High?contrast distance visual acuity showed a significant difference between CMF (0.00 [?0.10–0.04]) and PureVision2 modified monovision (PVMMV; ?0.10 [?0.14–0.00]) correction (P = 0.003) and also between CMF and clariti modified monovision (CMMV; ?0.10 [?0.20–0.00]) correction (P = 0.002). Both modified monovision lenses outperformed CMF. The current study did not show any statistically significant difference between contact lens corrections for low?contrast visual acuity, near visual acuity, and contrast sensitivity (P > 0.01). Stereopsis at near distance was significantly lower with both modified monovision (PVMMV: 70 [50–85]; P = 0.007, CMMV: 70 [70–100]; P = 0.006) and with CMF (50 [40–70]; P = 0.005) when compared to spectacles (50 [30–70]). Glare acuity was significantly lower with multifocal (PVMF: 0.46 [0.40–0.50]; P = 0.001, CMF: 0.40 [0.40–0.46]; P = 0.007) compared with spectacles (0.40 [0.30–0.40]), but no significant difference was noted between the multifocal contact lenses (P = 0.033). Conclusion: Modified monovision provided superior high?contrast vision compared to multifocal correction. Multifocal corrections performed better for stereopsis when compared to modified monovision. In parameters like low?contrast visual acuity, near acuity, and contrast sensitivity, both the corrections performed similarly. Both multifocal designs showed comparable visual performances.

Femtosecond laser-assisted cataract phacoemulsification combined with Toric intraocular lenses implantation in correction of high myopia cataract and corneal astigmatism / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To measure the indexes including postoperative distance, middle, near visual acuity and near stereopsis vision of patients with high myopia cataract and corneal astigmatism by femtosecond laser, which can quantify the diameter of capsulorhexis opening, and to evaluate the availability and necessity of Toric intraocular lenses(IOL)in high myopia.METHODS: Prospective case-control study. Patients with binocular high myopia cataract and corneal astigmatism who undergone femtosecond laser-assisted cataract surgery in our hospital were selected, and they were divided into two groups, with 20 cases(40 eyes)in group A(Toric IOL)and 20 cases(40 eyes)in group B(IQ IOL). Indexes, including preoperative corneal astigmatism and spherical equivalent and best-corrected distance visual acuity, uncorrected middle visual acuity, uncorrected near visual acuity, residual refractive astigmatism, near stereopsis acuity, total high-order aberration and total spherical aberration, were measured postoperatively at 7d, 1 and 3mo.RESULTS: The uncorrected middle and near visual acuity, Titmus near stereopsis acuity and residual astigmatism at 7d, 1 and 3mo after surgery were significantly improved in the Toric IOL group than the non-Toric group(all P<0.05). The dependence on glasses was reduced. The postoperative best-corrected distance visual acuity, total high-order aberration and total spherical aberration of the two groups showed no statistically significant differences(all P>0.05).CONCLUSIONS: The implantation of Toric IOL in patients with high myopia cataract and corneal astigmatism can effectively correct corneal astigmatism, improve postoperative uncorrected middle and near visual acuity and near stereopsis visual function, reduce postoperative dependence on glasses and enhance binocular stereopsis visual function.

Cortical Deficits are Correlated with Impaired Stereopsis in Patients with Strabismus / 神经科学通报·英文版

In this study, we explored the neural mechanism underlying impaired stereopsis and possible functional plasticity after strabismus surgery. We enrolled 18 stereo-deficient patients with intermittent exotropia before and after surgery, along with 18 healthy controls. Functional magnetic resonance imaging data were collected when participants viewed three-dimensional stimuli. Compared with controls, preoperative patients showed hypoactivation in higher-level dorsal (visual and parietal) areas and ventral visual areas. Pre- and postoperative activation did not significantly differ in patients overall; patients with improved stereopsis showed stronger postoperative activation than preoperative activation in the right V3A and left intraparietal sulcus. Worse stereopsis and fusional control were correlated with preoperative hypoactivation, suggesting that cortical deficits along the two streams might reflect impaired stereopsis in intermittent exotropia. The correlation between improved stereopsis and activation in the right V3A after surgery indicates that functional plasticity may underlie the improvement of stereopsis. Thus, additional postoperative strategies are needed to promote functional plasticity and enhance the recovery of stereopsis.

Multimedia visual physiological stimulation combined with stereoscopic system training for the treatment of ametropic amblyopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the efficacy of multimedia visual physiological stimulation combined with stereoscopic system training in the treatment of ametropic amblyopia in children.METHODS: A total of 102 patients(102 eyes)with ametropic amblyopia admitted to our hospital from June 2021 to June 2022 were randomly divided into two groups. The control group consisted of 51 patients(51 eyes)who received multimedia visual physiological stimulation on the basis of conventional treatment, while the observation group consisted of 51 patients(51 eyes)who received stereoscopic training on the basis of the control group. The binocular fusion function, binocular stereopsis and binocular disparity of the two groups of children were evaluated at 3mo after treatment, and the clinical efficacy was assessed based on the improvement of vision.RESULTS: After 3mo of treatment, the normal rates of binocular fusion function, binocular stereopsis, and binocular disparity in the observation group were significantly higher than those in the control group(all P<0.05). The total effective rate of the observation group was significantly higher than that of the control group(94.1% vs. 60.8%, P<0.05), and the total effective rate of treatment in children of different ages in the observation group was higher than that in the control group(P<0.05), with children aged 6-8 having the highest effective rate of treatment; The total effective rate of treatment for children with mild to moderate amblyopia in the observation group was higher than that in the control group(94.0% vs. 61.2%, P<0.05).CONCLUSION: The combination of multimedia visual physiological stimulation and stereoscopic system training has a good therapeutic effect on ametropic amblyopia, which can promote visual recovery, help reconstruct binocular stereopsis, and has a better effect on children aged 6-8 years or children with mild to moderate amblyopia.

Assessment of stereopsis in pediatric and adolescent spectacle-corrected refractive error – A cross-sectional study

Purpose: To assess the level of stereopsis in school children with spectacle?corrected refractive errors using Titmus fly and Randot stereo tests, evaluate the factors associated with the level of stereopsis, and determine the level of agreement between the two tests. Methods: A cross?sectional study was done on 5? to 18?year?old school?children wearing spectacles for at least 1?month duration. Visual acuity was assessed using Snellen’s visual acuity chart, and their spectacle correction being used currently was measured using an auto lensmeter. The level of stereopsis was assessed using Randot and Titmus fly stereo tests. Data were entered using Microsoft Excel and analyzed using IBM?SPSS version 20, Chicago, IL. The associations between stereopsis and type of refractive error, visual acuity, age, and gender were analyzed. An agreement between Randot and Titmus fly test was done using Kappa statistics. Results: A total of 222 children (101 boys and 121 girls; mean age 13 years) were assessed. Astigmatism was the most prevalent refractive error (60.4%), followed by myopia (24.8%) and hypermetropia (1.4%). Thirty children (13.5%) had anisometropia. All hyperopes had normal stereopsis. Children with spherical myopia had better stereopsis, followed by astigmatism and anisometropia in the same order (P = 0.036). Children with anisometropia ?1.5 D had better stereopsis than anisometropia more than 1.5 D. Stereopsis was also found to have no correlation with the age and visual acuity at the time of testing or the age at which the child first started wearing spectacles. Stereopsis values obtained from Randot and Titmus fly stereo tests showed moderate agreement with Kappa value 0.581. Conclusion: Anisometropia and astigmatism are the most critical factors determining the level of stereopsis in refractive errors

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.

Clinical characteristics of acute acquired comitant esotropia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To describe the clinical characteristics of 20 patients with acute acquired comitant esotropia(AACE). <p>METHODS: This retrospective, observational case series study enrolled patients with AACE examined from June 2018 to May 2021 in Guangdong Jiangmen Central Hospital. The age when attacked, the duration of excessive near work before illness, symptom, refraction, AC/A, deviation and near stereopsis were analyzed. All 20 patients had unremarkable neurological finding by imageological test. <p>RESULTS: Most patients whose mean age was 24.25±5.78 years immersed in near work for more than 6h a day before illness. All patients seeked for medical help because diplopia with normal ocular motility in all directions of gaze and meaningless finding in routine ophthalmologic examinations. They were all nearsightedness whose mean spherical equivalent was -5.73±5.09D, while mean AC/A was 2.65±1.16 within the upper limit. There was no different between the distant and near deviations(<i>P</i>>0.05). Deviations might be correlated with near stereopsis(<i>P</i><0.05), however the duration from onset to treatment was irrelevant(<i>P</i>>0.05).<p>CONCLUSION: The clinical features of AACE in older children and adults who immersed excessive near work are medium myopia, diplopia, normal ocular motility, no neurological finding and limited AC/A. Moreover, it is approximate between distant and near deviations. The deviations affect near stereopsisd more, while the influence of duration from onset to treatment may be less.

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.

Resultados de la cirugía mínimamente invasiva en pacientes con estrabismos horizontales / Results of the minimally invasive surgery in patient with horizontal strabismus

Objetivo: Determinar los resultados de la cirugía mínimamente invasiva en pacientes con estrabismos horizontales. Métodos: Se realizó un estudio descriptivo, longitudinal y prospectivo de una serie de 19 pacientes (16 ojos derechos, 17 izquierdos) atendidos en el Servicio de Oftalmología Pediátrica del Instituto Cubano de Oftalmología "Ramón Pando Ferrer", en el periodo comprendido entre junio de 2018 y julio de 2019, a quienes se les realizó cirugía mínimamente invasiva de estrabismo y fueron seguidos por 6 meses. Se evaluaron las variables: tipo de desviación, agudeza visual, signos posoperatorios, ángulo de desviación pre- y posquirúrgico, éxito quirúrgico, fusión, estereopsis y complicaciones. Resultados: El 73,7 por ciento de los pacientes presentaba esotropías; la media de agudeza visual pre- y posoperatoria entre los dos ojos fue muy similar; el signo posoperatorio más frecuente fue la hiperemia conjuntival ligera (75 por ciento ojos derechos y 64,5 por ciento ojos izquierdos) a las 24 horas. Se encontraron diferencias estadísticas (p < 0,001) en el ángulo de desviación horizontal en dioptrías prismáticas, pre- y poscirugía, con el 84,2 por ciento de éxito quirúrgico. El 78,6 y el 80 por ciento de los pacientes con esotropía y exotropías alcanzaron fusión, pero solo lograron estereopsis el 28,5 y el 60 por ciento de ellos respectivamente. La frecuencia de complicaciones ocurrió en el 15,8 por ciento de los pacientes. Conclusiones: Se alcanzaron buenos resultados motores, así como aceptables en los sensoriales en pacientes operados de estrabismos horizontales por cirugía mínimamente invasiva(AU)

Objective: Determine the results of minimally invasive surgery in patients with horizontal strabismus. Methods: A prospective longitudinal descriptive study was conducted of a series of 19 patients (16 right eyes, 17 left eyes) attending the Pediatric Ophthalmology Service at Ramón Pando Ferrer Cuban Institute of Ophthalmology from June 2018 to July 2019. These patients underwent minimally invasive strabismus surgery and were followed up for six months. The variables considered were deviation type, visual acuity, postoperative signs, pre- and postoperative angle of deviation, surgical success, fusion, stereopsis and complications. Results: Of the patients studied, 73.7 percent presented esotropias; mean pre- and postoperative visual acuity was very similar in the two eyes; the most common postoperative sign was slight conjunctival hyperemia (75 percent right eyes and 64.5 percent left eyes) at 24 hours. Statistical differences (p < 0.001) were found in the horizontal angle of deviation in pre- and postoperative prism diopters, with 84.2 percent surgical success. 78.6 percent and 80 percent of the patients with esotropia and exotropia achieved fusion, but only 28.5 and 60 percent of them, respectively, achieved stereopsis. Complications occurred in 15.8 percent of the patients. Conclusions: Good motor results were obtained, as well as acceptable sensory results in patients undergoing minimally invasive horizontal strabismus surgery(AU)

Curative effect of slanted bilateral lateral rectus recession for convergence insufficiency-type intermittent exotropia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To observe curative effect and safety of slanted bilateral lateral rectus recession for convergence insufficiency-type intermittent exotropia.<p>METHODS:This study included 29 patients who underwent slanted bilateral lateral rectus recession for convergence insufficiency-type intermittent exotropia in our hospital between October 2017 and November 2019 with a follow-up of 6mo, the deviation, the surgical success rate, the binocular vision function and the complications were observed.<p>RESULTS:In our study, the mean near deviations, the mean distance deviations and the near-distance deviation differences reduced from -41.72±3.35PD, -23.28±9.75PD and 16.90±2.47PD before surgery to -5.97±4.85PD, -2.66±4.78PD, 3.28±1.10PD 6mo after surgery, the surgical success rate was 76%. The Grades I and Ⅱ binocular vision function improved 6mo after surgery(<i>P</i><0.05), the distance stereopsis and the near stereopsis were not statistically significant(<i>P</i>>0.05). None of the patients developed A-V pattern, limitation of eye movement, restrictive strabismus, vertical strabismus, and rotated diplopia, some patients had transient horizontal diplopia, which disappeared within 2-3wk after surgery.<p>CONCLUSION:Slanted bilateral lateral rectus recession may successfully reduce the near exodeviations, the distance exodeviations and the near-distance deviations difference without obvious complications, proved to be a safe and effective procedure for the treatment of convergence insufficiency-type intermittent exotropia.

Características de los pacientes pediátricos con miopía por encima de 6 dioptrías / Characteristics of pediatric patients with greater than 6 diopter myopia

RESUMEN Objetivo: Identificar las características de los pacientes pediátricos con miopías por encima de 6 dioptrías. Métodos: Se realizó un estudio descriptivo y observacional, de corte longitudinal, en 43 niños entre 3 y 15 años de edad con diagnóstico de miopía igual o mayor de 6 dioptrías en uno o ambos ojos (72 ojos), quienes acudieron a la consulta del Servicio de Oftalmología Pediátrica y Estrabismo del Instituto Cubano de Oftalmología "Ramón Pando Ferrer" durante el periodo comprendido entre enero y diciembre del año 2018. Las variables del estudio fueron la edad, el sexo, el color de la piel, la miopía (isometrópica y anisometrópica), la longitud axial, la agudeza visual con corrección, el tipo de corrección óptica, la presencia y el grado de estereopsia. Resultados: Predominó el grupo de 3 a 5 años (34,4 por ciento), el sexo femenino y el color de la piel blanca. La longitud axial aumentó junto con el equivalente esférico de los pacientes. La corrección más usada correspondió a los cristales, aunque se demostró estadísticamente que con los lentes de gas permeables los pacientes presentaban mejor agudeza visual (p= 0,016), donde se registró también la media más alta de equivalente esférico. De 43 pacientes, 20 (46,5 por ciento) no presentaron estereopsia. Los pacientes con anisometropías (64 por ciento) no presentaron estereopsia, lo que fue estadísticamente significativo. Conclusiones: Con los lentes de gas permeables los pacientes presentan mejor agudeza visual y mayor equivalente esférico. La mayor cantidad de pacientes sin estereopsia corresponde a las miopías por anisometropías(AU)

ABSTRACT Objective: Identify the characteristics of pediatric patients with greater than 6 diopter myopia. Methods: An observational descriptive longitudinal study was conducted of 43 children aged 3-15 years diagnosed with myopia equal to or greater than 6 diopters in one or both eyes (72 eyes) who attended the Pediatric Ophthalmology and Strabismus Service at Ramón Pando Ferrer Cuban Institute of Ophthalmology from January to December 2018. The variables considered were age, sex, skin color, myopia (isometropic or anisometropic), axial length, corrected visual acuity, type of optical correction, and presence and degree of stereopsis. Results: A predominance was found of the 3-5 years age group (34.4 percent), female sex and white skin color. Axial length increased with spherical equivalent. The most common correction was glasses, but it was statistically demonstrated that gas permeable lenses provided better visual acuity (p= 0.016) and the highest spherical equivalent mean. Of the 43 patients evaluated, 20 (46.5 percent) did not present stereopsis. Patients with anisometropia (64 percent) did not present stereopsis, which constituted a statistically significant fact. Conclusion: Gas permeable lenses provide better visual acuity and a greater spherical equivalent. Most of the patients without stereopsis have anisometropic myopia(AU)

Tratamento da aniseiconia induzida na correção óptica de anisometropia em escolares do ensino fundamental / Treatment of aniseikonia induced by optical correction of anisometropia in elementary school children

Resumo Objetivos: Comparar a aniseiconia e a estereopsia em escolares anisometropes do primeiro ano do ensino fundamental corrigidos com lentes oftálmicas de estoque com curvas-base selecionadas para minimizar a diferença de tamanho interocular das imagens retínicas e com lentes iseicônicas sugeridas pelo software Aniseikonia Inspector 3 e verificar a preferência dos escolares por uma destas formas de correção. Métodos: Dezenove escolares com anisometropia ≥ 1,5 D em meridianos correspondentes no uso de óculos com lentes oftálmicas de estoque e com lentes iseicônicas foram avaliados para aniseiconia (software Aniseikonia Inspector 3) e estereopsia (teste Stereo Fly test com símbolos LEA. A preferência por uma das formas de correção foi verificada após 40-50 dias de uso dos óculos. Resultados: As médias e os desvios-padrão das aniseiconias vertical e horizontal no uso de óculos com lentes oftálmicas de estoque e com lentes iseicônicas foram, respectivamente, -1,05% ± 2,20% e -1,37% ± 2,36% (p=0,82739) e -0,895% ± 2,23% e -1,16% ± 2,03% (p=0,77018). 31,6% dos escolares corrigidos com lentes iseicônicas e 21,1% dos escolares corrigidos com lentes oftálmicas de estoque identificaram os optotipos que sugerem estereopsia < 100 segundos de arco (p= 0,475). Em relação à preferência, 4/15 (26,7%) escolheram os óculos com lentes iseicônicas, 2/15 (13,3%) escolheram os óculos com lentes oftálmicas de estoque e para 9/15 (60%) a escolha foi indiferente. Conclusão: A aniseiconia induzida nos escolares anisometropes corrigidos com lentes iseicônicas sugeridas pelo software Aniseikonia Inspector 3 foi similar ao obtido na correção com lentes oftálmicas de estoque com curvas-base selecionadas para minimizar a diferença de tamanho interocular das imagens retínicas.

Abstract Objectives: To compare the aniseikonia and the stereopsis in school children anisometropes of the first-year of elementary school corrected with stock ophthalmic lenses with base curve selected to minimize the interocular size difference of retinal images and with size lenses suggested by the software Aniseikonia Inspector 3, and to check the preference of them for one of these forms of correction. Methods: Nineteen school children with anisometropia ≥ 1.5 D in corresponding meridians, in the use of glasses with stock ophthalmic lenses and with size lenses were evaluated for aniseikonia (software Aniseikonia Inspector 3) and stereopsis (Stereo Fly test with LEA symbols). The preference for one of the forms of correction was verified after 40-50 days of wearing glasses. Results: The mean and standard deviations of the vertical and horizontal aniseikonia in the use of glasses with stock ophthalmic lenses and with size lenses were, respectively, -1.05% ± 2.20% and-1.37% ± 2.36% (p = 0,82739) and -0.895% ± 2.23% and -1.16% ± 2.03% (p = 0,77018). 31.6% of the school children corrected with size lenses and 21.1% of the students corrected with stock ophthalmic lenses identified the optotypes that suggest stereopsis less than 100 seconds of arc (p = 0.475). Regarding the preference, 4/15 (26.7%) of the students chose the glasses with size lenses, 2/15 (13.3%) chose the glasses with stock ophthalmic lenses, and for 9/15 (60%) the choice was indifferent. Conclusion: The induced aniseikonia in school children with anisometropia corrected with size lenses suggested by the software Aniseikonia Inspector 3 was similar to that obtained in the correction with stock ophthalmic lenses with base curves selected to minimize the difference of interocular size of retinal images.

Estereopsis en pacientes con ambliopía en ausencia de estrabismo / Stereopsis in patients with ambliopia in absence of strabismus

Introducción: los pacientes con estrabismo comúnmente tiene algún grado de compromiso en la estereopsis, y existe evidencia clara que el tratamiento de la ambliopía severa mejora este compromiso; sin embargo, no hay datos que reporten grados de estereopsis en pacientes con ambliopía en ausencia de estrabismo. Objetivo: determinar y comparar el grado de estereopsis en pacientes sin ambliopía, con ambliopía leve y moderada en ausencia de estrabismo, que asistieron a consulta de oft almología pediátrica en el Hospital de San José entre Enero de 2015 y Agosto de 2017. Diseño del estudio: estudio de tipo transversal. Método: pacientes entre 5 y 15 años. Se utilizó el Random Dot Test para la evaluación de estereopsis. Se comparó el grado de estereopsis entre los distintos niveles de ambliopía por medio de una prueba de Kruskal Wallis. Resultados: se incluyeron 119 niños, 64 no tuvieron ambliopía y 55 tuvieron ambliopía, de los cuales el 67.3% fue leve (n=37) y el 32.7% fue moderada (n=18). La principal causa fue la refractiva; en el grupo de ambliopía leve 64.9% y moderada 77.8%. Los pacientes entre 5 y 10 años presentaron una mediana de estereopsis de 40 segundos de arco independientemente de si tenían o no ambliopía, a diferencia de los pacientes mayores de 10 años en quienes a medida que aumentó el grado de ambliopía, disminuyó la estereopsis. Conclusión: de observó una tendencia al empeoramiento del grado de estereopsis según el grado de ambliopía aunque no se alcanzó significancia estadística. El diagnóstico precoz y tratamiento oportuno de la ambliopía durante los primeros años son fundamentales para garantizar un desarrollo visual adecuado de la población pediátrica.

Background: patients with strabismus usually have some degree of disturbance in stereopsis, and there is clear evidence that the treatment of severe amblyopia improves it. However, there are no data reporting grades of stereopsis in patients with amblyopia in absence of strabismus. Objective: to determine and compare the degree of stereopsis in patients without amblyopia, with mild and moderate amblyopia in absence of strabismus who the attended pediatric ophthalmology clinic at Hospital de San José between January 2015 and August of 2017. Study design: cross sectional study. Method: study design: cross-sectional study. Participants: Patients between 5 and 15 years. Process: The Random Dot Test was used for stereopsis evaluation. The degree of stereopsis between the different levels of amblyopia was compared by means of a Kruskal Wallis test. Results: 119 children were included, 64 did not have amblyopia and 55 had amblyopia. 67.3% were mild (n = 37) and 32.7% were moderate (n = 18). The principal cause was refractive, mild amblyopia 64.9% and moderate 77.8%. Patients between 5 and 10 years had a median stereopsis of 40 seconds of arc regardless of whether they had amblyopia or not, unlike patients older than 10 years in whom as the degree of amblyopia increased, stereopsis decreased. Conclusion: It was observed a tendency to worsen the degree of stereopsis according to the degree of amblyopia although statistical signifi cance was not reached. Th e early diagnosis and timely treatment of amblyopia during the fi rst years are fundamental to guarantee an adequate visual development of the pediatric population.

Relevant factors of successful surgery in the basic type of intermittent exotropia / 中华实验眼科杂志

Objective To explore the relevant factors of functionally healing the basic type of intermittent exotropia.Methods A prospective observation study was designed.One hundred and thirty-two cases with basic type of intermittent exotropia in Tianjin Eye Hospital from August 2015 to March 2016.Pre-and post-operation examinations to each patient,including the tests of ocular alignment,Worth four-dot test at 2 m and 33 cm,Titmus,functional visual analyzer (FVA),Frisby Davis distance (FD2) were used to explore the influencing factors of postoperative eye position and stereoscopic reconstruction,and to find the cutoff point of surgery.This study followed the Declaration of Helsinki.This study protocol was approved by Ethic Committee of Tianjin Eye Hospital (No.YKLL-2015-8-21).Written informed consent was obtained from each patient or guardian prior to entering study cohort.Results At 6 months postoperatively,there were 84 cases of orthopedic position,4 cases of overcorrection and 44 cases of undercorrection.The success rate was 63.6％.The deviation at day 1 and peripheral fusion function were statistically significant to postoperative eye position (b =-0.093,P =0.037;b =0.725,P =0.017).The area under the receiver operating characteristic (ROC) curve was 0.645,which showed that the result of Worth four-dot test at 33 cm had lower diagnostic value.Seventy-two cases with eye position between 0 and +10 PD at 1 day postoperatively were all successful in eye position at 6 months postoperatively.The postoperative eye position was the influencing factor for postoperative distance stereo with FVA (x2 =4.036,P =0.045).The age of onset and the preoperative distance stereoacuity with FD2 were the influencing factors of postoperative distance stereo reconstruction (b =-0.213,P =0.023;b =0.021,P =0.036).The area under the ROC curve of the age of onset and the preoperative distance stereoacuity with FD2 was 0.257 and 0.752,respectively.The former had no diagnostic value,and the latter had a medium diagnostic value.The best cutoff point was 22.5" with FD2 at 6 m.Conclusions Success rate of postoperative eye position is affected by the postoperative deviation at day 1.The optimal deviation at post-operation day 1 is 0-10 PD.Postoperative distance stereopsis is improved well and the surgery should be done before the distance stereoacuity is decreased to 22.5" with FD2 at 6 m.

Influencing factors of stereopsis function after strabismus operation / 国际眼科杂志(Guoji Yanke Zazhi)

@#Proper assessment of the establishment of stereopsis after strabismus surgery continues to be challenging for the strabismus surgeon. In view of the stereopsis, the timing of surgery for strabismus has been controversial because of concerns that it may result in an overcorrection or lateness. Recent literature on the strabismus surgeon has shown that the establishment of postoperative stereoscopic vision is closely related to the age of onset, types of strabismus, course of disease and ocular deviation. This review will summarize the recent points as below.

Calidad de vida relativa a la visión según estudios psicofísicos en pacientes hipermétropes con cirugía facorrefractiva / Quality of life relative to the vision according to psychophysical studies in hyperopic patients undergoing phaco-refractive surgery

Objetivo: describir los resultados de la calidad visual para la mejoría de la discriminación cromática, así como la estereopsia y la sensibilidad al contraste, posterior a la cirugía facorrefractiva en pacientes hipermétropes mayores de 40 años, y si la mejoría visual es sustancial en los parámetros de función visual según estudios psicofísicos. Métodos: se realizó un estudio descriptivo, longitudinal y prospectivo a 70 pacientes operados en el período de enero a diciembre del año 2016, hipermétropes présbitas con buena visión corregida, atendidos en el Servicio de Microcirugía del Instituto Cubano de Oftalmología "Ramón Pando Ferrer", quienes mostraron mejoría subjetiva en su calidad de vida al disminuir la dependencia de los espejuelos. Se realizó un estudio de sensibilidad al contraste con la cartilla de Pelli-Robson; discriminación cromática con la prueba de Farnsworth Munsell 100-Hue y estereopsia a través de la prueba de The Netherlands Organization. Resultados: hubo una mejoría significativa en todos los exámenes realizados. La sensibilidad al contraste pasó de una media en el prequirúrgico de 1,44 cd/m2 a 1,56 cd/m2 en el posquirúrgico. La prueba FMH-100 mejoró cuantitativa y cualitativamente (de 142,06 errores en el pre, bajó a 52,91 en la poscirugía); predominaron discriminadores promedios con 50 pacientes y 13 altos discriminadores; mejoró la estereopsia con y sin cristales después de la cirugía, lo que pudo cuantificarse. Conclusiones: hay una mejoría objetiva de la calidad visual después de la lensectomía refractiva en el paciente hipermétrope, demostrada en los resultados de la discriminación cromática, la estereopsia y la sensibilidad al contraste(AU)

Objective: describe visual quality results related to improved chromatic discrimination, stereopsis and contrast sensitivity after phaco-refractive surgery in hyperopic patients aged over 40 years, and determine whether substantial visual improvement is achieved in visual function parameters according to psychophysical studies. Methods: a prospective longitudinal descriptive study was conducted of 70 presbyopic hyperopic patients with good corrected vision undergoing surgery from January to December 2016 at the Microsurgery Service of "Ramón Pando Ferrer" Cuban Institute of Ophthalmology, who experienced subjective quality of life improvement on reducing their dependence on eyeglasses. Contrast sensitivity was evaluated with the Pelli-Robson chart, chromatic discrimination with the Farnsworth Munsell 100-Hue test and stereopsis with The Netherlands Organization test. Results: significant improvement was observed in all the tests performed. Contrast sensitivity rose from a preoperative mean of 1.44 cd/m2 to 1.56 cd/m2 in the postoperative period. Results of the FMH-100 test improved both quantitatively and qualitatively (from 142.06 errors in the preoperative period to 52.91 in the postoperative period); average discriminators prevailed with 50 patients and 13 high discriminators; stereopsis improved after surgery with and without glasses, which could be quantified. Conclusions: objective quality of life improvement is observed in hyperopic patients after refractive lensectomy, as is evidenced by chromatic discrimination, stereopsis and contrast sensitivity results(AU)

Stereopsis function of presbyopia effected by correcting of monovision contact lens / 中华实验眼科杂志

Objective This study was to study the effect of monovision contact lens (MV-CL) on distant and near vision,distant and near stereopsis,and to identify the effect of degree of monovision on vision function.Methods A prospective case observational study was designed.The clinical data of sixty-eight eyes of 47 cases were collected from November 2010 to August 2014 in Henan Provincial Corps Hospital,Chinese People's Armed Police Forces.Sixty-eight eyes of 47 cases wore contact lenses to improve near vision,in which the other eye of 21 cases with hyperopia wearing contact lenses to improve distant vision.Besides,far and near stereopsis were measured before and two weeks after wearing lenses respectively;and scotopia were measrued with lenses and in naked eyes respectively.Compared the changes of vision and stereopsis in patients before and after the MV-CL,and conducted the patient satisfaction survey.Results There were 89％ (42/47 cases) and 6％ (3/47 cases) of the patients whose naked far and near vision was 0.8/0.33 (J4) at 2 weeks after MV-CL and before MV-CL,respectively.There were no statistical significance about change of near stereopsis with Titmus stereopicture and the Yan's near random-dot stereogram (x2=1.30,0.56;both at P＞0.05).There were no statistical significance about change with apparent machine random dot stereogram iterative crossed parallax and uncrossed disparity (x2 =0.16,0.11;both at P＞0.05).The far distance fusion range and far stereopsis were not significantly different between before and after MV-CL (x2 =0.22,0.16;both at P＞0.05).Titmus stereopicture tests showed that there was a decrease in the number of people who had foveal stereopsis,while an increase was found in people who had macular stereopsis after MV-CL,but the difference had no statistical significance (x2 =2.28,P ＞ 0.05).Conclusions Near vision can be obviously increased and presbytism can be relieved by MV-CL.Stereopsis of some patients are decreased after MV-CL,but this can be accepted by the patients and there is no obvious decrease in far range of fusion.

Changes in lateral ocular movement after two muscle exotropia surgery / 中华实验眼科杂志

Objective This study was to identify the surgical procedures associated with changes of lateral eye movement to help inform surgical planning for patients with concomitant exotropia.Methods The medical records of 87 concomitant exotropia surgical procedures that were performed at Henan Eye Hospital from June 2014 to August 2015 were retrospectively reviewed.The deviation angle was measured by prism and alternate cover test.Photographs and arc campimeter was used to obtain changes of abduction and lateral monocular fixation field respectively.Data were compared preoperatively and postoperatively among five groups based on the surgical procedures.The surgical procedures were 0 mm for control group (61 eyes),8 mm unilateral rectus recession for lateral rectus recession (LR) group (27 eyes),5-6 mm recession/4-5 mm resection for small amount recess-resect (R-R) group (24 eyes),7-8 mm recession/5-6 mm resection for medium amount R-R group (29 eyes) and 8-10 mm recession/7-8 mm resection for large amount R-R group (33 eyes).The minimum follow-up period was 6 months.Informed consent was signed from each patient or the guardian.Results The success,overcorrection and undercorrection rate was 81.61％,5.56％ and 12.64％,respectively.Mean preoperative abduction of each group was (11.86± 1.11)mm in the control group,(12.04±0.68)mm in the LR group,(11.58 ± 1.06)mm in the small amount R-R group,(11.86±0.93)mm in the medium amount R-R group and (12.22±0.60)mm in the large amount R-R group.The postoperative mean abduction of each group was (11.81±1.03),(11.81 ±0.70),(10.78±1.05),(10.54±1.07) and (9.90±0.82)mm,respectively.Mean abduction among the five groups was not significantly different preoperatively (F =1.85,P =0.12),while it was significantly different postoperatively (F =28.04,P =0.00).The abduction between control group and small amount R-R group was not significantly different postoperatively (P =0.99),but the abduction of control group was significantly greater than that of all the R-R groups (all at P=0.00).Mean lateral monocular fixation field of each group preoperatively was (50.82 ± 3.30) ° in control group,(51.48 ±2.39)° in LR group,(50.13±3.51)° in small amount R-R group,(51.06±2.90)° in medium amount R-R group and (52.09±2.61)° in large amount R-R group.The postoperative mean lateral monocular fixation field of each group was (50.52 ± 3.51)°,(50.11 ± 2.36)°,(46.38 ± 3.67)°,(44.00 ± 3.00)°,(41.84 ±2.46)°,respectively.Preoperative lateral monocular fixation field among the five groups was not significantly different (F =1.75,P =0.14),while postoperative difference was significant (F =55.75,P =0.00).Lateral monocular fixation field between control group and LR group was not significantly different postoperatively (P=0.57),but the mean lateral monocular fixation field of control group was significantly greater than that of all the R-R groups (all at P =0.00).Conclusions The successful alignment rate of unilateral recess/resect procedure is satisfying,but it can also create abduction deficit especially in large surgical amounts eye.Patients with binocular vision will be sensitive to diplopia in side gaze;in such cases,the consequences of recess/resect procedure should be considered particularly to avoid decrease of the binocular single vision field.

Near and distance stereopsis restoration in amblyopia with S3D computer treatment / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the effect of stereoscopic 3D (S3D) technology as a visual training system in children with amblyopia. METHODS:Totally 30 children,aged 4-16 years old,18 with ametropic amblyopia ( AMA ), and 12 with anisometropic amblyopia(ANA) were recruited in this study. A binocular 3D shutter glasses technology visual training system was used for training trials. Each training time lasted 1h,and the number of training trials totaled 33 (mean士SD:32士8) times on average,per-person. Before and after each training trial, the best corrected visual acuity ( BCVA) of each eye, range of fusion by synoptophore, as well as near and distance stereopsis acuity by Yan Shaoming random - dot test and synoptophore respectively was measured. RESULTS: A significant difference was found pre- and post treatment in BCVA in both kinds of amblyopia studied. Significant improvement was also found in fusion range and stereopsis acuity. The improvement of fusion range and stereopsis recovery could be seen in ANA than in AMA patients. The near stereopsis acuity recovery in ANA group might more easily to regain stereoacuity at near than in AMA group. CONCLUSION: S3D display vision training systems are indicated for the recovery of stereoacuity in children with amblyopia.