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Amblyopia is one of the most common causes of visual defi cit in children. Presently, in the Ministry of Health Malaysia hospitals, there is no documented data on the characteristic and profi le of amblyopia cases. This study was conducted to describe the profi le of new amblyopia cases seen by optometrists at the Ministry of Health (MOH) Hospitals. This study was a retrospective and multicenter study including all MOH hospitals with optometry clinics. Clinical record data of amblyopic patients aged 3 to 17 years old who were newly diagnosed between 1st August 2010 to 31st January 2011 and who fulfi lled the inclusion criteria were obtained. Data collected included demography, systemic history, ocular history and optometric fi ndings and diagnosis. Thirty eight MOH hospitals participated and a total of 301 patients were diagnosed with functional amblyopia within the study period. Mean age for these amblyopic patients was 7.70 + 0.16 years old. Boys were the predominant gender (57.1%) and Malay preceded the other races with a 65.4% occurrence. Mild amblyopia was found in 51.5% of the patients, 31.6% were with moderate amblyopia and only 16.9% of patients were severe amblyopia. The underlying amblyogenic causes assessed were ametropia (61.5%), anisometropia (25.2%), strabismus (9.3%) and stimulus deprivation (4.0%). Refractive error was discovered as the most common cause of amblyopia in this study. It is crucial for optometrists to detect this type of visual impairment and undertake an early optometric intervention
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Background It is well known that the diminution of visual acuity appears before notable complications in some high myopic eyes.However,whether the impaired vision is associated with the change of retinal thickness at macula area is still under investigation.Objective This study was to investigate the relationship of macular retinal thickness with the change of visual acuity in high myopic eyes.Methods A consecutive caseobservational study was performed.Two hundred and forty-five eyes of 132 patients with the diopter of-6.00～-20.00 D were enrolled in this study during the January 2011 to January 2012 in Beijing Tongren Eye Center.All of the patients received the measurement of retinal thickness with Fourier Domain Optical Coherence Tomography (FDOCT),and the scan mode was MM6.The eyes were divided into the corrected vision ≥0.9 group and the corrected vision ≤0.8 group.In addition,the eyes were assigned to the non-posterior staphyloma group,posterior staphyloma Ⅰ group (macular symmetry) and posterior staphyloma Ⅱ group (macular gradient).The retinal thicknesses in different quadrants at the macular zone were measured and calculated by OCT software.Results The demography was matched in different groups.Corrected visual acuity was significantly increased in the corrected vision ≥ 0.9 group than that in the corrected vision ≤0.8 group (1.02±0.16 vs.0.62±0.08) (t=3.233,P=0.001).Retinal thickness value at fovea was (256.28±13.19) μm in the corrected vision ≥0.9 group,and that in the corrected vision ≤0.8 group was (231.17 ± 10.96) μm,with a significant difference between the two groups (t =2.134,P =0.031).The corrected visual acuity was 1.00±0.27,0.78±0.21 and 0.90±0.13 in the non-posterior staphyloma group,posterior staphyloma Ⅰ group and posterior staphyloma Ⅱ group,respectively,showing significant difference among the three groups (F=15.760,P=0.015),and the corrected visual acuity of the non-posterior staphyloma group and posterior staphyloma Ⅱ group were significantly higher than that of posterior staphyloma Ⅰ group (q =16.131,P =0.006 ; q =-10.831,P=0.008).A significant difference also was seen in the mean retinal thickness among the three groups (F=2.316,P =0.025).The mean retinal thickness in the posterior staphyloma Ⅰ group was (234.21 ± 15.69) μm,which was significantly smaller than (252.25± 15.31) μm of the posterior staphyloma Ⅱ group (q =12.977,P =0.023).There were no significant difference in the retinal thickness at para-fovea area among the three groups (F=0.318,P =0.078).However,significant difference was found at peri-fovea area in different groups (F=1.925,P =0.013).The mean retinal thicknesses at peri-fovea area was (273.26 ± 16.37) μm in the posterior staphyloma Ⅱ group and was significantly smaller than (289.11 ± 19.30) μm of the posterior staphyloma Ⅰ group and (290.33 ± 17.12) μm of the non-posterior staphyloma group (q =-8.305,P =0.023 ; q =-7.011,P =0.012).Conclusions The retinal thickness at fovea is associated with the corrected visual acuity in high myopic eyes.The thinning of retinal thickness at the vertex of posterior staphyloma is one of causes of visual function impairment.
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Background Both functional and morphological changes in amblyopic development are known to occur at various levels in the central visual pathway.However,whether the retina is involved or not during amblyopic progression remains controversial.Objective This study was designed to compare the thicknesses of the fovea and retinal nerve fiber layer (RNFL) of the normal fellow eye of amblyopic eye using optical coherence tomography (OCT) in children with myopic anisometropia.Methods Twenty-two patients with unilateral myopic anisometropic amblyopia were included as the anisometropia amblyopia group.Ten unilateral myopic anisometropic amblyopia subjects received treatment and recovered were used as the amblyopic cure group,and 11 individuals with simple myopic anisometropia without amblyopia were enrolled as the control group.OCT was performed on both eyes of all the subjects with informed consent.Fovea retinal thickness and RNFL thickness from the superior,inferior,nasal and temporal quadrants in the peripapillary region were evaluated.The measurement parameters were bilaterally compared in all the individuals by paired t test.The multiple regression model was used to analyze the correlation of retinal thickness with amblyopia patients.This study was approved by the Ethic Committee of this hospital.Written informed consent was obtain from each subject prior to the eye examination.Results Fovea retinal thickness increased in the amblyopic eyes compared with the fellow eyes,showing a statistically significant difference between them (P =0.001).However,no significant differences were found in the fovea retinal thickness between both eyes in the amblyopic cure group and simple myopic anisometropia without amblyopia group (P =0.778,0.943).Among the anisometropia amblyopia group,amblyopia cure group and simple myopic anisometropia without amblyopia group,the RNFL thicknesses of the temporal quadrant was significantly thicker in the higher myopic lateral eyes than those of the fellow eyes (P＜0.001,P =0.003,P =0.046).However,the differences in the superior,inferior,nasal and the average RNFL thickness were not statistically significant between the two eyes (P＞0.05).A negative correlation was found between the inferior retinal thickness with age (r=-0.559,P=0.016).Conclusions The fovea may be affected in unilateral myopic anisometropic amblyopia.There is no significant difference in the RNFL thickness between simple myopic eye and unilateral myopic anisometropia amblyopic eye.Improvement in amblyopia is coming along with the reduction of the thickness of the fovea.
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Background Flickering light is different from the normal light environment.Animal experiment proved that flickering light can induce myopia.But its mechanism remains unclear.Objective This study was to investigate the expression of c-fos gene in retina of myopic C57BL/6J mice induced by flickering light and monocular form deprivation.Methods Ninety clean C57BL/6J mice aged 28-day-old with the similar refraction in both eyes were randomly assigned to five groups.Fifteen mice in the control group were exposed to continuous white light environment.The white flickering light with the frequency of 10,5,2 Hz were used to irradiate the mice respectively in high frequency flickering group (15 mice),moderate frequency flickering group (15 mice) and low frequency flickering group (15 mice),respectively.The right eyes of other 30 mice were monocularly occluded with a semitransparent hemispherical thin plastic shell to establish the form deprivation models and then were exposed to white light environment.The diopter and ocular axial length were measured by murine-specific eccentric infrared photorefraction and A-scan ultrasonography before experiment and two weeks after the treatments.At the end of experiment,the mice were sacrificed by neck dislocation.Mice eyes were enucleated and retinal samples were prepared for the detect of c-fos protein and its mRNA by immunohistochemistry,Western blot and reverse transcription polymerase chain reaction (RT-PCR),respectively.Results Immunohistochemistry showed that the expressing rate ofc-fos protein in retina was (68.000±10.368)％,(51.000±6.519)％,(46.000±6.519)％,(31.000±7.416)％ and (25.000 ± 7.071)％ in the control group,high frequency flickering group,moderate frequency flickering group,low frequency flickering group and form deprivation group respectively 2 weeks after experiment.The expression rates of c-fos protein in retina in different frequencies of flickering light groups and form deprivation group were significantly lower than that in the control group (t =3.104,4.017,6.490,7.661,all P＜0.05),with the lowest rate in the form deprivation group (P＜0.05).The expression of c-fos detected by Western blot assay exhibited that the relative values of c-fos protein in retina (c-fos/GAPDH) was 0.804±0.050,0.687±0.047,0.667±0.036,0.558±0.036 and 0.532 ±0.056,respectively in the control group,high frequency flickering group,moderate frequency flickering group,low frequency flickering group and form deprivation group,illustrating significantly lowing in different frequencies of flickering light groups and form deprivation group compared with control group (t =2.961,3.184,6.971,6.276,all P＜0.05),whereas the c-fos in the low frequency group and form deprivation group,c-fos protein was less expressed in comparison with the higher frequency flicking group (P＜0.05).The expression level of c-fos mRNA (c-fos mRNA/GAPDH mRNA) in retina was 0.820±0.056,0.663±0.061,0.627±0.034,0.521±0.041 and 0.474 ±0.045 in the control group,high frequency flickering group,moderate frequency flickering group,low frequency flickering group and form deprivation group,respectively.These results demonstrated a significant decline in the expression of c-fos mRNA in different frequencies of flickering group and form deprivation group compared with the control group(t=3.262,5.070,7.173,8.305,all P＜0.05),and the inhibition ability of low frequency of flickering group and form deprivation group was much stronger.Conclusions The c-fos gene level in the retina has a negative relationship with the severity of myopia induced by flickering light and form deprivation.
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Background It has become a consensus about the necessity of topical administration of corticosteroid eye solutions after myopic laser-assisted in situ keratomileusis(LASIK).The glucocorticoid eye drops with good anti-inflammatory effect and less adverse effects is helpful for the repair of corneal epithelium following LASIK.Objective This study was to evaluate the clinical effects of 0.5％ loteprednol etabonate eye drops after LASIK.Methods A prospective randomized-controlled study was designed.One hundred and twelve myopia patients(224 eyes)who had received LASIK were included in this study and randomly divided into two groups,and 97 patients finished the follow-up,including 108 eyes of 54 patients in the 0.5％ ioteprednol etabonate eye drops treatment group and 86 eyes of 43 patients in the control group.0.5％ loteprednol etabonate eye drops or dexamethasone/tobramycin eye drops were administered topically to the treatment group and control group,respectively 4 times daily from postoperative day 1 through day 7 following LASIK in addition to regular basic treatment.The follow-up was performed 1 day,1 week and 1 month after LASIK.Subjective symptoms including eye pain,foreign body sensation and blurring were scored,and uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),intraocular pressure(IOP),central corneal thickness,corneal fluorescein staining and diffuse laminar keratitis(DLK)were evaluated and compared between the two groups 1 day,1 week,and 1 month after LASIK.This clinical trial was approved by the Ethic Commission of Zhongshan Ophthalmic Center,and written informed consent was obtained from each patient before the trial.Results No drug-related ocular and systemic adverse events were found in the treatment group throughout the follow-up duration.There was no significant difference in the subjective symptom score after 1 day,1 week and 1 month(P＞0.05).At 1 week post-LASIK,the corrected actual IOP was (16.27±3.31)mmHg in the treatment group and(17.49±4.48)mmHg in the control group,with a statistically significant difference between them(t =-2.113,P =0.036).However,there was no statistically significant difference in IOP between the treatment group(15.01±3.22)mmHg and the control group(15.30±4.17)mmHg at 1 month post-LASIK(t=-0.532,P=0.595).Mild diffuse lamellar keratitis developed in 7 eyes in the treatment group and 5 eyes in the control group without a significant difference on the first day after LASIK(x2 =0.153,P =0.926).The scores of corneal fluorescein staining were not statistically different between the two groups at 1 day,1 week and 1 month postoperative(Z=-0.566,P=0.571 ;Z=-0.689,P=0.491 ;Z=-1.628,P=0.103).Conclusions 0.5％ loteprednol etabonate eye drops could effectively inhibit postoperative inflammation and low the incidence of DLK.It can lessen the risk of IOP elevation in comparison with traditional steroid eye drops.