Bilateral congenital hypertropic strabismus fixus: A case report.

PURPOSE: To report an unusual and rare case of both eyes fixed in an extreme superomedial position. CASE REPORT: A case of 48-year-old woman presented with both eyes fixed in an extreme superomedial position; the microcorneas were covered almost completely by the upper eyelids even when she opened her eyes. A forced duction test was performed to confirm there were severe restrictions in all directions. She underwent disinsertion of the superior and medial rectus muscle, inferior oblique muscle belly transposition and sclera fixation. At the 1-year follow-up, there was improved ocular alignment. CONCLUSION: This case may be a special form of myopic strabismus fixus. The infratemporal fossa may be a bony landmark related to the etiology of global fixation.

Estimation of Solar Radiation for Tomato Water Requirement Calculation in Chinese-Style Solar Greenhouses Based on Least Mean Squares Filter.

The area covered by Chinese-style solar greenhouses (CSGs) has been increasing rapidly. However, only a few pyranometers, which are fundamental for solar radiation sensing, have been installed inside CSGs. The lack of solar radiation sensing will bring negative effects in greenhouse cultivation such as over irrigation or under irrigation, and unnecessary power consumption. We aim to provide accurate and low-cost solar radiation estimation methods that are urgently needed. In this paper, a method of estimation of solar radiation inside CSGs based on a least mean squares (LMS) filter is proposed. The water required for tomato growth was also calculated based on the estimated solar radiation. Then, we compared the accuracy of this method to methods based on knowledge of astronomy and geometry for both solar radiation estimation and tomato water requirement. The results showed that the fitting function of estimation data based on the LMS filter and data collected from sensors inside the greenhouse was y = 0.7634x + 50.58, with the evaluation parameters of R2 = 0.8384, rRMSE = 23.1%, RMSE = 37.6 Wm-2, and MAE = 25.4 Wm-2. The fitting function of the water requirement calculated according to the proposed method and data collected from sensors inside the greenhouse was y = 0.8550x + 99.10 with the evaluation parameters of R2 = 0.9123, rRMSE = 8.8%, RMSE = 40.4 mL plant-1, and MAE = 31.5 mL plant-1. The results also indicate that this method is more effective. Additionally, its accuracy decreases as cloud cover increases. The performance is due to the LMS filter's low pass characteristic that smooth the fluctuations. Furthermore, the LMS filter can be easily implemented on low cost processors. Therefore, the adoption of the proposed method is useful to improve the solar radiation sensing in CSGs with more accuracy and less expense.

Lamellar rotation surgery: a new procedure for repairing upper eyelid defects.

BACKGROUND: To report "Lamellar Rotation Surgery",a new technique for repairing large and moderate full-thickness upper eyelid defects. METHODS: A two-stage technique is described in which a vertical incision is made in the tarsus of the lower eyelid with elevation of the lateral posterior lamella while sparing the lower eyelid orbicularis and skin to be rotated superiorly to form the reconstructed posterior lamella of the upper eyelid. Additionally, a lateral periosteal flap is used to reconstruct the lateral canthal tendon, and a McGregor procedure is used to reconstruct the anterior lamella of the upper eyelid. The flap is divided during a second-stage surgery at 3 months. Three cases are described to showcase this technique. RESULTS: Good functional and aesthetic results were achieved for the eyelids. CONCLUSIONS: This new procedure may help to address the challenge of repairing full-thickness defects of the upper eyelid. TRIAL REGISTRATION: Registration number: ChiCTR1800018990 , 20 Oct 2018, retrospectively registered.

Tract-based spatial statistics analysis of white matter changes in children with anisometropic amblyopia.

Amblyopia is a neurological disorder of vision that follows abnormal binocular interaction or visual deprivation during early life. Previous studies have reported multiple functional or structural cortical alterations. Although white matter was also studied, it still cannot be clarified clearly which fasciculus was affected by amblyopia. In the present study, tract-based spatial statistics analysis was applied to diffusion tensor imaging (DTI) to investigate potential diffusion changes of neural tracts in anisometropic amblyopia. Fractional anisotropy (FA) value was calculated and compared between 20 amblyopic children and 18 healthy age-matched controls. In contrast to the controls, significant decreases in FA values were found in right optic radiation (OR), left inferior longitudinal fasciculus/inferior fronto-occipital fasciculus (ILF/IFO) and right superior longitudinal fasciculus (SLF) in the amblyopia. Furthermore, FA values of these identified tracts showed positive correlation with visual acuity. It can be inferred that abnormal visual input not only hinders OR from well developed, but also impairs fasciculi associated with dorsal and ventral visual pathways, which may be responsible for the amblyopic deficiency in object discrimination and stereopsis. Increased FA was detected in right posterior part of corpus callosum (CC) with a medium effect size, which may be due to compensation effect. DTI with subsequent measurement of FA is a useful tool for investigating neuronal tract involvement in amblyopia.

Abnormal functional connectivity density in children with anisometropic amblyopia at resting-state.

Amblyopia is a developmental disorder resulting from anomalous binocular visual input in early life. Task-based neuroimaging studies have widely investigated cortical functional impairments in amblyopia, but changes in spontaneous neuronal functional activities in amblyopia remain largely unknown. In the present study, functional connectivity density (FCD) mapping, an ultrafast data-driven method based on fMRI, was applied for the first time to investigate changes in cortical functional connectivities in amblyopia during the resting-state. We quantified and compared both short- and long-range FCD in both the brains of children with anisometropic amblyopia (AAC) and normal sighted children (NSC). In contrast to the NSC, the AAC showed significantly decreased short-range FCD in the inferior temporal/fusiform gyri, parieto-occipital and rostrolateral prefrontal cortices, as well as decreased long-range FCD in the premotor cortex, dorsal inferior parietal lobule, frontal-insular and dorsal prefrontal cortices. Furthermore, most regions with reduced long-range FCD in the AAC showed decreased functional connectivity with occipital and posterior parietal cortices in the AAC. The results suggest that chronically poor visual input in amblyopia not only impairs the brain's short-range functional connections in visual pathways and in the frontal cortex, which is important for cognitive control, but also affects long-range functional connections among the visual areas, posterior parietal and frontal cortices that subserve visuomotor and visual-guided actions, visuospatial attention modulation and the integration of salient information. This study provides evidence for abnormal spontaneous brain activities in amblyopia.

Grey and white matter changes in children with monocular amblyopia: voxel-based morphometry and diffusion tensor imaging study.

AIMS: To investigate the potential morphological alterations of grey and white matter in monocular amblyopic children using voxel-based morphometry (VBM) and diffusion tensor imaging (DTI). METHODS: A total of 20 monocular amblyopic children and 20 age-matched controls were recruited. Whole-brain MRI scans were performed after a series of ophthalmologic exams. The imaging data were processed and two-sample t-tests were employed to identify group differences in grey matter volume (GMV), white matter volume (WMV) and fractional anisotropy (FA). RESULTS: After image screening, there were 12 amblyopic participants and 15 normal controls qualified for the VBM analyses. For DTI analysis, 14 amblyopes and 14 controls were included. Compared to the normal controls, reduced GMVs were observed in the left inferior occipital gyrus, the bilateral parahippocampal gyrus and the left supramarginal/postcentral gyrus in the monocular amblyopic group, with the lingual gyrus presenting augmented GMV. Meanwhile, WMVs reduced in the left calcarine, the bilateral inferior frontal and the right precuneus areas, and growth in the WMVs was seen in the right cuneus, right middle occipital and left orbital frontal areas. Diminished FA values in optic radiation and increased FA in the left middle occipital area and right precuneus were detected in amblyopic patients. CONCLUSIONS: In monocular amblyopia, cortices related to spatial vision underwent volume loss, which provided neuroanatomical evidence of stereoscopic defects. Additionally, white matter development was also hindered due to visual defects in amblyopes. Growth in the GMVs, WMVs and FA in the occipital lobe and precuneus may reflect a compensation effect by the unaffected eye in monocular amblyopia.