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Journal of Pediatric Ophthalmology and... Jun 2024To contribute evidence about the effectiveness of dichoptic therapy in patients with mild to moderate amblyopia.
PURPOSE
To contribute evidence about the effectiveness of dichoptic therapy in patients with mild to moderate amblyopia.
METHODS
A retrospective study was conducted in patients enrolled for dichoptic therapy on the Bynocs AmblyGo platform (Kanohi Eye Pvt Ltd) from January to August 2023. Data collected included logarithm of the minimum angle of resolution best corrected visual acuity, anterior and posterior segment examination, fixation pattern, dynamic and cycloplegic refraction, orthoptic evaluation, and number of dichoptic therapy sessions. Visual acuity, binocularity, and stereopsis before and after therapy were analyzed.
RESULTS
Of 59 patients (median age: 11 years, range: 5 to 30 years) enrolled, 34 (57.6%) had anisometropic amblyopia, 12 (20.3%) had ametropic amblyopia, 10 (17.0%) had strabismic amblyopia, and 3 (5.1%) had deprivation amblyopia. All 6 (10.2%) and 15 (22.4%) patients who had no binocular single vision for near and distance before therapy, respectively, attained normal binocular single vision on completion, except one who suppressed at distance. Twenty-one (75.0%) had improved near stereopsis, and 21 (60.0%) had improved distance stereopsis. Of 74 eyes treated, 61 (82.4%) had improved visual acuity and 73 (98.6%) improved in at least one tested parameter. A majority of these eyes had residual amblyopia after occlusion therapy.
CONCLUSIONS
Dichoptic therapy improves visual acuity, binocularity, and stereoacuity in patients with amblyopia, including those older than 8 years, especially in partial deprivation, ametropic, and anisometropic amblyopia. .
PubMed: 38940308
DOI: 10.3928/01913913-20240521-03 -
Bioengineering (Basel, Switzerland) Jun 2024In recent years, the use of smartphones and other wireless technology in medical care has developed rapidly. However, in some cases, especially for pediatric medical... (Review)
Review
In recent years, the use of smartphones and other wireless technology in medical care has developed rapidly. However, in some cases, especially for pediatric medical problems, the reliability of information accessed by mobile health technology remains debatable. The main aim of this paper is to evaluate the relevance of smartphone applications in the detection and diagnosis of pediatric medical conditions for which the greatest number of applications have been developed. This is the case of smartphone applications developed for the diagnosis of acute otitis media, otitis media with effusion, hearing impairment, obesity, amblyopia, and vision screening. In some cases, the information given by these applications has significantly improved the diagnostic ability of physicians. However, distinguishing between applications that can be effective and those that may lead to mistakes can be very difficult. This highlights the importance of a careful application selection before including smartphone-based artificial intelligence in everyday clinical practice.
PubMed: 38927864
DOI: 10.3390/bioengineering11060628 -
Ophthalmic & Physiological Optics : the... Jun 2024To conduct a large retrospective study of screening refractive error in young children.
PURPOSE
To conduct a large retrospective study of screening refractive error in young children.
METHODS
This retrospective study included children aged from 4 months to 8 years in Daxing District, Beijing, who underwent refractive examinations without cycloplegia. It included a cross-sectional assessment of refractive error screening for all children, and a longitudinal component for a subgroup with data available for two to five visits.
RESULTS
A total of 14,987 children were included in the cross-sectional study. In the group <1 year of age, the percentage of children with a spherical equivalent (SE) >+2.00 D or with cylinder <-1.50 D was 15.25% and 33.24%, respectively. These were significantly higher than for the 1- to 4-year-old group (SE 8.1% higher, cylinder 13.2% higher) (χ = 53.57, p < 0.001; χ = 790.39, p < 0.001). Furthermore, 34.83% of children in the 0-year-old group had amblyopia risk factors (ARFs). In the 4-year-old group, boys had a significantly longer axial length (AL) than girls (differences in the right and left eyes were 0.53 and 0.56 mm, respectively; z = 5.48 p < 0.001, z = 5.80, p < 0.001). AL increased with age, while the AL difference between boys and girls remained stable at 4-8 years of age. The percentage of children aged 5-8 years with myopia in 2020-2021 was significantly higher than that in 2018-2019 (H = 12.44, p = 0.006). In the longitudinal study of 4406 children (up to 12-month follow-up), annual changes in SE were -0.27, -0.06, 0.19 and 0.13 D between 0 and 3 years, and -0.38, -0.58, -0.70 and -0.75 D between 5 and 8 years.
CONCLUSIONS
Children's refractive error varied significantly from ages 4 months to 1 year, with a high proportion having ARFs. Children aged 5-8 years showed a trend towards myopia. The prevalence of myopia in the cross-sectional analysis in 2020-2021 was greater than in 2018-2019. Screening refraction changed minimally over a 12-month period for children aged 1-3 years, but became more myopic for children aged 5-8 years.
PubMed: 38923044
DOI: 10.1111/opo.13355 -
Vision (Basel, Switzerland) Jun 2024The purpose was to define the threshold of normal visual acuity (VA), mean monocular and binocular VA, and interocular difference in the uniform cohort of healthy...
The purpose was to define the threshold of normal visual acuity (VA), mean monocular and binocular VA, and interocular difference in the uniform cohort of healthy four-year-old children. All the children were recruited from the Croatian National Registry of Early Amblyopia Detection database. LEA Symbols inline optotypes were used for VA testing at near and distance, binocularly and monocularly. The pass cut-off level was set to ≤0.1 logMAR. The final sample consisted of 58,712 four-year-old children. In total, 83.78% of the children had unremarkable results, and 16.22% of the children were referred to examination. Of those, 92% of the children were referred due to binocular, and 8% of the children due to monocular causes. The children referred due to binocular causes demonstrated a VA of 0.3 ± 0.24, while the children referred due to monocular causes 0.6 ± 0.21. The ROC curve analysis defined the uniform cut-off value for a normative VA of 0.78. We analyzed the largest uniform cohort of 58,712 children, and have determined normative data for binocular and monocular VA tested with gold standard logMAR chart in four-year-old children. The results presented here established no reasoning to further utilize historical protocols in testing VA in preschool children aged ≥ 4 years.
PubMed: 38922184
DOI: 10.3390/vision8020039 -
PloS One 2024The aim of this pilot study was to determine whether viewing an immersive 3D movie with large disparities in a cinema resulted in improved visual acuity (VA),...
PURPOSE
The aim of this pilot study was to determine whether viewing an immersive 3D movie with large disparities in a cinema resulted in improved visual acuity (VA), stereoscopic depth perception (ST), and improved eye alignment in residual amblyopic children and children without amblyopia.
METHODS
A total of 24 children aged between 5 and 12 years with a history of anisometropic and/or strabismic amblyopia, that had been previously treated and who currently have residual amblyopia (N = 14), and in children with typical development without amblyopia (N = 10) viewed the movie in 3D Sing 2 in a cinema for 110 minutes. Visual acuity, stereoacuity and ocular deviation were assessed before viewing the movie, and three months later. Stereoacuity and ocular deviation were also measured immediately after viewing the movie.
RESULTS
We observed an improvement in visual acuity in the non-dominant (amblyopic) eye 3 months after viewing the movie in the amblyopic group (P<0.001). Stereopsis improved immediately after viewing the movie (P = 0.02), and after 3 months by ≈ 40% (P = 0.01). Moreover, improvements in stereopsis were also observed in children without amblyopia (P = 0.04). No significant changes in ocular deviation were observed in either group.
CONCLUSIONS
These pilot results suggest that brief exposure to large disparities by viewing a 3D movie in a cinema can help to improve stereopsis and visual acuity in children aged 5‒12 years with previously treated amblyopia, and provide a rationale for a randomized clinical trial.
Topics: Humans; Amblyopia; Child; Pilot Projects; Visual Acuity; Female; Male; Child, Preschool; Depth Perception; Motion Pictures
PubMed: 38917142
DOI: 10.1371/journal.pone.0305401 -
Medicine Jun 2024To evaluate the usefulness of the Tokyo Metropolitan Government's Eye Health Screening Program for 3-year-old children, which combines the Single-Picture Optotype Visual... (Observational Study)
Observational Study
Combination of 2 test methods, single-picture optotype visual acuity chart and spot™ vision screener, in the eye health screening program for 3-year-old children in Tokyo: A retrospective, observational study.
To evaluate the usefulness of the Tokyo Metropolitan Government's Eye Health Screening Program for 3-year-old children, which combines the Single-Picture Optotype Visual Acuity Chart (SPVAC) and Spot™ Vision Screener (SVS) tests. This was a retrospective, observational, matched study. Patients who underwent the eye health screening program and had abnormalities were classified into 3 groups according to the outcomes of the SPVAC (SPVAC-passed, SPVAC-P; SPVAC-failed, SPVAC-F) and SVS (SVS-passed, SVS-P; SVS-failed, SVS-F) tests as follows: SPVAC-P/SVS-F, SPVAC-F/SVS-P, and SPVAC-F/SVS-F. We evaluated the age at examination, SPVAC and SVS test success rates, and SVS refractive power. Additionally, the rates of refractive error, amblyopia, and strabismus were compared among the 3 groups. The SPVAC-P/SVS-F, SPVAC-F/SVS-P, and SPVAC-F/SVS-F groups comprised 158, 28, and 74 eyes, respectively. The mean age was 37.4 months. The success rates of the SPVAC and SVS tests were 69.8% and 96.2%, respectively. The mean SVS hyperopia value in the SPVAC-F/SVS-F group (2.71 ± 1.50 D) was significantly higher than that of the SPVAC-P/SVS-F group. The mean SVS astigmatism and myopia values were -2.21 diopter (D) ± 1.09 D and -3.40 ± 1.82 D, respectively; they did not differ significantly from that of the SPVAC-P/SVS-F group. Significant differences were observed in the refractive error, amblyopia, and strabismus rates among the 3 groups. Regarding disease determination, no significant difference was observed among participants who passed and failed the SPVAC test, regardless of the outcome of the other test. However, a significant difference was observed between those passing and failing the SVS tests. The SPVAC method used to screen 3-year-old children should be modified to commence at 42 months of age or be replaced with a single Landolt C test. The SVS test is useful for screening younger patients. Furthermore, the SVS test showed that the degree of hyperopia was higher in patients who did not pass the SPVAC test.
Topics: Humans; Retrospective Studies; Child, Preschool; Male; Female; Vision Screening; Tokyo; Visual Acuity; Strabismus; Refractive Errors; Amblyopia; Vision Tests
PubMed: 38905427
DOI: 10.1097/MD.0000000000038488 -
Vision Research Jun 2024It is important to understand the development of meridional anisotropies in neurotypical children since those with poor visual development, such as amblyopia, can have...
It is important to understand the development of meridional anisotropies in neurotypical children since those with poor visual development, such as amblyopia, can have different patterns of meridional anisotropies. While the oblique effect is usually observed in adults, neurotypical children who have normal 20/20 visual acuity tend to demonstrate a horizontal effect electrophysiologically. In this longitudinal study, orientation-specific visual evoked potentials (osVEPs) and psychophysical grating acuity were used to investigate the changes in the meridional anisotropies in children aged 3.8 to 9.2 years over two visits averaging four months apart. While it was hypothesized that the electrophysiological horizontal effect may shift towards an oblique effect, it was found that the electrophysiological horizontal effect persisted to be present in response to the suprathreshold moderate contrast 4 cycles-per-degree grating stimuli. Psychophysical grating acuity, however, demonstrated an oblique effect when assessed binocularly. In addition, a significant effect of visit, representing an increase in the average age over this period, was observed in the average osVEP C3 amplitudes (4.5 μV) and psychophysical grating acuity (0.28 octaves or approximately 1-line on the logMAR chart). These findings are relevant when evaluating amblyopia treatments and interventions, as it confirms the necessity to take into account of the effect of normal maturation and learning effects when evaluating young children. Special attention should also be given to children with early-onset myopia and high astigmatism even when their visual acuity is 20/20 as the electrophysiological findings are suggestive of poor visual development, which warrants further investigation.
PubMed: 38896923
DOI: 10.1016/j.visres.2024.108439 -
BioRxiv : the Preprint Server For... Jun 2024Amblyopia is a developmental disorder associated with reduced performance in visually guided tasks, including binocular navigation within natural environments. To help...
Amblyopia is a developmental disorder associated with reduced performance in visually guided tasks, including binocular navigation within natural environments. To help understand the underlying neurological disorder, we used fMRI to test the impact of amblyopia on the functional organization of scene-selective cortical areas, including the posterior intraparietal gyrus scene-selective (PIGS) area, a recently discovered region that responds selectively to ego-motion within naturalistic environments (Kennedy et al., 2024). Nineteen amblyopic adults (10 female) and thirty age-matched controls (12 female) participated in this study. Amblyopic participants spanned a wide range of amblyopia severity, based on their interocular visual acuity difference and stereoacuity. The visual function questionnaire (VFQ-39) was used to assess the participants' perception of their visual capabilities. Compared to controls, we found weaker scene-selective activity within the PIGS area in amblyopic individuals. By contrast, the level of scene-selective activity across the occipital place area (OPA), parahippocampal place area (PPA), and retrosplenial cortex (RSC)) remained comparable between amblyopic and control participants. The subjects' scores on "general vision" (VFQ-39 subscale) correlated with the level of scene-selective activity in PIGS. These results provide novel and direct evidence for amblyopia-related changes in scene-processing networks, thus enabling future studies to potentially link these changes across the spectrum of documented disabilities in amblyopia.
PubMed: 38895262
DOI: 10.1101/2024.06.05.597579 -
Strabismus Jun 2024: To evaluate the effect of strabismus surgery on dynamic balance by using computerized dynamic posturography in children with strabismus. : This study was designed as a...
: To evaluate the effect of strabismus surgery on dynamic balance by using computerized dynamic posturography in children with strabismus. : This study was designed as a prospective observational study. Hearing tests and complete ophthalmological examinations were performed for all subjects. Patients with moderate and severe amblyopia, hearing loss at any level, and/or any suspicion of balance impairment were excluded from the study. Postural stability evaluation was performed by computerized dynamic posturography including sensory organization test, adaptation test, and rhythmic weight shift test. All tests were applied preoperatively and in the postoperative 1st and 3rd months, respectively. : Fifteen female and twelve male pre-adolescents aged between 7 and 12 (9.67 ± 1.62 years) were included in the current study. In the sensory organization test, the preoperative visual ratio percentages (73.19 ± 14.95%) improved statistically significantly at the postoperative 1st and 3rd months (78.59 ± 16.21% and 81.44 ± 14.18; = .026, = .021, respectively). The preoperative toes up (110.66 ± 33,48) and toes down (81.46 ± 28.36) adaptation tests improved statistically significantly in the postoperative 3rd month (88.74 ± 20.94 and 63.36 ± 16.03; < .001, = .001, respectively). In the Rhythmic Weight Shift test, the postoperative 3rd-month directional control (forward-backward) value (74.25 ± 11.51%) was statistically significantly higher compared to the preoperative directional control (forward-backward) value (67.76 ± 11.38%) ( = .011). The postoperative 3rd-month directional control (forward-backward) value (74.25 ± 11.51%) was statistically significantly higher compared to the postoperative 1st-month directional control (forward-backward) value (68.43 ± 14.00%) ( = .028). : Surgical treatment resulted in an improvement in the maintenance of dynamic balance in children with strabismus.
PubMed: 38889053
DOI: 10.1080/09273972.2024.2367070 -
Harefuah Jun 2024Amblyopia is a common cause of visual impairment in children. There is circumstantial evidence for the correlation between living in impoverished areas and treatment...
INTRODUCTION
Amblyopia is a common cause of visual impairment in children. There is circumstantial evidence for the correlation between living in impoverished areas and treatment failure. However, no large study directly assessed this correlation.
AIMS
To check the correlation between socioeconomic status and amblyopia treatment success rates, in children 3-18 years old.
METHODS
A retrospective cohort study, review of the electronic medical records of patients treated for amblyopia in a tertiary center during a period of 24 years.
RESULTS
A total of 102 participants were enrolled in the study, of whom 50 came from impoverished areas and were the study group. The study and control group participants had similar distribution of age, sex and baseline clinical data. Study group participants had significantly lower baseline visual acuity. The mean follow-up time was 34 months. Both groups had a significant improvement in visual acuity and a significant decline in severe amblyopia proportion. Final visual acuity, visual improvement and amblyopia severity were similar in both groups. The proportion of successful treatments was similar in both groups.
DISCUSSION
Although participants from impoverished areas began follow-up with significantly lower visual acuity, their vision has improved during follow-up and was similar to final visual acuity of the control group. Amblyopia treatment has eliminated the gap in visual acuity between amblyopic patients from impoverished areas and amblyopic patients in the general population. Conclusion: Given good treatment compliance, social disparities were not significant determinants of amblyopia treatment success.
Topics: Humans; Amblyopia; Israel; Visual Acuity; Female; Child; Male; Retrospective Studies; Child, Preschool; Adolescent; Tertiary Care Centers; Treatment Outcome; Follow-Up Studies; Socioeconomic Factors; Cohort Studies; Severity of Illness Index; Poverty; Social Class
PubMed: 38884287
DOI: No ID Found