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Oman Journal of Ophthalmology 2024Purpose was to determine the prevalence of amblyopia and its related risk factors in children aged 3-6 years in Bojnurd, north-eastern Iran.
BACKGROUND
Purpose was to determine the prevalence of amblyopia and its related risk factors in children aged 3-6 years in Bojnurd, north-eastern Iran.
MATERIALS AND METHODS
In this cross-sectional study, from 12,331 children aged 3-6 in Bojnurd, 6600 children participated in annual amblyopic screening program and among them, around 1100 suspected cases were referred for full ophthalmic examinations. Measurement of visual acuity, cycloplegic refraction, subjective refraction, and cover test were performed for all participants. Amblyopia was defined as CDVA of 0.2 LogMar or less in each eye or 2-line difference or more in best-corrected visual acuity between two eyes.
RESULTS
The prevalence of amblyopia was estimated 0.95% (95% confidence interval [CI]: 0.73%-1.2%). There was no relationship between amblyopia with age and genders. Most amblyopic children were hyperopic (61.9%; 95% CI: 48.7-73.8). Strabismus was found in 17.4% of amblyopic patients (95% CI: 9.05%-29.09%). Approximately half of the amblyopic children were anisometropic (55.5%; 95% CI: 42.40%-68.08%). The most common type of amblyopia was anisohyperopic (55.56%; 95% CI: 42.5%-67.5%). The prevalence of bilateral amblyopia was more than unilateral amblyopia. The assessment of data showed that hyperopia, astigmatism, and anisometropia were the most common causes of amblyopia in this study.
CONCLUSIONS
The prevalence of amblyopia was estimated about 1% in north-eastern Iran. Our study indicated a valuable information around the effect of refractive error and anisometropia on amblyopia which could be helpful in designing a comprehensive vision screening program for preschool children.
PubMed: 38524325
DOI: 10.4103/ojo.ojo_295_22 -
The British Journal of Ophthalmology Mar 2024The purpose of this study was to assess the prevalence of strabismus and nystagmus and to analyse associated factors in preterm and full-term infants in adulthood.
AIM
The purpose of this study was to assess the prevalence of strabismus and nystagmus and to analyse associated factors in preterm and full-term infants in adulthood.
METHODS
The Gutenberg Prematurity Eye Study is a retrospective cohort study with a prospective ophthalmological examination of participants born preterm and full-term (aged 18-52 years). Perinatal data were carefully assessed for risk factors and comprehensive ophthalmological examinations were conducted. The association between strabismus and nystagmus was assessed by analysing 16 different perinatal and actual risk factors in multivariable analysis. Participants were grouped into full-term controls (gestational age (GA) at birth ≥37 weeks), preterm participants without retinopathy of prematurity (ROP) and GA 33-36 weeks (group 2), GA 29-32 weeks (group 3), GA ≤28 weeks (group 4), non-treated ROP (group 5) and treated ROP (group 6).
RESULTS
In total, 892 eyes of 450 preterm and full-term individuals (mean age: 28.6 years, SD: ± 8.6 years, 251 females) were included. Strabismus was observed in 2.1% (3/140), 6.6% (9/137), 17.4% (16/92), 11.1% (2/18), 27.1% (13/48) and 60% (9/15) of participants and nystagmus in 0.7% (1/140), 1.5% (2/137), 4.3% (4/92), 5.6% (1/18), 10.4% (5/48) and 26.7% (4/15) of participants in the respective groups. In the multivariable regression model, strabismus was associated with GA (OR=0.90; p=0.046), anisometropia ≥1.5 diopter (OR=3.87; p=0.003), hypermetropia ≥2 diopter (OR=9.89; p<0.001) and astigmatism ≥1.5 diopter (OR=2.73; p=0.017). Esotropia was more frequent than exotropia and hypermetropia/hypometropia. Most strabismus cases occurred within the first 10 years of life. The strongest predictor associated with nystagmus was perinatal adverse events (OR=15.8; p=0.002).
CONCLUSION
Low GA and refraction of the eye are independent risk factors for strabismus, which typically occurs in the first 10 years of life. Perinatal adverse events are the most important factors for the presence of nystagmus in adulthood.
PubMed: 38503479
DOI: 10.1136/bjo-2023-324698 -
Frontiers in Medicine 2024To analyze and compare the temporal trends in the incidence of anisometropia among Chinese school-aged children both before and during the COVID-19 pandemic, and to...
OBJECTIVE
To analyze and compare the temporal trends in the incidence of anisometropia among Chinese school-aged children both before and during the COVID-19 pandemic, and to investigate the impact of the pandemic on the incidence of anisometropia.
METHODS
We conducted a retrospective study comprising six distinct and independent longitudinal cohorts, each including children aged 6 to 13 years who visited the Joint Shantou International Eye Center between January 2010 and December 2021. Children were grouped into cohorts based on the year of their first eye clinic visit: 2010, 2012, 2014, 2016, 2018, or 2020. Only children without anisometropia at initial visits, followed for 18 ± 6 months, were included. The cumulative incidence and risk factors of anisometropia were analyzed using Kaplan-Meier estimation and Cox proportional hazards regression models. Subgroup analyses were performed based on sex, age groups, initial refractive error status, and initial interocular SE difference. Anisometropic children were further categorized into myopic and non-myopic, with subsequent subgroup analyses conducted.
RESULTS
Of 11,235 children were recruited from six cohorts (2010: = 1,366; 2012: = 1,708; 2014: = 1,896; 2016: = 2,354; 2018: = 2,514; 2020: = 1,397), 869 children developed anisometropia during a mean follow-up of 17.5 ± 3.7 months. After adjustment of confounding factors, we found that the risk of anisometropia remained relatively stable before 2020 but significantly increased in the 2020 cohort (adjusted HR 2.93, 95% CI 2.23 to 3.86; < 0.001). This trend persisted in studies of spherical anisometropia (adjusted HR 2.52, 95% CI 1.60 to 3.97; < 0.001) and cylindrical anisometropia (adjusted HR 2.91, 95% CI 1.69 to 3.62; < 0.001). Older age and a greater initial difference in SE between the two eyes were also significantly associated with a higher risk of developing anisometropia ( < 0.001). Subgroup analyses consistently showed increased risk in the 2020 cohort.
CONCLUSION
This study reveals a concerning rise in anisometropia incidence among Chinese school-aged children during the period of the COVID-19 pandemic. These findings highlight the worrisome rise in anisometropia risk during the COVID-19 pandemic and emphasize the importance of early detection and management to safeguard children's visual health.
PubMed: 38410753
DOI: 10.3389/fmed.2024.1322402 -
BioRxiv : the Preprint Server For... Feb 2024We employed high-resolution functional MRI (fMRI) to distinguish the impacts of anisometropia and strabismus (the two most frequent causes of amblyopia) on the evoked...
We employed high-resolution functional MRI (fMRI) to distinguish the impacts of anisometropia and strabismus (the two most frequent causes of amblyopia) on the evoked ocular dominance (OD) response. Sixteen amblyopic participants (8 females), comprising 8 individuals with strabismus, 7 with anisometropia, 1 with deprivational amblyopia, along with 8 individuals with normal visual acuity (1 female), participated in this study for whom, we measured the difference between the response to stimulation of the two eyes, across early visual areas (V1-V4). In controls, as expected from the organization of OD columns, the evoked OD response formed a striped pattern that was mostly confined to V1. Compared to controls, the OD response in amblyopic participants formed larger fused patches that extended into downstream visual areas. Moreover, both anisometropic and strabismic participants showed stronger OD responses in V1, as well as in downstream visual areas V2-V4. Although this increase was most pronounced in V1, the correlation between the OD response level and the interocular visual acuity difference (measured behaviorally) was stronger in higher-level visual areas (V2-V4). Beyond these common effects, and despite similar densities of amblyopia between the anisometropic and strabismic participants, we found a greater increase in the size of V1 portion that responded preferentially to fellow eye stimulation in anisometropic compared to strabismic individuals. We also found a greater difference between the amplitudes of the response to binocular stimulation, in those regions that responded preferentially to the fellow vs. amblyopic eye, in anisometropic compared to strabismic subjects. In contrast, strabismic subjects demonstrated increased correlation between the OD responses evoked within V1 superficial and deep cortical depths, whereas anisometropic subjects did not. These results provide some of the first direct functional evidence for distinct impacts of strabismus and anisometropia on the mesoscale functional organization of the human visual system, thus extending what was inferred previously about amblyopia from animal models.
PubMed: 38405701
DOI: 10.1101/2024.02.11.579855 -
Children (Basel, Switzerland) Feb 2024Different designs of ophthalmic lenses have been studied to control the progression of myopia in children. This study aims to evaluate the short-term efficacy of a new...
BACKGROUND
Different designs of ophthalmic lenses have been studied to control the progression of myopia in children. This study aims to evaluate the short-term efficacy of a new design of ophthalmic lens with asymmetric myopic peripheral defocus (MPDL) on myopia progression in children compared to a control group wearing a single-vision lens (SVL).
METHODS
Children aged 5 to 12 with myopia up to -0.50 D, astigmatism and anisometropia under 1.50 D, and corrected visual acuity over 20/20 were randomized to either the study group (MPDL) or control group (SVL). The myopia progression was evaluated by measuring axial length (AL) growth (IOL Master; Zeiss) over a period of one year.
RESULTS
Ninety-two subjects were recruited. Forty-six children were randomly assigned to the control group, and 46 to the study group. In total, 83 children completed the clinical trial, with a mean age of 10.81 [9.53-11.92] years, among which 59.04% were female. After one year of treatment, there was less AL elongation in the study group compared to the control group (0.16 ± 0.16 mm vs. 0.24 ± 0.16 mm, = 0.034).
CONCLUSIONS
The MPDL significantly reduced the absolute growth of AL by 39% ( = 0.014) and relative growth of AL by 37.3% ( = 0.012) after 12 months in comparison to the control group in a Spanish population.
PubMed: 38397289
DOI: 10.3390/children11020177 -
Scientific Reports Feb 2024This cross-sectional study aims to investigate the prevalence and causes of visual impairment (VI) and blindness in Jiangsu Province, China in 2022 during the COVID-19...
This cross-sectional study aims to investigate the prevalence and causes of visual impairment (VI) and blindness in Jiangsu Province, China in 2022 during the COVID-19 pandemic. Participants (n = 13,208, aged 18-93) underwent comprehensive ocular examinations. The prevalence and causes of binocular VI (presenting visual acuity [VA] ≥ 20/400 and < 20/63 in the better eye) and blindness (presenting VA < 20/400 in the better eye) were assessed according to the World Health Organization (WHO) criteria. The estimation of refractive error prevalence was conducted using the following classification: myopia ≤ - 0.50 diopters (D), high myopia ≤ - 6.00 D, hyperopia ≥ 0.50 D, and anisometropia ≥ 1.00 D. The overall prevalence of binocular VI and blindness was 21.04% (95% confidence interval [CI] 20.35-21.74%) and 0.47% (95% CI 0.37-0.60%). The highest prevalence of binocular VI was in the population aged 18-24 years old (46.29%, [95% CI 44.30-48.28%]), those with education at university and above (43.47%, [95% CI 41.93-45.02%]), students (54.96%, [95% CI 52.73-57.17%]). Uncorrected refractive error (URE) was the leading cause of presenting binocular VI (93.40%) and blindness (50.79%). The prevalence of myopia was 54.75% (95% CI 53.90-55.60%). Actions are needed to control URE and myopia within the adult Chinese population, with a particular emphasis on the younger, well-educated demographic.
Topics: Adult; Humans; Adolescent; Young Adult; Cross-Sectional Studies; Visually Impaired Persons; Prevalence; Pandemics; COVID-19; Blindness; Vision, Low; Refractive Errors; Myopia; China
PubMed: 38365946
DOI: 10.1038/s41598-024-54325-0 -
PeerJ 2024Accurate differentiation between stereopsis assessments in the natural and dichoptic presentation states has proven challenging with commercial stereopsis measurement...
BACKGROUND
Accurate differentiation between stereopsis assessments in the natural and dichoptic presentation states has proven challenging with commercial stereopsis measurement tools. This study proposes a novel method to delineate these differences more precisely.
METHODS
We instituted two stereopsis test systems predicated on a pair of 4K smartphones and a modified Frisby Near Stereotest (FNS) version. Stereoacuity was evaluated both in the natural environment state ( the modified FNS) and the dichoptic state ( smartphones). Thirty subjects aged 20 to 28 years participated in the study with the best-corrected visual acuity (VA) of each eye no less than 0 logMAR and stereoauity of no worse than 40″. Varying degrees of monocular VA loss were induced using the fogging method, while this study does not explore conditions where the VA of both eyes is worse than 0 logMAR.
RESULTS
When the VA difference between the two eyes did not exceed 0.2 logMAR, the modified FNS produced lower stereoacuity values compared to the 4K smartphones (Wilcoxon signed-rank test: difference = 0 logMAR, = -3.879, < 0.001; difference = 0.1 logMAR, = -3.478, = 0.001; difference = 0.2 logMAR, = -3.977, < 0.001). Conversely, no significant differences were observed when the binocular vision difference exceeded 0.2 logMAR (difference = 0.3 logMAR, = -1.880, = 0.060; difference = 0.4 logMAR, = -1.784, = 0.074; difference = 0.5 logMAR, = -1.812, = 0.070).
CONCLUSION
The findings suggest that stereoacuity values measurements taken in the natural environment state surpass those derived from the dichoptic presentation. However, the observed difference diminishes as stereopsis decreases, corresponding to an increase in induced anisometropia.
Topics: Humans; Smartphone; Depth Perception; Visual Acuity; Eye; Vision, Binocular
PubMed: 38361768
DOI: 10.7717/peerj.16941 -
Journal of Clinical Medicine Jan 2024: To analyze the factors associated with surgical outcomes after bilateral rectus recession (BLR) in children with intermittent exotropia (IXT). A retrospective study...
: To analyze the factors associated with surgical outcomes after bilateral rectus recession (BLR) in children with intermittent exotropia (IXT). A retrospective study was performed on 125 patients who had all received preoperative patch treatment with a ≥1 year follow-up. The surgical outcomes were grouped as success (esodeviation ≤5 PD to exodeviation ≤10 PD) or failure (esodeviation >5 PD or exodeviation >10 PD) according to the angle of deviation at 1 year postoperatively. The patients' magnitude of exodeviation, near and distant stereoacuity, and 3-mo patch responses were assessed. The factors associated with the surgical outcomes were determined using univariate and multivariate analyses. Of the 125 patients, 102 (81.6%) and 23 (18.4%) were assigned to the success and failure groups, respectively. According to the univariate analysis, the absence of anisometropia, a smaller preoperative near exodeviation, a better near stereopsis, a smaller magnitude of deviation on day 1 postoperatively, and response to patching were significantly associated with surgical success for IXT after 1 year. In the multivariate analysis, distant esotropic deviation on day 1 postoperatively and response to patching were the factors affecting successful surgical outcomes. Esotropic distant deviation on day 1 postoperatively is a prognostic factor for favorable surgical outcomes. Preoperative patching could be a factor influencing surgical success in children with IXT.
PubMed: 38337425
DOI: 10.3390/jcm13030731 -
Journal of Pediatric Ophthalmology and... 2024A 15-year-old boy whose anisometropic amblyopia was effectively treated with glasses was examined. Despite years of stability, his visual acuity decreased from 20/20 to...
A 15-year-old boy whose anisometropic amblyopia was effectively treated with glasses was examined. Despite years of stability, his visual acuity decreased from 20/20 to 20/60 with poor glasses compliance. Although amblyopia recurrence is well recognized, this case emphasizes potential late recurrence after prolonged success. Fortunately, he improved to 20/20 after improved compliance. .
Topics: Male; Humans; Adolescent; Amblyopia; Visual Acuity; Strabismus; Anisometropia
PubMed: 38306235
DOI: 10.3928/01913913-20231214-05 -
AJPM Focus Apr 2024The purpose of this study is to assess the prevalence of comprehensive eye examinations in multiethnic preschool children, including children with visually significant...
INTRODUCTION
The purpose of this study is to assess the prevalence of comprehensive eye examinations in multiethnic preschool children, including children with visually significant eye conditions, and identify factors associated with comprehensive eye examinations.
METHODS
A sample of 9,197 African American, Hispanic, Asian American, and non-Hispanic White children aged 6-72 months was recruited for the Multi-Ethnic Pediatric Eye Disease Study from 2003 to 2011. Logistic regression performed in 2022 identified independent factors associated with parent-reported history of comprehensive eye examinations. The proportion of children with previous comprehensive eye examinations and the proportion with undetected amblyopia or strabismus were measured.
RESULTS
The prevalence of comprehensive eye examinations was 6.3% overall and 38.3%, 24.8%, 19.1%, 15.1%, and 9.8% among children with strabismus, amblyopia, significant anisometropia, hyperopia, and astigmatism, respectively. Children without prior comprehensive eye examinations were more likely to have undetected amblyopia or strabismus than those with comprehensive eye examination history (s<0.001). The prevalence of comprehensive eye examinations was higher among older children. Prevalence varied by race/ethnicity, with 8.1%, 7.9%, 6.3%, and 4.9% of non-Hispanic White, Asian American, African American, and Hispanic children having had prior comprehensive eye examinations, respectively; however, the differences did not remain after adjusting for other associated factors. Older age, a primary caregiver with a college/university degree or higher, having vision insurance, gestational age <33 weeks, neurodevelopmental disorder diagnosis, strabismus, and ocular disease history were all statistically significantly associated with a relatively higher prevalence of comprehensive eye examinations in multivariable analyses.
CONCLUSIONS
Comprehensive eye examinations were uncommon among preschool children, including those with treatable vision disorders. Interventions, such as parent education and vision insurance, are needed to imaprove comprehensive eye examination access and utilization for at-risk preschool children.
PubMed: 38283739
DOI: 10.1016/j.focus.2024.100184