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Journal of Pediatric Neurosciences Sep 2022Patients presenting with craniofacial conditions present a unique challenge from an ophthalmological view point. There are no set guidelines as to their management or... (Review)
Review
Patients presenting with craniofacial conditions present a unique challenge from an ophthalmological view point. There are no set guidelines as to their management or their long-term monitoring and follow-up. Largely, this should be the remit of a dedicated craniofacial team. Here we present pertinent ophthalmological pathology occurring in combination with craniosynostosis alongside the protocol employed in Birmingham Children's Hospital for the management of these patients.
PubMed: 36388012
DOI: 10.4103/jpn.JPN_45_22 -
The British Journal of Ophthalmology Oct 1996
Topics: Amblyopia; Anisometropia; Humans
PubMed: 8976692
DOI: 10.1136/bjo.80.10.857 -
La Clinica Terapeutica 2019Outcomes Research Study on patients suffering from anisometropia or isoametropia associated with amblyopia and microstrabismus to show the impact of late occlusion...
PURPOSE
Outcomes Research Study on patients suffering from anisometropia or isoametropia associated with amblyopia and microstrabismus to show the impact of late occlusion treatment on therapeutic prognosis.
MATERIALS AND METHODS
Enrollment of all the eligible patients presenting to recruiting centers at the Department of Pediatric Ophthalmology and Strabismus - Ophthalmological Clinic - Policlinico Umberto I - Rome. At baseline, all patients will undergo an opthalmologic evaluation. Recruited patients will be followed for a 2-year period. Our test group was composed of 31 patients, 11 with bilateral and 20 with monolateral amblyopia, totalling 42 amblyopic eyes, and it was assessed - always by the same examiner - with the help of the following orthoptic examinations: Wirt test, Irvine-Jampolsky test (4 dioptre fixation task), Visuscope, Cover Test, Bagolini striated glasses, and Worth lights test. We assessed pre-post treatment variations observed in the overall group of amblyopic eyes, regardless of the differences between RE and LE.
OUTCOMES
Of the 31 children, 58.1% were males and 41.9% female, average age between 6 and 14 years. Of the 42 amblyopic eyes, after daily occlusion of 8 hours ± 2.30 SD, we recorded an improvement of 71.4%, and visual acuity increased from an average of 0.4 LogMAR to 0.1 LogMAR.
CONCLUSION
Late anti-amblyopic occlusion treatment proved effective in the long term for children 6 to 12 years, specifically regarding visual acuity, fixation, stereopsis, and binocular collaboration in patients suffering from anisometropia or isoametropia and microstrabismus.
Topics: Adolescent; Amblyopia; Anisometropia; Child; Child, Preschool; Female; Humans; Male; Outcome Assessment, Health Care; Physical Examination; Strabismus; Visual Acuity
PubMed: 31612190
DOI: 10.7417/CT.2019.2158 -
Disease Markers 2022To study the changes of macular retinal thickness and microvascular system in children with monocular hyperopic anisometropia and severe amblyopia using optical...
OBJECTIVE
To study the changes of macular retinal thickness and microvascular system in children with monocular hyperopic anisometropia and severe amblyopia using optical coherence tomography angiography (OCTA) and to explore the value of OCTA in the diagnosis and treatment of amblyopia.
METHODS
Thirty-two children with monocular hyperopic anisometropia and severe amblyopia who were treated in the Department of Ophthalmology of the First Affiliated Hospital of Gannan Medical College from January 2020 to December 2020 were included in the study. Eyes with amblyopia ( = 32) served as the experimental group, and the contralateral healthy eyes ( = 32 eyes) served as the control group. All children underwent comprehensive ophthalmological examination including slit lamp, eye position, visual acuity, optometry, eye movement, intraocular pressure, ocular axis, and fundus examination to rule out organic lesions. Macular 6 mm × 6 mm scans were performed on both eyes of all subjects by the same experienced clinician using an OCTA instrument. After ImageJ processing, the vessel density, inner layer, and full-layer retinal thickness (RT) of superficial retinal capillary plexus (SCP) were obtained. All data were analyzed by SPSS21.0 software, and a paired -test was used for comparison between groups. < 0.05 was considered to indicate statistical significance.
RESULTS
The vessel densities of macular SCP in the amblyopia and control groups were 47.66 ± 2.36% and 50.37 ± 2.24% in the outer superior, 49.19 ± 2.64% and 51.44 ± 2.44% in the inner inferior, 49.63 ± 2.51% and 51.41 ± 3.03% in the outer inferior, and 45.56 ± 3.44% and 50.44 ± 3.52% in the outer temporal regions, respectively. The vessel density of macular SCP in the amblyopia group was significantly lower than that in contralateral healthy eyes in the outer superior, inner inferior, outer inferior, outer temporal, and central regions. There was no significant difference between the two groups in the inner superior, inner nasal, outer nasal, and inner temporal regions. The macular RT in the amblyopia group and the control group is 90.38 ± 6.09 m and 87.56 ± 5.55 m in the outer temporal, respectively. The RT in the macular inner layer in the outer temporal region of the amblyopia group was thicker than that of the control group ( < 0.05). There was no significant difference in the other eight regions between the two groups. The whole macular RT in the amblyopia group was thicker than that in the control group in nine regions, and the central area of macular RT in the amblyopia and control groups was 229.06 ± 6.70 m and 214.50 ± 10.36 m, respectively.
CONCLUSION
The OCTA results showed the overall RT of macula in 9 areas in the amblyopia group was thicker than that in the control group, which could show that the macular retinal thickness can be a potential way to distinguish the children with monocular hyperopic anisometropia and severe amblyopia.
Topics: Amblyopia; Anisometropia; Case-Control Studies; Child; Cross-Sectional Studies; Female; Humans; Macula Lutea; Male; Tomography, Optical Coherence; Visual Acuity
PubMed: 35082933
DOI: 10.1155/2022/9431044 -
International Journal of Ophthalmology 2023To investigate the differences in retinal refraction difference values (RDVs) of adult patients with myopic anisometropia compared with those without myopic...
AIM
To investigate the differences in retinal refraction difference values (RDVs) of adult patients with myopic anisometropia compared with those without myopic anisometropia, and to investigate the relationship between ocular biometric measurements and relative peripheral refraction.
METHODS
This clinical observation study included 130 patients with myopia (-0.25 to -10.00 D) between October 2022 and January 2023 aged between 18 and 40y. The patients were divided into anisometropia (=63; difference in binocular anisometropia ≥1.00 D) and non-anisometropia (=67; difference in binocular anisometropia <1.00 D) groups accordingly. Ocular biometric measurements were performed by optical biometrics and corneal topography to assess the steep keratometry (Ks), flap keratometry (Kf), axial length (AL), corneal astigmatism (CYL; Ks-Kf), surface regularity index (SRI), surface asymmetry index (SAI), and central corneal thickness (CCT). The RDV was measured at five retinal areas from the fovea to 53 degrees (RDV-0-10, RDV-10-20, RDV-20-30, RDV-30-40, and RDV-40-53), the total RDV (TRDV) of 53 degrees, and four regions, including RDV-superior, RDV-inferior, RDV-temporal, and RDV-nasal. An analysis of Spearman correlation was carried out to examine the correlation between RDV and the spherical equivalent (SE) and ocular biological parameters.
RESULTS
Within RDV-20-53, both groups showed relative hyperopic defocus, and the increase in RDV corresponds to the increase in eccentricity. In the myopic anisometropia group, the TRDV, RDV-20-53, RDV-superior, and more myopic eyes had significantly higher RDV-temporal values than less myopic eyes. (<0.05). In the non-anisometropia group, there was no significant difference in the RDV between the more and less myopic eyes at different eccentricities (>0.05). There was a negative correlation between SE and TRDV (=-0.205, =0.001), RDV-20-53 (=-0.281, -0.183, -0.176, <0.05), RDV-superior (=-0.251, <0.001), and RDV-temporal (=-0.230, <0.001), a negative correlation between CYL and RDV-10-30 (=-0.147, -0.180, <0.05), and a negative correlation between SRI and RDV-0-20 (=-0.190, -0.170, <0.05). AL had a positive correlation with RDV-20-30 (=0.164, =0.008) and RDV-temporal (=0.160, =0.010).
CONCLUSION
More myopic eyes in patients with myopic anisometropia show more peripheral hyperopic defocus. Diopter and corneal morphology may affect peripheral retinal defocus.
PubMed: 38111932
DOI: 10.18240/ijo.2023.12.22 -
Frontiers in Medicine 2021To explore the associations between refractive errors and multiple eye health outcomes. This is an umbrella review based on systematic reviews with meta-analyses. In...
To explore the associations between refractive errors and multiple eye health outcomes. This is an umbrella review based on systematic reviews with meta-analyses. In our study, refractive errors included myopia, hyperopia, astigmatism, and anisometropia. We reconducted the meta-analyses whose primary data were available in sufficient detail by random effect model. Heterogeneity was assessed by . The main outcomes included myopic macular degeneration (MMD), retinal detachment (RD), cataract, open-angle glaucoma (OAG), strabismus, age-related macular degeneration (AMD), and diabetic retinopathy (DR). Myopia was associated with increased risk of MMD (relative risk = 102.11, 95% CI 52.6-198.22), RD (3.45, 1.08-11.00), nuclear cataract (2.15, 1.53-3.03), posterior subcapsular (PSC) cataract (1.74, 1.41-2.15), OAG (1.95, 1.74-2.19), exotropia (5.23, 2.26-12.09), but decreased risk of DR (0.83, 0.66-1.04), and early AMD (0.80, 0.67-0.94). From mild-to-high myopia, the association strengthened for MMD, RD, nuclear cataract, PSC cataract, OAG, and DR. Hyperopia was associated with an increased risk of early AMD (1.09, 1.01-1.18) and esotropia (22.94, 10.20-51.62). Astigmatism and anisometropia were associated with increased risk of both exotropia and esotropia. Myopia, especially high myopia, demonstrated the highest risk for eye health outcomes, such as MMD, RD, OAG, nuclear and PSC cataracts, and exotropia. However, myopia was associated with a lower risk of early AMD and DR. Individuals with hyperopia are more likely to suffer early AMD and esotropia. Astigmatism and anisometropia predispose to strabismus. A lot of research studies on the mechanism of the associations are needed. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=239744; identifier: 239744.
PubMed: 34805225
DOI: 10.3389/fmed.2021.759767 -
International Journal of Ophthalmology 2023To assess the effect of experimentally induced anisometropia on binocularity in normal adults with glasses-free three-dimensional (3D) technique.
AIM
To assess the effect of experimentally induced anisometropia on binocularity in normal adults with glasses-free three-dimensional (3D) technique.
METHODS
Totally 54 healthy medical students with normal binocularity in the cross-sectional study were enrolled. Anisometropia was induced by placing trail lenses over the right eye, in 0.5 D steps including lenses of -0.5, -1, -1.5, -2, -2.5 D (hyperopic anisometropia) and lenses of +0.5, +1, +1.5, +2, +2.5 D (myopic anisometropia). The glasses-free 3D technique was used to evaluated not only fine stereopsis, but also coarse stereopsis, dynamic stereopsis, foveal suppression, and peripheral suppression in these subjects. One-way analysis of variance was used to compare quantitative data such as fine stereopsis, coarse stereopsis. Pearson's Chi-square test was performed to compare categorical data such as dynamic stereopsis, foveal suppression and peripheral suppression.
RESULTS
The subjects showed a statistically significant decline in fine stereopsis, coarse stereopsis, and dynamic stereopsis with increasing levels of anisometropia (<0.001). Binocularity was affected when induced anisometropia was more than 1 D (<0.05). Foveal suppression and peripheral suppression were evident and increased in proportion to anisometropia (<0.001).
CONCLUSION
The relatively low degrees of anisometropia may have a potentially significant effect on high-grade binocular interaction. The mechanisms underlying the defect of binocularity seem to involve not only foveal suppression, but also peripheral suppression.
PubMed: 37077487
DOI: 10.18240/ijo.2023.04.14 -
Journal of Ophthalmology 2024To assess the differences in accommodation and binocular vision in children with myopic anisometropia and determine the correlation with anisometropia.
PURPOSE
To assess the differences in accommodation and binocular vision in children with myopic anisometropia and determine the correlation with anisometropia.
METHOD
A total of 110 patients with myopia aged 8-15 years were recruited from June 2021 to February 2022 from the Affiliated Hospital of Xuzhou Medical University. Based on the interocular differences of spherical equivalent refraction, patients were divided into the isometropia (35 children), low anisometropia (LA group, 42 children), and high anisometropia (HA group, 33 children). The variables assessed were refraction, heterophoria, amplitude of accommodation (AMP), accommodative response (AR), gradient AC/A, positive and negative relative accommodation (PRA/NRA), and near stereopsis in the three groups. Pearson's correlation coefficient tests were used to investigate the possible association between each parameter and interocular differences (IODs).
RESULTS
Among 110 subjects, there were 49 males and 61 females with a mean age of 11.39 ± 2.28 years. Compared with those in the isometropia group, AMP was lower and near stereopsis was higher in the LA group, and the distance and near heterophoria, PRA, AR, and near stereopsis were higher, and PRA, AMP, and gradient AC/A were lower in the HA group (all < 0.05). Compared with those in the LA group, the near stereopsis, AR, and the near stereopsis were higher in the HA group, and the gradient AC/A was lower (all < 0.05). However, no significant differences existed in the negative relative accommodation ( > 0.05). The distance and near heterophoria, AR, AMP, and near stereopsis were observed to be correlated with IODs, respectively ( = -0.259, = 0.006; = -0.201, = 0.036; = 0.306, = 0.001; = -0.315, = 0.001; = 0.535, < 0.001).
CONCLUSION
Our results suggested that with the increase of anisometropia, distance and near heterophoria, AR, AMP, and near stereopsis had a tendency to get worse in children with myopic anisometropia.
PubMed: 38264273
DOI: 10.1155/2024/6525136 -
BMC Ophthalmology May 2022To compare biometric parameters, especially lens parameters, in patients with high myopia and anisometropia.
BACKGROUND
To compare biometric parameters, especially lens parameters, in patients with high myopia and anisometropia.
METHODS
Patients with spherical equivalent greater than -6D and at least one eye with an axial length greater than 26 mm and a difference in binocular axial length greater than 2 mm were included in this study. In each patient, the eye with a relatively shorter axial length was assigned to Group S, and the other eye was assigned to Group L. In patients whose binocular axial length difference was greater than 4 mm, the eye with the shorter axial length was assigned to Group S1 and the other eye was assigned to Group L1. In patients whose shorter eye axial was less than 26 mm, the eye with the shorter axial was assigned to Group S2 and the other eye was assigned to Group L2. Central corneal thickness, corneal curvature radius, axial length, anterior chamber depth, lens thickness, white-to-white corneal diameter and the radius of the anterior and posterior lens capsules were compared between Group S and Group L, Groups S1 and L1, and Groups S2 and L2.
RESULTS
Sixty-four people were enrolled in the study. There were 26 people with an axial length difference more than 4 mm (Group S1 and Group L1) and 34 patients with an axial length less than 26 mm (Group S2 and Group L2). No significant differences were found in any parameters except axial length between Group S and Group L, Groups S1 and L1, or Groups S2 and L2 (p > 0.05).
CONCLUSIONS
The anterior parameters of patients with high myopia did not change with the axial length.
Topics: Anisometropia; Axial Length, Eye; Biometry; Humans; Lens, Crystalline; Myopia; Refraction, Ocular
PubMed: 35596208
DOI: 10.1186/s12886-022-02450-7 -
Eye and Vision (London, England) Dec 2021This study aims to examine interocular differences in the choroidal thickness and vascular density of the choriocapillaris in anisometropic myopes and to further explore...
BACKGROUND
This study aims to examine interocular differences in the choroidal thickness and vascular density of the choriocapillaris in anisometropic myopes and to further explore the relationship between choroidal blood flow and myopia.
METHODS
The sample comprised 44 participants with anisometropic myopia, aged 9 to 18 years, with normal best-corrected visual acuity. All participants underwent a series of examinations, including spherical equivalent refraction (SER) and axial length (AL), measured by a Lenstar optical biometer and optical coherence tomography angiography (OCTA) scanner. OCT measured the choroidal thickness, vascular density, and flow voids of the choriocapillaris, and a customized algorithm was implemented in MATLAB R2017a with the post-correction of AL. The choroidal thickness was measured at the fovea and 0.5, 1.0, 1.5, 2.0, 2.5, and 3.0 mm nasally, temporally, inferiorly, and superiorly to the fovea. The vascular density and the flow voids of the choriocapillaris were measured at a 0.6-mm-diameter central circle, and the 0.6-2.5 mm diameter circle in the nasal, temporal, inferior, and superior regions. Repeated-measured ANOVAs were used to analyze the interocular differences. Partial correlations with the K value and age adjustments were used to study the relationships between the choroidal thickness, the choriocapillaris vascular density and flow voids, the SER and AL.
RESULTS
The choroidal thickness of the more myopic eyes was significantly thinner than less myopic eyes (P ≤ 0.001), and the flow voids in the more myopic eyes were more than less myopic eyes (P = 0.002). There was no significant difference in the vascular density of the choriocapillaris between the more and less myopic eyes (P = 0.525). However, when anisometropia was more than 1.50 D, the vascular density of choriocapillaris in the more myopic eyes was significantly less than the less myopic eyes (P = 0.026). The interocular difference of the choroidal thickness was significantly correlated with the interocular difference in SER and AL in the center, superior, and inferior regions but not in the nasal or temporal regions. The interocular differences of the vascular density and the flow voids of the choriocapillaris were not correlated with the interocular difference of SER and AL.
CONCLUSIONS
The choroidal thickness is thinner in the more myopic eyes. The flow void is increased, and the vascular density of the choriocapillaris is reduced in the more myopic eyes of children with anisometropia exceeding 1.50 D.
PubMed: 34857053
DOI: 10.1186/s40662-021-00269-9