-
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 -
Heliyon Jun 2024Understanding the pathophysiology of the macula in amblyopic eyes is an active research area.
IMPORTANCE
Understanding the pathophysiology of the macula in amblyopic eyes is an active research area.
OBJECTIVE
To correlate macular retinal vascular density changes with best-corrected visual acuity changes following occlusion therapy for amblyopia in children.
DESIGN
A prospective cohort study of children visiting the Pediatric Ophthalmology Division of our institution between January 2020 and January 2022 was conducted.
SETTING
A specialist eye hospital in Saudi Arabia.
PARTICIPANTS
Thirty children with unilateral amblyopia.
EXPOSURE
Occlusion therapy for amblyopia.Main Outcome and Measures: Best corrected visual acuity (logMAR) before and at each of the four optical coherence tomographic angiographies was compared in amblyopic and fellow eyes. The effect of pretreatment determinants on the correlation between best-corrected visual acuity and retinal vascular density changes was reviewed.
RESULTS
In this cohort of 30 amblyopic and 30 fellow eyes from 30 children (mean age 8.7 ± 1.4 years; male: female 18:12. The best-corrected visual acuity improved from a median of 0.6 (interquartile range 0.5; 1.1) pretreatment to a median of 0.4 (interquartile range 0.2; 0.6) posttreatment in amblyopic eyes, and from a median of 0.1 to 0.05 in the fellow eyes. The total percentage change in retinal vascular density in the amblyopic eye was significantly higher than that in the fellow eye ( = -1.92, = 0.05). The change in best-corrected visual acuity in the amblyopic eye after a median of 98 months (interquartile range, 69-126 months) of intervention was significantly correlated with the refraction-adjusted change in retinal vascular density ( = -0.03, 95 % confidence interval -0.04, -0.02, < 0.001) and was influenced by strabismus ( = -0.46, 95 % confidence interval -0.59, -0.34, < 0.001), type of amblyopia ( = 0.24, 95 % confidence interval 0.12, 0.36, < 0.001), duration of occlusion ( = -0.43, 95 % confidence interval -0.65, -0.22, < 0.001), and occlusion compliance ( = 0.24, 95 % confidence interval 0.11, 0.36, < 0.001).
CONCLUSIONS
and Relevance: The RVD in amblyopic eyes in the first six months of therapy was significantly lower than that in fellow eyes, but not in subsequent assessments.
PubMed: 38845943
DOI: 10.1016/j.heliyon.2024.e31899 -
The Neuroscientist : a Review Journal... Jun 2024The current study investigates the intricate connection between neurology and islands shedding light on the historical, epidemiological, and genetic aspects. Based on an...
The current study investigates the intricate connection between neurology and islands shedding light on the historical, epidemiological, and genetic aspects. Based on an elaborate literature review, we identified neurological conditions having a significant clustering in an island(s), confined to a particular island(s), named after an island, and described first in an island. The genetic factors played a crucial role, uncovering disorders like Cayman ataxia, Machado Joseph disease, SGCE-mediated dystonia-myoclonus syndrome, X-linked dystonia parkinsonism, hereditary transthyretinrelated amyloidosis, Charcot Marie Tooth 4F, and progressive myoclonic epilepsy syndromes, that exhibited remarkable clustering in diverse islands. Local customs also left enduring imprints. Practices such as cannibalism in Papua New Guinea led to Kuru, while cycad seed consumption in Guam triggered Lytico-Bodig disease. Toxin-mediated neurologic disorders exhibited intricate island connections, exemplified by Minamata disease in Kyushu islands and atypical parkinsonism in French Caribbean islands. Additionally, the Cuban epidemic of amblyopia and neuropathy was associated with severe nutritional deficiencies. This study pioneers a comprehensive review narrating the genetic, environmental, and cultural factors highlighting the spectrum of neurological disorders in island settings. It enriches the medical literature with a unique understanding of the diverse influences shaping neurological health in island environments.
PubMed: 38842035
DOI: 10.1177/10738584241257927 -
Neuroscience Bulletin Jun 2024Abnormal visual experience during the critical period can cause deficits in visual function, such as amblyopia. High magnesium (Mg) supplementary can restore ocular...
Abnormal visual experience during the critical period can cause deficits in visual function, such as amblyopia. High magnesium (Mg) supplementary can restore ocular dominance (OD) plasticity, which promotes the recovery of amblyopic eye acuity in adults. However, it remains unsolved whether Mg could recover binocular vision in amblyopic adults and what the molecular mechanism is for the recovery. We found that in addition to the recovery of OD plasticity, binocular integration can be restored under the treatment of high Mg in amblyopic mice. Behaviorally, Mg-treated amblyopic mice showed better depth perception. Moreover, the effect of high Mg can be suppressed with transient receptor potential melastatin-like 7 (TRPM7) knockdown. Collectively, our results demonstrate that high Mg could restore binocular visual functions from amblyopia. TRPM7 is required for the restoration of plasticity in the visual cortex after high Mg treatment, which can provide possible clinical applications for future research and treatment of amblyopia.
PubMed: 38833201
DOI: 10.1007/s12264-024-01242-x -
Cureus May 2024The purpose of this case report is to report a case of congenital idiopathic enlargement of extraocular muscles. A four-month-old girl showed limitation of adduction and...
The purpose of this case report is to report a case of congenital idiopathic enlargement of extraocular muscles. A four-month-old girl showed limitation of adduction and supraduction in the right eye. A computerized axial tomography (CAT) scan revealed hypertrophy of the lateral rectus muscle and inferior rectus muscle of the right eye. Thyroid hormone and antibody levels were normal. No inflammatory findings on magnetic resonance imaging (MRI). A traction test under general anesthesia revealed a strong limitation of supraduction and a mild limitation of adduction. Therefore, the inferior rectus muscle was recessed 4.5 mm at the age of six months. A partial biopsy of the inferior rectus showed no inflammatory cell infiltration. After the first surgery, the patient's limitation of supraduction improved, but the limitation of adduction persisted. So, a 5 mm recession of the right lateral rectus muscle was added at one year and one month. However, the hypertropia of the sound eye became stronger after treatment of amblyopia. Because of the strong limitation of supraduction, tenotomy of the inferior rectus was performed at the age of six years. Postoperatively, no impairment of infraduction occurred, and the limitation of supraduction was mildly improved. Since the findings on MRI were not changed through our observation period, we concluded that the patient had idiopathic external ophthalmoplegia.
PubMed: 38826915
DOI: 10.7759/cureus.59496 -
Cureus May 2024Aphakia is a condition in which the eye's crystalline lens is not in its proper position because of a perforating injury, surgical removal, dislocation of the lens, or... (Review)
Review
Aphakia is a condition in which the eye's crystalline lens is not in its proper position because of a perforating injury, surgical removal, dislocation of the lens, or congenital anomaly. The management of aphakia can be either conservative or surgical. Various surgical techniques could be used, including retro pupillary-fixated iris-claw intraocular lenses (IOLs) and anterior-fixated iris-claw IOLs. One of the challenges faced by ophthalmologists is the optical rehabilitation of pediatric aphakic patients because a child's eye is still growing, resulting in fundamental variations in their refractive elements, and the immature visual system faces the risks of amblyopia development in the case of defocus or inequality of visual input between both eyes. There is also the risk of the incidence of side effects that can be accepted in adults but not in children. Finally, accurate postoperative supervision and optical rehabilitation in pediatrics will be more complex than that in adults. This review showed that it is possible to place, replace, and exchange the Artisan IOL with minor surgical trauma. Hence, this procedure can be an acceptable therapeutic method for correcting the developmental refractive changes of the growing aphakic eye. However, some worries are still caused by probable long-term side effects, including endothelial cell loss. Finally, a significant attempt at visual rehabilitation is to treat pediatric aphakia with Artisan IOL.
PubMed: 38826882
DOI: 10.7759/cureus.59435 -
[Zhonghua Yan Ke Za Zhi] Chinese... Jun 2024Multifocal intraocular lenses (MIOLs) have demonstrated efficacy and safety in adult cataract surgery, yet they encounter many challenges in pediatric applications. This...
Multifocal intraocular lenses (MIOLs) have demonstrated efficacy and safety in adult cataract surgery, yet they encounter many challenges in pediatric applications. This article elaborates on the difficulties in biometric measurements in children, the unpredictability of postoperative refraction outcomes, the lack of long-term spectacle independence in children with MIOLs, the absence of significant advantages in correcting childhood amblyopia, and the potential increase in the rate of secondary surgeries. Due to the insufficient clinical evidence supporting the use of MIOLs in children at present, it is proposed that MIOLs be cautiously applied to children with congenital cataracts in clinical practice. Further research in this area is encouraged.
Topics: Humans; Cataract; Child; Lens Implantation, Intraocular; Cataract Extraction; Lenses, Intraocular; Multifocal Intraocular Lenses; Refraction, Ocular; Amblyopia; Visual Acuity
PubMed: 38825948
DOI: 10.3760/cma.j.cn112142-20240325-00139 -
IScience Jun 2024Within the population of humans with otherwise normal vision, there exists some proportion whose ability to perceive depth from binocular disparity is poor or absent....
Within the population of humans with otherwise normal vision, there exists some proportion whose ability to perceive depth from binocular disparity is poor or absent. The prevalence of this "stereo-anomaly" has been reported to be as small as 2%, or as great as 30%. We set out to investigate this discrepancy. We used a digital tool to measure stereoacuity in tasks requiring either the detection of disparity or the discrimination of the direction of disparity. In a cohort of 228 participants, we found that 98% were able to consistently perform the detection task. Of these, only 69% consistently performed the discrimination task. The 31% of participants who had difficulty with the discrimination task could further be divided into 17% who were consistently unable to perform the task and 14% who showed limited ability. This suggests that identification of the direction of disparity requires further processing beyond merely detecting its presence.
PubMed: 38812554
DOI: 10.1016/j.isci.2024.109879 -
The British and Irish Orthoptic Journal 2024The preschool orthoptics visual screening program began in Brunei Darussalam in 2004 to detect amblyopia, a common cause of treatable visual disorders in children....
BACKGROUND
The preschool orthoptics visual screening program began in Brunei Darussalam in 2004 to detect amblyopia, a common cause of treatable visual disorders in children. Amblyopia can be asymptomatic, easily missed, and cause permanent adverse visual consequences; hence, it is necessary to be screened. The parental role in ensuring timely visual screening is pivotal to their child's visual well-being and educational success. This study explored parental awareness and reasons for their nonattendance.
METHODS
A cross-sectional study of 401 parents was conducted in the Brunei-Muara district in private kindergarten schools and maternal and child health clinics. A self-designed and self-administered questionnaire was used. Data collected was analysed using RStudio in the form of descriptive and analytic statistics.
RESULTS
The study findings showed that 52.8% defaulted their screening and there was a significant association between parental awareness and the defaulters ( < 0.05). Only 39.9% of parents were aware of the screening service availability, and 50.1% had not taken their children for an eye check. The most significant sociodemographic factor that influenced awareness of the importance of vision screening was parental employment status ( = 0.013), revealing a 4.43 times higher likelihood of default if the father was unemployed. This study found that with each additional child, parents are 1.25 times less likely to seek eye screening ( < 0.05).
CONCLUSIONS
The main reason for nonattendance was a lack of awareness of the situation and parents believed that their children were seeing well. Mitigating child visual screening defaults requires a community-focused approach.
PubMed: 38799230
DOI: 10.22599/bioj.349