-
Journal of Binocular Vision and Ocular... Oct 2023Unilateral or asymmetric astigmatism is considered a principal refractive error leading to amblyopia and regular eye examinations should be carried out during childhood...
INTRODUCTION
Unilateral or asymmetric astigmatism is considered a principal refractive error leading to amblyopia and regular eye examinations should be carried out during childhood to prevent visual impairment. The aim of this study was to evaluate the prevalence of astigmatism and spectacle wear among Polish schoolchildren.
METHODS
A cross sectional study was carried out in children aged 6 to 14 years old from 50 schools in Poland. The presence of astigmatism was assessed by non-cycloplegic autorefraction, and defined as a cylinder equal or greater than 0.75 D. Children were classified as living in urban or rural areas according to the school location. Spectacle wear was defined as having spectacles at school.
RESULTS
The study included 1041 children and 52.3% were girls ( = 544). The mean age was 8.62 ± 2.04 years. The prevalence of astigmatism was 7.3% (95% confidence interval [CI]: 5.8-9.1%). Only 21.7% of children with astigmatism wore spectacles at school. Astigmatism was diagnosed in 8.2% of boys (95% CI: 6.0-11.0%) and 6.4% of girls (95% CI: 4.5-8.8%; = .13); cylindrical anisometropia was present in 19/76 (25.0%) of children with astigmatism (95% CI: 15.8%-36.3%). Against-the-rule astigmatism was the most common; it was observed in 48.7% of children with astigmatism, followed by with-the-rule astigmatism (44.7%) and oblique astigmatism (6.6%). The prevalence of astigmatism was not linearly correlated with age ( = 0.24; = .53). Gender, age and place of living were not significantly associated with the presence of astigmatism.
CONCLUSIONS
This study reports a low prevalence of astigmatism in Polish school children. However, the majority of children with astigmatism were uncorrected. Further longitudinal studies are warranted.
Topics: Male; Child; Female; Humans; Adolescent; Astigmatism; Poland; Prevalence; Eyeglasses; Cross-Sectional Studies
PubMed: 37526941
DOI: No ID Found -
American Journal of Medical Genetics.... Nov 2023Cardio-facio-cutaneous syndrome (CFCS) is a rare genetic disorder belonging to the RASopathies, a group of developmental syndromes caused by upregulated RAS/MAPK...
Cardio-facio-cutaneous syndrome (CFCS) is a rare genetic disorder belonging to the RASopathies, a group of developmental syndromes caused by upregulated RAS/MAPK signaling. Pathogenic variants affecting four genes, KRAS, BRAF, MAP2K1 and MAP2K2, encoding core signal transducers of the pathway, underlie the condition. Major clinical features include a distinctive facies, ectodermal and cardiac anomalies, reduced postnatal growth, intellectual disability, and musculoskeletal abnormalities. Similar to other RASopathies, reports of visual impairment, high refractive error, optic nerve pallor, and other ocular abnormalities have been anecdotally reported in the literature. The aim of our study is to report the prevalence of ophthalmologic abnormalities in a large monocentric cohort of individuals affected by CFCS and explore the occurrence of genotype-endophenotype correlations in this series of patients. We observed that BRAF mutations are associated to a higher prevalence of anisometropia >3D (11.8% vs. 0%) and high astigmatism (29.4% vs. 0%; both p < 0.001) while patients with mutations in other genes had a significantly higher prevalence of myopia >6 D (60% vs. 5.9%; p = 0.012). Pale optic disc was associated with higher prevalence of inferior oblique muscle (IO) overaction (33.3% vs. 0%) and lower prevalence of ptosis (0% vs. 11.8%; both p < 0.001). Combined exotropia, IO overaction and nystagmus were frequent in patients with pale optic nerve. Our findings might suggest the need for earlier ophthalmologic referral for CFCS patients due to high risk of amblyopia, especially those expressing BRAF mutations.
PubMed: 37697822
DOI: 10.1002/ajmg.a.63395 -
The British Journal of Ophthalmology Mar 2024The objective of this study was to assess the efficacy of low-dose atropine 0.01% in controlling myopia progression among Indian children over a 2-year period.
OBJECTIVE
The objective of this study was to assess the efficacy of low-dose atropine 0.01% in controlling myopia progression among Indian children over a 2-year period.
METHODS
This retrospective study, conducted across 20 centres in India, monitored the progression of myopia over 2 years after initiating treatment with 0.01% atropine eye drops. This included children between 6 and 14 years with baseline myopia ranging from -0.5 D to -6 D, astigmatism≤-1.5 D, anisometropia ≤ -1 D and documented myopia progression of ≥0.5 D in the year prior to starting atropine. Subjects with any other ocular pathologies were excluded.
RESULTS
A total of 732 children were included in the data analysis. The mean age of the subjects was 9.3±2.7 years. The mean myopia progression at baseline (1 year before starting atropine) was -0.75±0.31 D. The rate of myopia progression was higher in younger subjects and those with higher baseline myopic error. After initiating atropine, myopia progression significantly decreased to -0.27±0.14 D at the end of the first year and -0.24±0.15 D at the end of the second year (p0.001). Younger children (p<0.001) and higher baseline myopia (p<0.001) was associated with greater myopia progression and poor treatment response (p<0.001 for both).
CONCLUSION
Low-dose atropine (0.01%) effectively reduces myopia progression over 2 years in Indian children.
Topics: Child; Humans; Atropine; Retrospective Studies; Disease Progression; Myopia; Ophthalmic Solutions; Refraction, Ocular; Mydriatics
PubMed: 38290805
DOI: 10.1136/bjo-2023-324450 -
European Journal of Pediatrics Oct 2023This study aimed to determine the progression pattern of non-amblyopic anisomyopic children from ages 6 to 16 years. This retrospective study analyzed the electronic...
This study aimed to determine the progression pattern of non-amblyopic anisomyopic children from ages 6 to 16 years. This retrospective study analyzed the electronic medical records of 8680 myopic children who visited Sankara Nethralaya, Chennai, India over eight years (2009 to 2017). A total of 711 records were retrieved based on inclusion criteria. In addition, 423 records out of 711 had consecutive follow-up for three years (baseline plus three follow-up visits) and were considered to determine the progression pattern. The cycloplegic sphero-cylindrical refraction was taken for analysis and converted to vector notation of M (SE), J0, and J45. Anisomyopia referred to the interocular difference of myopic SE of ≥ 1 D whereas isomyopia referred to the interocular difference of myopic SE of < 1 D. Based on the refraction of the less ametropic eye, anisomyopes were further categorized into bilateral anisometropic myopia (BAM) and unilateral anisometropic myopia (UAM). The isomyopic cohort showed a mean annual progression of -0.49 ± 0.54 D (median [IQR] -0.38 D [{-0.75}-0.00]). In BAM, the mean annual progression of the more myopic eye was -0.45 ± 0.55 D (median [IQR] -0.38 D [{-0.75}-0.00]), and the less myopic eye was -0.37 ± 0.55 D (median [IQR] -0.25 D [{-0.63}-0.00]). This difference was significant (t (212) = -2.14, p < 0.05). In UAM, the myopic eyes (-0.39 ± 0.51 D; median [IQR] -0.25 D [{-0.75}-0.00]) showed a statistically significant higher mean annual progression compared to emmetropic eyes (-0.22 ± 0.36 D; median [IQR] 0.00 D [{-0.44}-0.00]; t (96) = -3.30, p < 0.001). In terms of progression trend, in the BAM group, the rate of change of mean SE between the more myopic and the less myopic eyes were similar (-1.12 ± 1.20 D; median [IQR] -1.13 D [{-2.00}-{-0.38}] vs. -1.05 ± 1.25 D; median [IQR] -0.88 D [{-1.75}-{-0.13}]; t (138) = -0.64, p > 0.05). However, the more myopic eyes of UAM showed a higher myopic trend compared to the emmetropic eyes (-1.37 ± 1.06 D; median [IQR] -1.32 D [{-2.13}-{-0.50}] vs. -0.96 ± 1.11 D; median [IQR] -0.75 D [{-1.56}-{-0.25}]; t (61) = -2.74, p < 0.05). Conclusion: Children with BAM and UAM eyes exhibit different progression patterns from each other. While the rate of the refractive shift in myopic eyes of UAM is similar to isomyopic eyes, BAM eyes present a slower rate of progression than isomyopic eyes. What is Known: • The rate of change of refraction in anisomyopes is higher compared to isomyopic children. • Less myopic eyes tend to shift towards more myopia while more myopic eyes show stable refraction. What is New: • The progression pattern of bilateral anisometropic myopia and unilateral anisometropic myopia differ from one another. • While the rate of the refractive shift in myopic eyes of unilateral anisometropic myopia is similar to isomyopic eyes, bilateral anisometropic myopia eyes present a slower rate of progression than isomyopic eyes. • The pattern of change in the interocular difference of anisometropia depends on the laterality (bilateral or unilateral ametropia), and degree of spherical equivalent in the more ametropic eye.
Topics: Child; Humans; Retrospective Studies; India; Refraction, Ocular; Myopia; Anisometropia
PubMed: 37462797
DOI: 10.1007/s00431-023-05088-9 -
Frontiers in Neuroscience 2023This study was conducted to reexamine the question of whether children treated for anisometropic amblyopia have contour integration deficits. To do so, we used...
PURPOSE
This study was conducted to reexamine the question of whether children treated for anisometropic amblyopia have contour integration deficits. To do so, we used psychophysical methods that require global contour processing while minimizing the influence of low-level deficits: visibility, shape perception, and positional uncertainty.
METHODS
Thirteen children with anisometropic amblyopia (age: 10.1 ± 1.8 years) and thirteen visually normal children (age: 10.8 ± 2.0 years) participated in this study. The stimuli were closed figures made up of Gabor patches either in noise or on a blank field. The contrast thresholds to detect a circular contour on a blank field, as well as the thresholds of aspect ratio and contour element number to discriminate a circular or elliptical contour in noise, were measured at Gabor spatial frequencies of 1.5, 3, and 6 cpd for amblyopic eyes (AEs), fellow eyes (FEs), and normal control eyes. Visual acuities and contrast sensitivity functions for AEs and FEs and the Randot stereoacuity were measured before testing.
RESULTS
The AEs showed contrast deficits and degraded shape perception compared to the FEs at higher spatial frequencies (6 cpd). When the influence of abnormal contrast sensitivity and shape perception were minimized, the AEs showed contour integration deficits at spatial frequencies 3 and 6 cpd. These deficits were not related to basic losses in contrast sensitivity and acuity, stereoacuity, and visual crowding. Besides, no significant difference was found between the fellow eyes of the amblyopic children and the normal control eyes in the performance of contour integration.
CONCLUSION
After eliminating or compensating for the low-level deficits, children treated for anisometropic amblyopia still show contour integration deficits, primarily at higher spatial frequencies, which might reflect the deficits in global processing caused by amblyopia. Contour integration deficits are likely independent of spatial vision deficits. Refractive correction and/or occlusion therapies may not be sufficient to fully restore contour integration deficits, which indicates the need for the development of clinical treatments to recover these deficits.
PubMed: 37564367
DOI: 10.3389/fnins.2023.1160853 -
Ophthalmic Plastic and Reconstructive...Congenital nasolacrimal duct obstruction is a known risk factor for amblyopia and anisometropia. The purpose of this study was to investigate whether the rate of...
PURPOSE
Congenital nasolacrimal duct obstruction is a known risk factor for amblyopia and anisometropia. The purpose of this study was to investigate whether the rate of anisometropia and amblyopia development differed based on the age at CNLDO resolution in older infants.
METHODS
This retrospective chart review at a single tertiary children's hospital from 2007 to 2017 compared early versus late spontaneous resolution (cutoff 12 months) and intervention (cutoff 15 months) groups presenting at ≥9 months of age, comparing visual outcomes, including anisometropia (≥1 D of sphere or cylinder) and amblyopia (≥2 levels difference in Teller acuity or optotype testing). Parents/guardians were contacted by phone for missing data on spontaneous resolution or intervention status.
RESULTS
A total of 462 patients were included (152 early; 310 late group). The early group presented at a median age of 12.0 (interquartile range: 10.0, 13.0) months, while the late group presented at 21.0 (interquartile range: 15.0, 32.0) months. Unilateral disease occurred in 62% and 59%, respectively. Anisometropia was seen in (12/102) 12% of early versus (25/243) 10% of late patients (p = 0.686, 95% CI: -0.059, 0.088), and amblyopia in (4/131) 3% of early versus (14/286) 5% of late patients (p = 0.322, 95% CI: -0.061, 0.018). In patients presenting <24 months without undergoing surgery, spontaneous resolution occurred in 76% between 12 and 24 months (n = 41).
CONCLUSIONS
Anisometropia and amblyopia rates did not significantly differ between early and delayed intervention for congenital nasolacrimal duct obstruction in this retrospective cohort presenting beyond 9 months of age to a children's hospital. This study found frequent late spontaneous resolution.
Topics: Infant; Child; Humans; Aged; Amblyopia; Lacrimal Duct Obstruction; Anisometropia; Retrospective Studies; Nasolacrimal Duct
PubMed: 38241617
DOI: 10.1097/IOP.0000000000002496 -
Journal of Optometry 2024To report the visual and refractive characteristics and the prevalence of amblyopia in patients with different types of Duane's Retraction Syndrome (DRS).
PURPOSE
To report the visual and refractive characteristics and the prevalence of amblyopia in patients with different types of Duane's Retraction Syndrome (DRS).
METHOD
This retrospective study was performed on hospital records of 582 DRS patients at Farabi Hospital, Iran, from 2012 to March 2022.
RESULTS
The mean age of patients was 19.4 ± 11.9 (range, 3-70) years [335 (57.6 %) females and 247 (42.4 %) males (P < .001)]. DRS type I, II, III, and IV were presented in 347 (59.6 %), 148 (25.4 %), 82 (14.1 %), and 5 (0.9 %) patients, respectively. There were 530 (91.1 %) patients with unilateral and 52 (8.9 %) with bilateral involvement. In the unilateral patients, the DRS eyes' corrected distance visual acuity (CDVA) and astigmatism were significantly worse than the Non-DRS Eyes (P < .001). The mean amount of all refractive and visual parameters in bilateral patients' right or left eyes was significantly lower than in unilateral patients' non-DRS eyes (all P < .05). Anisometropia was observed in 75(12.9 %) of the patients. Amblyopia was observed in 18.5 % (98 patients) and 36.5 % (19 patients) of unilateral and bilateral DRS patients, respectively (P < .001). In unilateral patients, amblyopia was found in 57 (16.4 %) patients with Type I, 22 (14.9 %) patients with Type II, 16 (19.5 %) patients with Type III, and 3 (60 %) patients with Type IV. Forty-four (37.6 %) of patients with amblyopia had anisometropia.
CONCLUSION
This large-scale study indicates that DRS types differ in terms of refractive error, visual acuity, and the prevalence of amblyopia and anisometropia. Clinicians should be aware of the clinical features associated with different types of DRS.
Topics: Humans; Amblyopia; Male; Female; Retrospective Studies; Adult; Visual Acuity; Child; Child, Preschool; Middle Aged; Young Adult; Adolescent; Aged; Iran; Duane Retraction Syndrome; Prevalence; Refraction, Ocular; Refractive Errors; Anisometropia
PubMed: 38215611
DOI: 10.1016/j.optom.2023.100508 -
BMC Ophthalmology Jun 2024Functional visual impairments in children are primarily caused by amblyopia or strabismus. This study aimed to determine the prevalence and clinical profile of amblyopia...
BACKGROUND
Functional visual impairments in children are primarily caused by amblyopia or strabismus. This study aimed to determine the prevalence and clinical profile of amblyopia and strabismus among individuals aged 3-16 years in Shanghai, China.
METHODS
From February 2023 to February 2024, this hospital-based, cross-sectional study included data of children who visited the Ophthalmology Department of Shanghai General Hospital. Comprehensive ocular examinations included visual acuity measurement after cycloplegic refraction, slit lamp examination, cover test, and dilated fundus examination. Descriptive statistics were performed to estimate the proportion and clinical characteristics of amblyopia and strabismus.
RESULTS
A total of 920 children were enrolled in our study. Among them, 223 (24.24%) children were identified as amblyopia. Unilateral amblyopia occupied 57.85%, and bilateral amblyopia occupied 42.15%. Most participants were within the age range of 5-10 years (75.97% for unilateral amblyopia, and 70.21% for bilateral amblyopia). Anisometropia was the primary cause of unilateral amblyopia (68.99%). Most amblyopic children have high hyperopia (38.76% for unilateral amblyopia, and 39.89% for bilateral amblyopia). 30 (3.26%) children were diagnosed with strabismus, and 19 (63.3%) of them were aged 5-10 years. Seven of the children had both strabismus and amblyopia.
CONCLUSION
The proportion of patients with amblyopia and strabismus was determined as 24.24% and 3.26% in our study. Anisometropia was the leading cause of unilateral amblyopia, whereas high hyperopia was a crucial refractive error in the amblyopic population. These findings shed light on further longitudinal studies targeting the age-related changes in amblyopia, strabismus and refraction errors. Therefore, efforts should be made to manage uncorrected refractive errors, amblyopia, and strabismus among children in Shanghai.
Topics: Humans; Amblyopia; China; Prevalence; Cross-Sectional Studies; Child; Child, Preschool; Adolescent; Female; Male; Strabismus; Refractive Errors; Visual Acuity; Age Distribution; Refraction, Ocular
PubMed: 38849757
DOI: 10.1186/s12886-024-03477-8 -
Investigative Ophthalmology & Visual... Apr 2024Individuals with amblyopia experience central vision deficits, including loss of visual acuity, binocular vision, and stereopsis. In this study, we examine the...
PURPOSE
Individuals with amblyopia experience central vision deficits, including loss of visual acuity, binocular vision, and stereopsis. In this study, we examine the differences in peripheral binocular imbalance in children with anisometropic amblyopia, strabismic amblyopia, and typical binocular vision to determine if there are systematic patterns of deficits across the visual field.
METHODS
This prospective cohort study recruited 12 participants with anisometropic amblyopia, 10 with strabismic amblyopia, and 10 typically sighted controls (age range, 5-18 years). Binocular imbalance was tested at 0°, 4°, and 8° eccentricities (4 angular locations each) using band-pass filtered Auckland optotypes (5 cycles per optotype) dichoptically presented with differing contrast to each eye. The interocular contrast ratio was adjusted until the participant reported each optotype with equal frequency.
RESULTS
Participants with anisometropic and strabismic amblyopia had a more balanced contrast ratio, or decreased binocular imbalance, at 4° and 8° eccentricities as compared with central vision. Participants with strabismic amblyopia had significantly more binocular imbalance in the periphery as compared with individuals with anisometropic amblyopia or controls. A linear mixed effects model showed a main effect for strabismic amblyopia and eccentricity on binocular imbalance across the visual field.
CONCLUSIONS
There is evidence of decreased binocularity deficits, or interocular suppression, in the periphery in anisometropic and strabismic amblyopia as compared with controls. Notably, those with strabismic amblyopia exhibited more significant peripheral binocular imbalance. These variations in binocularity across the visual field among different amblyopia subtypes may necessitate tailored approaches for dichoptic treatment.
Topics: Humans; Amblyopia; Vision, Binocular; Male; Female; Child; Prospective Studies; Adolescent; Strabismus; Visual Acuity; Visual Fields; Child, Preschool; Anisometropia; Depth Perception
PubMed: 38652649
DOI: 10.1167/iovs.65.4.36 -
American Journal of Ophthalmology Case... Dec 2023To report Vogt-Koyanagi-Harada (VKH) disease in a patient with extreme anisometropia.
PURPOSE
To report Vogt-Koyanagi-Harada (VKH) disease in a patient with extreme anisometropia.
OBSERVATIONS
A 56-year-old woman was referred to our hospital. Her past medical history was significant for amblyopia in the right eye. At the initial visit, decimal best-corrected visual acuity (BCVA) was 0.03 (Snellen equivalent 5/160) in the right eye and 0.03 (Snellen equivalent 5/160) in the left eye, and axial length was 28.44 mm and 22.36 mm, respectively. Anterior chamber inflammation was seen predominantly in the right eye with fibrin exudates. Swept-source optical coherence tomography demonstrated choroidal thickening and folds predominantly in the left eye. Additionally, serous retinal detachment (SRD) was much more evident in the left eye than in the right eye. Subfoveal choroidal thickness (SCT) was 417 μm in the right and over 800 μm in the left eye. Cerebrospinal fluid examination revealed lymphocyte-dominant hypercellularity. Based on these findings, we diagnosed the patient with VKH disease and treated her with a high-dose systemic corticosteroid. One month after the initiation of treatment, SRD in both eyes fully resolved, and SCT decreased to 105 μm in the right and 311 μm in the left eye.
CONCLUSIONS AND IMPORTANCE
The marked discrepancy in axial length between the right and left eyes might contribute to the different severity of inflammation in VKH disease.
PubMed: 37771387
DOI: 10.1016/j.ajoc.2023.101929