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Journal of Clinical Medicine May 2024Presbyopia, a common age-related refractive error, affects over a billion people globally and significantly impacts daily life. This retrospective study analyzed 288...
Outcomes of Corneal Compound Myopic Astigmatism with Presbyopia by Zeiss PRESBYOND Laser Blended Vision LASIK Using Default CRS-Master Target Refractions for Reduced Anisometropia.
Presbyopia, a common age-related refractive error, affects over a billion people globally and significantly impacts daily life. This retrospective study analyzed 288 eyes of 144 patients undergoing LBV PRESBYOND treatment for myopic presbyopia with astigmatism, aiming to evaluate precision, efficacy, safety, and stability over six months. Key findings include high efficacy, with 99% of distance-eyes achieving uncorrected distance visual acuity (UDVA) of 20/25 or better, and 85% of near-eyes achieving UDVA of 20/32 or better. The results show excellent refractive outcomes, with 99% of long-sighted eyes and 97% of near-sighted eyes having a postoperative spherical equivalent within ±1.00 D. Safety was demonstrated by no loss of two or more Snellen lines after treatment, with 94% of patients maintaining corrected distance visual acuity (CDVA) before and after surgery. Overall, LBV PRESBYOND proved effective, safe, and well tolerated for myopic presbyopia correction, offering satisfactory visual outcomes and potential spectacle independence for various distances. This study underscores the importance of individualized treatment based on patient age, highlighting the positive impact of binocular summation on visual function. This study contributes to the growing body of evidence supporting LBV PRESBYOND as a viable option for addressing presbyopic myopia, offering insights into its efficacy and safety profile. Further research could explore postoperative stereopsis and long-term outcomes to enhance understanding and refine treatment protocols.
PubMed: 38792550
DOI: 10.3390/jcm13103011 -
Journal of Surgical Case Reports May 2024We herein report a case of a 4-year-old female patient who presented with anisometropic amblyopia with initial visual acuity recorded at 20/400 OD and 20/100 OS. The...
We herein report a case of a 4-year-old female patient who presented with anisometropic amblyopia with initial visual acuity recorded at 20/400 OD and 20/100 OS. The patient was recommended for patching. Eighteen months later, the patient presented with visual acuity of 20/60 OD and 20/80 and reverse amblyopia was noted. In settings of amblyopia, where alternate patching may be used, it is most likely that reverse amblyopia, if present, will affect the more myopic eye. However, unexpectedly, in this case, reverse amblyopia occurred in the less myopic eye. With discontinuation of occlusion therapy and continued use of optical correction, the patients reverse amblyopia resolved and the visual equity equalized. To our knowledge, this is the first case described in the literature demonstrating such an occurrence. Awareness of this rare presentation by clinicians is of great importance to aid in correctly diagnosing and treating such patients.
PubMed: 38784199
DOI: 10.1093/jscr/rjae320 -
PloS One 2024Scoliosis is one of the most common surgical disorders of the pediatric spine. Refractive errors are commonly associated with vision impairment worldwide. However, it is...
BACKGROUND
Scoliosis is one of the most common surgical disorders of the pediatric spine. Refractive errors are commonly associated with vision impairment worldwide. However, it is currently unclear whether refractive error correlates directly with the development of scoliosis.
METHODS
A cross-sectional study was performed in 2023, and a stratified cluster sampling technique was employed among school-aged students in Nantong City, China. Univariate and multivariate logistic regression analyses were used to investigate specific correlations between scoliosis and related parameters; various types of refractive errors were also included in the study.
RESULTS
The prevalence of scoliosis among school-aged students was 2.2% in Nantong city. Multiple logistic regression analyses showed that myopia, hyperopia, astigmatism, and anisometropia were not correlated with the development of scoliosis (all, p≥0.05). Lower body mass index (BMI) [adjusted odds ratio (aOR) = 0.92; 95% confidence interval (CI): 0.88-0.95; p<0.001], living in rural areas (aOR = 1.40; 95% CI: 1.05-1.86; p = 0.020), and older age (aOR = 1.32; 95% CI: 1.25-1.38; p<0.001) had significantly higher risks of scoliosis.
CONCLUSIONS
Refractive errors did not correlate with the development of scoliosis. However, BMI, living in rural areas and older age did correlate with the development of scoliosis.
Topics: Scoliosis; Humans; Male; Female; Cross-Sectional Studies; Refractive Errors; Child; Adolescent; China; Prevalence; Risk Factors; Body Mass Index; Logistic Models
PubMed: 38739623
DOI: 10.1371/journal.pone.0303324 -
Lancet (London, England) May 2024Amblyopia, the most common visual impairment of childhood, is a public health concern. An extended period of optical treatment before patching is recommended by the... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
Extended optical treatment versus early patching with an intensive patching regimen in children with amblyopia in Europe (EuPatch): a multicentre, randomised controlled trial.
BACKGROUND
Amblyopia, the most common visual impairment of childhood, is a public health concern. An extended period of optical treatment before patching is recommended by the clinical guidelines of several countries. The aim of this study was to compare an intensive patching regimen, with and without extended optical treatment (EOT), in a randomised controlled trial.
METHODS
EuPatch was a randomised controlled trial conducted in 30 hospitals in the UK, Greece, Austria, Germany, and Switzerland. Children aged 3-8 years with newly detected, untreated amblyopia (defined as an interocular difference ≥0·30 logarithm of the minimum angle of resolution [logMAR] best corrected visual acuity [BCVA]) due to anisometropia, strabismus, or both were eligible. Participants were randomly assigned (1:1) via a computer-generated sequence to either the EOT group (18 weeks of glasses use before patching) or to the early patching group (3 weeks of glasses use before patching), stratified for type and severity of amblyopia. All participants were initially prescribed an intensive patching regimen (10 h/day, 6 days per week), supplemented with motivational materials. The patching period was up to 24 weeks. Participants, parents or guardians, assessors, and the trial statistician were not masked to treatment allocation. The primary outcome was successful treatment (ie, ≤0·20 logMAR interocular difference in BCVA) after 12 weeks of patching. Two primary analyses were conducted: the main analysis included all participants, including those who dropped out, but excluded those who did not provide outcome data at week 12 and remained on the study; the other analysis imputed this missing data. All eligible and randomly assigned participants were assessed for adverse events. This study is registered with the International Standard Randomised Controlled Trial Number registry (ISRCTN51712593) and is no longer recruiting.
FINDINGS
Between June 20, 2013, and March 12, 2020, after exclusion of eight participants found ineligible after detailed screening, we randomly assigned 334 participants (170 to the EOT group and 164 to the early patching group), including 188 (56%) boys, 146 (44%) girls, and two (1%) participants whose sex was not recorded. 317 participants (158 in the EOT group and 159 in the early patching group) were analysed for the primary outcome without imputation of missing data (median follow-up time 42 weeks [IQR 42] in the EOT group vs 27 weeks [27] in the early patching group). 24 (14%) of 170 participants in the EOT group and ten (6%) of 164 in the early patching group were excluded or dropped out of the study, mostly due to loss to follow-up and withdrawal of consent; ten (6%) in the EOT group and three (2%) in the early patching group missed the 12 week visit but remained on the study. A higher proportion of participants in the early patching group had successful treatment (107 [67%] of 159) than those in the EOT group (86 [54%] of 158; 13% difference; p=0·019) after 12 weeks of patching. No serious adverse events related to the interventions occurred.
INTERPRETATION
The results from this trial indicate that early patching is more effective than EOT for the treatment of most children with amblyopia. Our findings also provide data for the personalisation of amblyopia treatments.
FUNDING
Action Medical Research, NIHR Clinical Research Network, and Ulverscroft Foundation.
Topics: Humans; Amblyopia; Child, Preschool; Female; Male; Child; Eyeglasses; Visual Acuity; Sensory Deprivation; Treatment Outcome; Europe
PubMed: 38704172
DOI: 10.1016/S0140-6736(23)02893-3 -
Taiwan Journal of Ophthalmology 2024The purpose of this study was to describe a case and clinical course of simultaneous anterior chamber phakic intraocular lens (AC-pIOL) removal, implantation of a...
The purpose of this study was to describe a case and clinical course of simultaneous anterior chamber phakic intraocular lens (AC-pIOL) removal, implantation of a posterior chamber phakic intraocular implantable collamer lens (ICL), and Descemet membrane endothelial keratoplasty (DMEK). This was a case report of a 44-year-old male with a unilateral decompensated cornea from a displaced Duet-Kelman lens on his left eye that underwent pIOL extraction and implantation of a posterior chamber phakic intraocular ICL and simultaneous DMEK. After 6 months, the cornea of the left eye had regained clarity, the Descemet membrane was graft stable, and the ICL implanted was centered with good vault. Postoperative anisometropia was avoided. There was no development of cataracts or other complications. The simultaneous pIOL extraction, ICL implantation, and DMEK in our case showed good results with full restoration of anterior segment anatomy and return of transparency of the cornea. The current case shows the feasibility of the simultaneous approach instead of sequential as an alternative for patients with endothelial disease associated with AC pIOLs, restoring vision and anatomy and also avoiding postoperative anisometropia.
PubMed: 38654997
DOI: 10.4103/tjo.TJO-D-23-00168 -
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 -
Saudi Journal of Ophthalmology :... 2024To evaluate and contrast the contrast sensitivity defects present in strabismic and anisometropic amblyopes. And to find out the association of contrast deterioration...
PURPOSE
To evaluate and contrast the contrast sensitivity defects present in strabismic and anisometropic amblyopes. And to find out the association of contrast deterioration with the visual acuity of the amblyopic eye, the magnitude of strabismus, and the amount of anisometropia in both groups.
METHODS
This cross-sectional study was carried out in the orthoptics unit of a tertiary eye care facility between October 2021 and December 2021. There were 45 patients altogether. In the first phase, the patient's history and ocular examination data were recorded after informed consent. The Pelli-Robson chart was used to measure contrast sensitivity. In the second phase, results were interpreted using the SPSS (Statistical Package for the Social Sciences) version 26.0.
RESULTS
Strabismic amblyopes were 24 and anisometropic amblyopes were 21. A significant positive association existed between both groups' contrast sensitivity and visual acuity ( = 0.000). A moderately negative correlation between contrast and anisometropia was statistically significant ( = 0.025) in anisometropic amblyopes. However, no association ( > 0.050) existed between the contrast and magnitude of strabismus in any group.
CONCLUSION
The study concluded that contrast sensitivity decreases in both groups, whereas anisometropic amblyopes have poorer contrast than strabismic amblyopes. Excessively decreased contrast sensitivity among anisometropic amblyopes was solely because of the worst amblyopia in this group, whereas the magnitude of strabismus does not affect contrast sensitivity.
PubMed: 38628417
DOI: 10.4103/sjopt.sjopt_7_23 -
Saudi Journal of Ophthalmology :... 2024To evaluate the clinical profile of amblyopia among patients referred to a tertiary care facility in Saudi Arabia.
PURPOSE
To evaluate the clinical profile of amblyopia among patients referred to a tertiary care facility in Saudi Arabia.
METHODS
All patients between 1 and 14 years presenting to the amblyopia clinic from 2016 to 2020 were retrospectively reviewed. Amblyopia was defined as visual acuity <0.2 LogMAR (20/30) in the worse eye or two-line difference between the two eyes. We classified patients into strabismic, refractive, mixed strabismic, and refractive and deprivation amblyopia. We subclassified our cohort according to age (< and ≥5 years).
RESULTS
Three hundred and eighty-three patients (199 male 54%) were seen in our clinic. Seventeen patients were excluded because they did not meet our inclusion criteria. The mean age at presentation was 5.05 ± 2.49 years. Strabismic amblyopia was found in 180 (49%), refractive in 101 (27.6%), mixed in 69 (19%), and deprivation in 16 (4.2%). Anisometropia in 85.25% and isometropia in 14.75%. Hyperopic astigmatism was the most common refractive error in 246 (67.2%). Esotropia was the most common deviation (90%). Strabismic amblyopia was significantly higher in the <5 years group (62.4% vs. 36.7%). While refractive amblyopia was significantly higher in ≥5 years group (38.8% vs. 15.7%) ( < 0.001).
CONCLUSION
Strabismic amblyopia was the most commonly diagnosed in our cohort, especially among patients <5 years of age. Refractive amblyopia was more common in older patients and may be under-detected due to the lack of proper vision screening. The implementation of proper vision screening should help in early detection and successful treatment at an early age.
PubMed: 38628408
DOI: 10.4103/sjopt.sjopt_87_22 -
Heliyon Apr 2024To explore the association between the cause of amblyopia and pre-treatment contrast sensitivity, stereoacuity, fixation and nystagmus.
PURPOSE
To explore the association between the cause of amblyopia and pre-treatment contrast sensitivity, stereoacuity, fixation and nystagmus.
DESIGN
Retrospective cohort study.
METHODS
A retrospective review was conducted for 3408 patients with amblyopia who had not yet started amblyopia treatment utilizing a large amblyopia patient database maintained at Zhongshan Ophthalmic Centre. Six amblyogenic factor subtypes were identified: anisometropia, isoametropia, strabismus, anisometropia and strabismus, monocular visual deprivation, and binocular visual deprivation amblyopia. Monocular best corrected visual acuity (BCVA), the contrast sensitivity function (CSF), fixation, and stereopsis were compared between the subtypes before and after propensity score matching (PSM) for age and sex.
RESULTS
The two deprivation groups had poorer BCVA and CSF than the other groups. There were no systematic differences in CSF between the non-deprivation groups. Nystagmus was more common in the bilateral amblyopia groups compared to the monocular amblyopia groups. Eccentric fixation was uncommon with the exception of the anisometropia and strabismus group which had an eccentric fixation rate of 20%. Distance stereoacuity measured without monocular cues was absent for almost all patients. The results were consistent when analyzed using PSM.
CONCLUSION
Visual deprivation causes more severe amblyopia than other amblyogenic factors. For non-deprivation amblyopia subtypes, individual differences such as variation in the severity of the amblyogenic factor might be more important in determining pre-treatment vision than whether amblyopia was caused by refractive error, strabismus or both.
PubMed: 38596124
DOI: 10.1016/j.heliyon.2024.e28857 -
Ophthalmic Research 2024This study aimed to explore the functional connectivity of the primary visual cortex (V1) in children with anisometropic amblyopia by using the resting-state functional...
INTRODUCTION
This study aimed to explore the functional connectivity of the primary visual cortex (V1) in children with anisometropic amblyopia by using the resting-state functional connectivity analysis method and determine whether anisometropic amblyopia is associated with changes in brain function.
METHODS
Functional magnetic resonance imaging (fMRI) data were obtained from 16 children with anisometropia amblyopia (CAA group) and 12 healthy children (HC group) during the resting state. The Brodmann area 17 (BA17) was used as the region of interest, and the functional connection (FC) of V1 was analyzed in both groups. A two-sample t test was used to analyze the FC value between the two groups. Pearson's correlation was used to analyze the correlation between the mean FC value in the brain function change area of the CAA group and the best corrected visual acuity (BCVA) of amblyopia. p < 0.05 was considered statistically significant.
RESULTS
There were no significant differences in age and sex between the CAA and HC groups (p > 0.05). Compared to the HC group, the CAA group showed lower FC values in BA17 and the left medial frontal gyrus, as well as BA17 and the left triangle inferior frontal gyrus. Conversely, the CAA group showed higher FC values in BA17 and the left central posterior gyrus. Notably, BCVA in amblyopia did not correlate with the area of change in mean FC in the brain function of the CAA group.
CONCLUSION
Resting-state fMRI-based functional connectivity analysis indicates a significant alteration in V1 of children with anisometropic amblyopia. These findings contribute additional insights into the neuropathological mechanisms underlying visual impairment in anisometropic amblyopia.
Topics: Humans; Amblyopia; Female; Male; Child; Magnetic Resonance Imaging; Visual Acuity; Primary Visual Cortex; Anisometropia; Brain Mapping; Rest; Visual Cortex
PubMed: 38588644
DOI: 10.1159/000538380