AIM:To describe the demographics,clinical characteristics and treatment outcomes of childhood amblyopia in a tertiary eye center in western India.METHODS:This was a retrospective longitudinal hospital-based study of 1...AIM:To describe the demographics,clinical characteristics and treatment outcomes of childhood amblyopia in a tertiary eye center in western India.METHODS:This was a retrospective longitudinal hospital-based study of 1382 children aged≤12y included in the National Institute of OphthalMology AmBlyopia StUdy in Indian Paediatric EyeS(NIMBUS)Study.Data on patient demographics,treatment approach,and best-corrected visual acuity(BCVA)changes were reviewed.RESULTS:The mean age of the study cohort was 4.54±2.46y,with males constituting the majority(55.4%).The cause of amblyopia was refractive error in 73.2%,strabismus in 7.3%,and anisometropia in 6.8%of eyes.The majority of therapies comprised glasses(74.4%),followed by occlusion+glasses(10.3%),occlusion alone(7.3%),and surgery+patching+glasses(5.1%).The mean occlusion time was 2.46±1.14h.After a median follow-up of 10.00(6-85)mo,the mean BCVA significantly improved from 0.85±0.41 to 0.55±0.42 logMAR.Subgroup analysis revealed BCVA gain for all etiologies,including refractive errors(P<0.001),strabismus(P<0.001),cataract(P<0.001),and ptosis(P<0.001).Additionally,eyes with refractive errors showed significantly better BCVA than eyes with cataracts(P<0.001),strabismus(P<0.001)and marginally better BCVA than eyes with ptosis(P<0.05),both at the baseline and final visit.CONCLUSION:Refractive errors are the commonest cause of amblyopia,followed by strabismus and anisometropia.Timely detection,optimal therapy,and periodic follow-up are crucial in bettering visual acuity regardless of the cause.展开更多
AIM:To assess the visual electrophysiological outcomes in children with functional amblyopia who exhibited poor response to conventional treatment.METHODS:Twenty-one children with functional amblyopia,aged 5.7±2....AIM:To assess the visual electrophysiological outcomes in children with functional amblyopia who exhibited poor response to conventional treatment.METHODS:Twenty-one children with functional amblyopia,aged 5.7±2.1y(range:4-10y),underwent comprehensive ophthalmic and refractive evaluations.Spectral domain-optical coherence tomography(SD-OCT)and multifocal electroretinography(mfERG)were conducted to analyze the macular retinal thickness and the first-order response P1 ring of the mfERG in the amblyopic eye(AE)compared to the fellow good eye(GE).RESULTS:Initially,visual acuity in the AE ranged from 20/800 to 20/40,while the GE exhibited a range of 20/25 to 20/20(P<0.01).After 6mo of treatment,17 patients demonstrated improved visual acuity in the AE to 20/50 or better,while 4 children showed no improvement.SD-OCT revealed comparable macular and optic disc structures between the AE and GE.Prior to treatment,the mfERG P1 ring amplitude was significantly reduced in the AE compared to GE(P<0.05).The AE/GE ratio of P1 ring amplitude showed significant improvement post-treatment.However,a smaller AE/GE ratio before treatment was associated with poorer improvement post-treatment.CONCLUSION:In the management of functional amblyopia,a thorough assessment of amblyopic eye examinations is crucial.Approximately 20%of amblyopic eyes may not achieve significant improvement in visual acuity,despite the absence of detectable organic retinal abnormalities.mfERG may reveal underlying abnormalities.Integrating mfERG into initial assessments or treatment follow-ups can aid in identifying potential hidden retinal defects and predicting the prognosis of the amblyopic eye.展开更多
Abnormal visual experience during the critical period can cause deficits in visual function,such as amblyopia.High magnesium(Mg^(2+))supplementary can restore ocular dominance(OD)plasticity,which promotes the recovery...Abnormal visual experience during the critical period can cause deficits in visual function,such as amblyopia.High magnesium(Mg^(2+))supplementary can restore ocular dominance(OD)plasticity,which promotes the recovery of amblyopic eye acuity in adults.However,it remains unsolved whether Mg^(2+)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^(2+)in amblyopic mice.Behaviorally,Mg^(2+)-treated amblyopic mice showed better depth perception.Moreover,the effect of high Mg^(2+)can be suppressed with transient receptor potential melastatin-like 7(TRPM7)knockdown.Collectively,our results demonstrate that high Mg^(2+)could restore binocular visual functions from amblyopia.TRPM7 is required for the restoration of plasticity in the visual cortex after high Mg^(2+)treatment,which can provide possible clinical applications for future research and treatment of amblyopia.展开更多
AIM:To evaluate the visual outcomes of standard amblyopic treatment add-on training via perceptual learning in refractive amblyopic children and to identify the risk factors for treatment failure.METHODS:Retrospective...AIM:To evaluate the visual outcomes of standard amblyopic treatment add-on training via perceptual learning in refractive amblyopic children and to identify the risk factors for treatment failure.METHODS:Retrospective charts were reviewed in children with refractive amblyopia who received standard treatment and add-on Cambridge Visual Stimulator(CAM)training.The add-on CAM group that was enrolled had worn full-corrected glasses for at least 2mo before training.A control group received only the standard treatment.Treatment success was defined as best-corrected visual acuity(BCVA)≥20/25.The age,sex,initial BCVA,refractive errors,sessions and duration of training,and final BCVA were recorded.RESULTS:A total of 209 children(129 children in add-on CAM group and 80 children in control group)were enrolled.Seventy-six percent of unilateral and 87%of bilateral amblyopic children achieved treatment success.In children with unilateral or bilateral moderate amblyopia,the duration to reach BCVA≥20/25 was significantly shorter in add-on CAM group than in control group.Poor initial BCVA(P<0.001)and high astigmatism(P=0.007)were risk factors for treatment failure after add-on CAM training.Age,sex,and types of refractive error were not associated with treatment success.CONCLUSION:Add-on CAM training is an effective strategy for visual improvement and can shorten the treatment course when the effect of standard treatment is limited in amblyopic children.展开更多
Amblyopia is a neurodevelopmental vision disorder resulting from abnormal visual input during the critical period of visual development,such as strabismus,uncorrected anisometropia,high refractive errors,and form depr...Amblyopia is a neurodevelopmental vision disorder resulting from abnormal visual input during the critical period of visual development,such as strabismus,uncorrected anisometropia,high refractive errors,and form deprivation.It is frequently associated with reduced visual acuity and deficits in binocular vision.Traditional occlusion therapy for amblyopia has typically been restricted to infants and young children during the critical period of visual development,as it is believed to be ineffective for older children and adults due to the decreased plasticity of the mature brain.Our research group has concentrated on pivotal scientific issues in amblyopia,including quantitative methods for detecting binocular vision,especially interocular visual suppression,the mechanisms underlying binocular vision impairment in amblyopia,treatment methods and their evaluations for amblyopia,and visual plasticity and its neural mechanisms in amblyopia.This paper summarizes the visual mechanisms and treatment modalities of amblyopia based on our research and both domestic and foreign sources,while also looking forward to the future development of this field in light of existing problems.展开更多
Amblyopia is a neurodevelopmental disorder of the visual cortex arising from abnormal visual experience early in life. Amblyopia is a major cause of impaired vision in infants and young children (prevalence around 3.5...Amblyopia is a neurodevelopmental disorder of the visual cortex arising from abnormal visual experience early in life. Amblyopia is a major cause of impaired vision in infants and young children (prevalence around 3.5%). There are different treatment options for amblyopia based on its severity and age of the patient. Traditional treatments include patching or occlusion of the dominant eye and pharmacological penalisation using Atropine (1%). Recent developments in amblyopia management have found success with the use of binocular exercises and certain modifications of glasses and contact lenses. The critical age up to which amblyopia is treatable or reversible is also being pushed up with more research. With newer advancements in amblyopia therapy, the success rate is also improving with multimodal approach.展开更多
Strabismic amblyopia is characterized by a distorted spatial perception.In this condition,the neurofunctional disorder occurring during first years of life provoke several monocular and binocular anomalies such as cro...Strabismic amblyopia is characterized by a distorted spatial perception.In this condition,the neurofunctional disorder occurring during first years of life provoke several monocular and binocular anomalies such as crowding,deficits in the accommodative response,contrast sensitivity,and ocular motility abilities.The inhibition of the binocular function of the brain by the misaligned amblyopic eye induces a binocular imbalance leading to interocular suppression and the reduction or lack of stereoacuity.Passive treatments such as occlusion,optical and/or pharmacological penalization,and Bangerter foils has been demonstrated to be potentially useful treatments for strabismic amblyopia.Recent researches have proved new pharmacological options to improve and maintain visual acuity af ter occlusion treatment in strabismic amblyopia.Likewise,the active vision therapy,in the last years,is becoming a very relevant therapeutic option in combination with passive treatments,especially during and after monocular therapy,in the attempt of recovering the imbalanced binocular vision.展开更多
Amblyopia is a common eye d isease caught by many children. For some reason, the traditional treating method is unsatisfactory and ineffective. By connecting home and hospital through Inte rnet, patients can receive...Amblyopia is a common eye d isease caught by many children. For some reason, the traditional treating method is unsatisfactory and ineffective. By connecting home and hospital through Inte rnet, patients can receive service of treatment designed for their own purpose. Thus the effectiveness of therapy is expected to have sigificent improvment. A n ew Internet based telemedicine system for amblyopia is put forward in this pape r with further discussions of its principles, framework and implementation method s.展开更多
Objective To compare the differences of effect on infantile amblyopia treated with auricular point sticking therapy and regular comprehensive therapy of western medicine.Methods Two hundreds and thirty cases of amblyo...Objective To compare the differences of effect on infantile amblyopia treated with auricular point sticking therapy and regular comprehensive therapy of western medicine.Methods Two hundreds and thirty cases of amblyopia patients were randomly divided into two groups,namely the group of auricular point sticking therapy,which had 120 cases（212 eyes）,and the group of comprehensive therapy,which had 110 cases（194 eyes）.The seed of Semen Vaccariae was applied at the ear point such as the eye,ear Shenmen,the liver,the spleen and the kidney.Regular comprehensive therapy of western medicine included covering method,vision corrected with glasses and fine exercise.Vision improvements of the two groups were observed with a three-year follow up.Results The effective rates of the auricular point sticking therapy group and comprehensive therapy group of ametropic amblyopia were 81.0%（64/79） and 52.2%（36/69）,respectively.The effective rates of anisometropic amblyopia of the two groups were 73.1%（49/67） and 47.7%（31/65）,respectively.And the effective rates of the two groups of strabismic amblyopia were 71.2%（47/66） and 45.0%（27/60）,respectively.The therapeutic effects of auricular point sticking therapy on all kinds of amblyopia were better than those of the comprehensive therapy（all P0.05）.Conclusion The effect of auricular point sticking therapy on infantile amblyopia is better than that of regular comprehensive therapy of western medicine,which can obviously improve the vision of the patients with easy manipulations.展开更多
Objective:To explore the changes of lateral geniculate body and visual cortex in monocular strabismus and form deprived amblyopic rat,and visual development plastic stage and visual plasticity in adult rats.Methods:A ...Objective:To explore the changes of lateral geniculate body and visual cortex in monocular strabismus and form deprived amblyopic rat,and visual development plastic stage and visual plasticity in adult rats.Methods:A total of 60 SD rats ages 13 d were randomly divided into A,B,C three groups with 20 in each group,group A was set as the normal control group without any processing,group B was strabismus amblyopic group,using the unilateral extraocular rectus resection to establish the strabismus amblyopia model,group C was monocular form deprivation amblyopia group using unilateral eyelid edge resection+lid suture.At visual developmental early phase(P2S),meta phase(P3S),late phase(P45)and adult phase(P120),the lateral geniculate body and visual cortex area 17 of five rats in each group were exacted for C-fos Immunocytochemistry.Neuron morphological changes in lateral geniculate body and visual cortex was observed,the positive neurons differences of C-fos expression induced by light stimulation was measured in each group,and the condition of radiation development of P120 amblyopic adult rats was observed.Results:In groups B and C,C-fos positive cells were significantly lower than the control group at P25(P<0.05),there was no statistical difference of C-fos protein positive cells between group B and group A(P>0.05),C-fos protein positive cells level of group B was significantly lower than that of group A(P<0.05).The binoculus C-fos protein positive cells level of groups B and C were significantly higher than that of control group at P35,P4S and P120 with statistically significant differences(P<0.05).Conclusions:The increasing of C-fos expression in geniculate body and visual cortex neurons of adult amblyopia suggests the visual cortex neurons exist a certain degree of visual plasticity.展开更多
BACKGROUND： Conventional methods （such as occlusion therapy, fine manipulation, complementary, and alternative medicine） take effects slowly, are time and labor consuming, and have uncertain curative effects in the...BACKGROUND： Conventional methods （such as occlusion therapy, fine manipulation, complementary, and alternative medicine） take effects slowly, are time and labor consuming, and have uncertain curative effects in the treatment of amblyopia. Perceptual learning, a new method for treating amblyopia, improves the ability to process signals from the cerebral optic nerve system by specific visual stimulation and visual learning, as well as activation of the visual signal pathway utilizing brain nervous system plasticity. OBJECTIVE： This study investigated and evaluated the curative effects of perceptual learning, which can directionally increase brain plasticity, on the treatment of amblyopia in children. The relationship between curative effect and time was also analyzed. DESIGN： A self-control experiment. SETTING： Visual Science and Optometry Center, People＇s Hospital of Guangxi Zhuang Autonomous Region. PARTICIPANTS： A total of 125 amblyopic children （250 amblyopic eyes）, 73 males, 52 females, averaging （6±2） years of age, received treatment at the Visual Science and Optometry Center, People＇s Hospital of Guangxi Zhuang Autonomous Region between September 2006 and February 2007 and were recruited for this study. All children presented with no structural disease of the eyeballs. Written informed consent for therapeutic regiments was obtained from each child＇s parent. The protocol received approval from the Hospital＇s Ethics Committee. METHODS： Visual function was tested with a perceptual learning system （Research Center for Human Health and Development of Sun Yat-sen University, National Engineering Technique Research Center for Medical Care Implement） for visual noise, position noise, contour discrimination, contrast sensitivity, grating stereogram, and random-dot fusion. These tests helped to evaluate the efficiency of visual information processing of these children, and to determine the degree of defects of the optic nerve cells and the connections of visual cortical neurons. According to results of visual function tests, individualized treatment was adopted for each amblyopia patient using perceptual learning system. One course of treatment lasted one month, and treatment was performed twice every day with two training procedures （each training procedure lasted for ten minutes）. There was a ten-minute time interval between the two training procedures. The training treatment was performed in a quiet and dark environment. Visual acuity and recovery of visual function were tested every month. Original training procedure was continued or adjusted according to the results of visual function. MAIN OUTCOME MEASURES： Visual function change; relationship of curative effects and curative time. RESULTS： A total of 125 amblyopia children were included in the final analysis. The total efficiency of perceptual learning for treating amblyopia in children was 75.2%. Visual acuity began to greatly increase 3 months after treatment （P 〈 0.05）. Visual acuity was best corrected from 0.60 ± 0.23 before treatment to 0.86 ± 0.26 after treatment （P 〈 0.05）. The mean time to reach improved levels with curative effects was （2.82 ± 1.30） months, and to reach a basically cured level was （2.87 ±1.40） months. Percentage of improved visual acuity was the highest [98% （39/40）] in children that received 3 months of treatment and the lowest [55% （31/56）] in children that received 1 month of treatment （P 〈 0.05）. The percentage of basically cured levels with curative effects increased with length of learning time and was the greatest in children that received 4 months of treatment [67% （31/46）, P 〈 0.05]. CONCLUSION： Perceptual learning rapidly and remarkably improves visual function of amblyopia children; however, the curative effects are first apparent two and three months after intervention.展开更多
AIM: To determine the prevalence and factors associated with amblyopia among children aged 30-83 mo in central south of China.METHODS: A population-based, cross-sectional study was conducted in children aged 30-83 mo ...AIM: To determine the prevalence and factors associated with amblyopia among children aged 30-83 mo in central south of China.METHODS: A population-based, cross-sectional study was conducted in children aged 30-83 mo in Changsha(an urban city) and Zhangjiajie(a rural area) in central south of China. Clinical examinations including ocular alignment, ocular motility, visual acuity(VA), prism cover test, cycloplegic refraction, slit lamp examination and fundus examination were performed by trained study ophthalmologists and optometrists. Unilateral amblyopia was defined as a 2-line difference between eyes with VA<20/32 in the worse eye and with coexisting anisometropia [≥1.00 D spherical eutivalent(SE) for hyperopia, ≥3.00 D SE for myopia, and ≥1.50 D for astigmatism], strabismus, or past or present visual axis obstruction. Bilateral amblyopia was defined as VA in both eyes <20/40(≥ 48-month-old) and <20/50(< 48-month-old), with coexisting hyperopia ≥4.00 D SE, myopia ≤-6.00 D SE, and astigmatism ≥2.50 D, or past or present visual axis obstruction.RESULTS: There were 8042 children enrolled and 7713 children were screened. The amblyopia prevalence in children aged 30-83 mo was 1.09%(95% confidence interval, 0.86%-1.35%) with no age(P=0.81), gender(P=0.46) or area distribution(P=0.93) differences. Of these, 0.68% were unilateral cases and 0.41% were bilateral cases. Underlying causes included anisometropia(40%), binocular refractive error(36%), strabismus(14%) and deprivation(10%). Hyperopia combined with astigmatism was the frequent refractive error for ametropic and anisometropic amblyopia.CONCLUSION: In this rural and urban Chinese population, 1.09% of children with 30-83 mo of age had amblyopia, a prevalence rate similar to that of many other studies. Anisometropia and refractive error are the most common causes of unilateral and bilateral amblyopia respectively.展开更多
AIM:To compare the retinal nerve fiber layer (RNFL) thickness and macular thickness in the amblyopic eye with that in the sound eye of children with hyperopic anisometropic amblyopia using optical coherence tomography...AIM:To compare the retinal nerve fiber layer (RNFL) thickness and macular thickness in the amblyopic eye with that in the sound eye of children with hyperopic anisometropic amblyopia using optical coherence tomography (OCT). METHODS:A prospective, nonrandom, intraindividual comparative cohort study includes 72 children with hyperopic anisometropic amblyopia in a single center. Macular thickness, macular foveola thickness, and peripapillary RNFL thickness were compared between the amblyopia eyes and the contralateral sound eyes. ·RESULTS:There were 38 male and 34 female patients, with a mean age as 9.7 ±1.9 years (range, 5-16 years). Hyperopic was +3.62±1.16D (range +2.00D to +6.50D) in the amblyopic eyes, which was significantly higher in the control eyes with +0.76±0.90D (range 0D to +2.00D) (P 【 0.01). The mean peripapillary RNFL thickness was 113.9± 7.2μm and 109.2 ±6.9μm in the amblyopic eye and the normal eye, respectively, reaching statistical significance (P = 0.02). The mean macular foveola thickness was significantly thicker in the amblyopic eyes than the contralateral sound eyes (181.4±14.2μm vs 175.2±13.3μm, P 【0.01), but the 1mm, 3mm or 6mm macular thickness central macular thickness was not significantly different. Degree of anisometropia in the contralateral eyes was not significantly correlated with differences of peripapillary RNFL, macular foveola thickness or central macular thickness. CONCLUSION:Eyes with hyperopic anisometropic amblyopia are found thicker macular foveola and peripapillary RNFL than the contralateral eyes in children.展开更多
AIM： To assess the outcomes of posterior chamber implantable collamer lens （ICL） implantation in Chinese pediatric patients with unilateral high myopic amblyopia.METHODS： Eleven eyes of 11 amblyopic patients aged ...AIM： To assess the outcomes of posterior chamber implantable collamer lens （ICL） implantation in Chinese pediatric patients with unilateral high myopic amblyopia.METHODS： Eleven eyes of 11 amblyopic patients aged 11.02±3.34y underwent ICL （model V4, Staar Surgical Inc.） implantation to treat unilateral anisometropia were studied. Visual acuity, cycloplegic refraction, contrast sensitivity, stereopsis, intraocular pressure （IOP）, vaulting, corneal endothelial cell count and complications were evaluated. Patients completed follow-up at 3d, 1, 3mo and the last follow-up time （mean 8.18±2.82mo） after surgery.RESULTS： The mean myopic anisometropia was -13.70±3.25 D preoperatively and ＋0.69±2.63 D at 8mo postoperatively. The logMAR corrected distance visual acuity （CDVA） of the amblyopic eye was 1.51±0.72 preoperatively and 0.75±0.40 at 8mo postoperatively. The logMAR CDVA at 3d, 1, 3 and 8mo postoperatively improved by a mean of 0.64, 1.55, 1.82 and 2.64 lines and gained more than 2 lines accounted for 18%, 45%, 45%, 64%, respectively. The contrast sensitivity of 0.5, 1 and 2 cpd in amblyopic eyes was significantly increased after surgery. No patient had near stereopsis recovery. The vaulting at 3 and 8mo was significantly lower than that at 1mo postoperatively. No other intraoperative or postoperative complications were observed, except an acute pupillary block glaucoma happened in a patient at two weeks postoperatively.CONCLUSION： This short-term results indicate that ICL implantation can be a promising alternative therapy for high myopic anisometropic amblyopia in pediatric patients who have failed with conventional treatments and not suitable to corneal refraction surgery.展开更多
AIM:To investigate peripapillary retinal nerve fiber layer (RNFL), macula and ganglion cell layer thicknesses (GCC) in amblyopic eyes with spectral domain optical coherence tomography (SD-OCT). METHODS:Thirty six pati...AIM:To investigate peripapillary retinal nerve fiber layer (RNFL), macula and ganglion cell layer thicknesses (GCC) in amblyopic eyes with spectral domain optical coherence tomography (SD-OCT). METHODS:Thirty six patients with a history of unilateral amblyopia and thirty two children who had emmetropia without amblyopia were included in this study. In this institutional study, 36 eyes of 36 patients with amblyopia (AE), 36 fellow eyes without amblyopia (FE), and 32 eyes of 32 normal subjects (NE) were included. RNFL, GCC and macular thickness measurements were performed with RS-3000 OCT Retina Scan (Nidek Inc CA. USA). RESULTS:The mean global thicknesses of the RNFL were 113.22 ±21.47, 111.57 ±18.25, 109.96 ±11.31μm in the AE, FE, and NE, respectively. There was no statistically significant difference for mean global RNFL thickness among the eyes (P =0.13). The mean thicknesses of the macula were 258.25±18.31, 258.75±19.54, 248.62±10.57μm in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of macula among the eyes (P =0.06). The GCC was investigated into two parts:superior and inferior. The mean thicknesses of superior GCC were 102.57 ±13.32, 103.32 ±10.64, 100.52 ± 5.88μm in the AE, FE, and NE, respectively. The mean thicknesses of inferior GCC were 103.82 ±12.60, 107.82 ± 12.33, 105.86±10.79μm in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of superior and inferior GCC between the eyes (P =0.63, P =0.46). ·CONCLUSION:The macular thicknesses of AE and FE were greater than the NE, although it was not statistically significant. Amblyopia does not seem to have a profound effect on the RNFL, macula and GCC.展开更多
AIM: To conduct a systematic review and Meta-analysis of the published literature to evaluate the pooled prevalence rate of amblyopia in patients with congenital ptosis.METHODS: We searched the PubMed, Embase, the Coc...AIM: To conduct a systematic review and Meta-analysis of the published literature to evaluate the pooled prevalence rate of amblyopia in patients with congenital ptosis.METHODS: We searched the PubMed, Embase, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang Data, and Chongqing VIP databases for studies reporting the prevalence of amblyopia in patients with congenital ptosis. The reference lists of relevant studies were scanned. Heterogeneity of effect sizes across studies was tested. We calculated prevalence ratios to compare prevalence estimates for different causes of amblyopia in patients with congenital ptosis, as well as for different geographical regions, year of publication and sample size in subgroup analyses. A systematic review and Meta-analysis were performed.RESULTS: We identified 29 eligible surveys with a total population of 2436. Prevalence rates of amblyopia ranged from 13.8% to 69%. We noted substantial heterogeneity in prevalence estimates for amblyopia in congenital ptosis(Cochran’s χ2 significant at P<0.0001; I2=90%). The pooled prevalence using random-effects models of 29 studies was 32.8%(95%CI: 27.3%-38.4%) in the overall population. Compared to the overall pooled prevalence, amblyopia prevalence was higher in studies in which only subjects with blepharophimosis syndrome were included.CONCLUSION: We confirm that nearly one-third of congenital ptosis patients are suffering from or at risk for amblyopia. Patients with blepharophimosis syndrome are more likely to develop amblyopia. The identificationand management of amblyopia should be integral to the treatment of congenital ptosis.展开更多
The article introduced the application of Tuina at"Simingxue"(four points named after"ming")and pressing therapy at auricular points in treatment of 17 cases of anisometropic amblyopia in children....The article introduced the application of Tuina at"Simingxue"(four points named after"ming")and pressing therapy at auricular points in treatment of 17 cases of anisometropic amblyopia in children.The methods:pressing and kneading with the thumb at Jingming(睛明BL1),Shangming(上明Extra),Yiming(翳明EX-HN14)and Guangming(光明GB37).Pressing with the finger digital at Yintang(印堂EX-HN3),Cuanzhu(攒竹BL2),Yuyao(鱼腰EX-HN4),Taiyang(太阳EX-HN5),Yingbai(阳白GB14),Sizhukong(丝竹空TE23),Tongziliao(瞳子髎GB1),Qiuhou(球后EX-HN7)and Chengqi(承泣ST1).Scraping the upper and lower orbits,nipping the eyebrows,pushing the orbits,pushing baoping and warming the eyes.Pressing Quchi(曲池LI11),Hegu(合谷LI4),GB37,Zusanli(足三里ST36),Xuehai(血海SP10)and Sanyinjiao(三阴交SP6).Rolling on the bilateral distributions of bladder meridian on the back.Pressing and kneading at Touwei(头维ST8),Qucha(曲差BL4),Baihui(百会GV20),Sishencong(四神聪EX-HN1),Fengchi(风池GB20)and Dazhui(大椎GV14).Grasping five meridians,scattering bilateral temporal regions,grasping and kneading the neck and nape region and holding Jianjing(肩井GB21).Auricular pressing therapy was exerted at Yan(眼eye,LO5),Gan(肝liver,CO12),Shen(肾kidney,CO10),Pi(脾spleen,CO13),Wei(胃stomach,CO4),Pizhixia(皮质下subcortex,AT4),Pingjianqian(屏间前anterior intertragic notch,TG21)and Pingjianhou屏间后(posterior intertragic notch,AT11).The treatment was given 3 times a week,6 treatments made one course and 4 courses of treatment were required.Of 17 patients,2 cases were cured,13 cases cured basically,1 case improved and 1 case failed.The total effective rate was 88.2%.展开更多
AIM:To assess the quantitative association between anisometropia magnitude(AM) and the losses of resolution and contrast sensitivity;and to exemplify how the function of fusion and stereopsis vary with AM in previousl...AIM:To assess the quantitative association between anisometropia magnitude(AM) and the losses of resolution and contrast sensitivity;and to exemplify how the function of fusion and stereopsis vary with AM in previously untreated anisometropic amblyopia. METHODS:A total of 57 patients with previously untreated anisometropic amblyopia without strabismus(range:8-35 years),were measured refractive error,best corrected visual acuity(BCVA),fusion and stereopsis,and 48 patients have completed contrast sensitivity function test.AM was determined by dioptric vector addition model,and the amblyopia depth was determined by the difference of BCVA in logMAR units between the amblyopic and fellow eyes.RESULTS:AM was significantly correlated with both amblyopia depth(Pearson R=0.728,P【0.001) and the inter-ocular difference of the area under the log contrast sensitivity function(AULCSF)(R=0.505,P【0.001).Depth of amblyopia and the inter-ocular difference of AULCSF was also significantly correlated(R=0.761,P【0.001).The more severity of amblyopia,the poorer levels of contrast sensitivity.Most pure anisometropes with AM was less than 3.0D retain fusion and some stereopsis,but when AM were more than 3.0D,especially for the anisometropes whose AM was more than 6.0D,fusion and stereopsis function were seriously impaired.CONCLUSION:In the patients with previously untreated anisometropic amblyopia,higher degree of anisometropia is significantly associated with deeper amblyopia,worse contrast sensitivity,fusion and stereopsis functions.展开更多
Amblyopia is the most common cause of vision loss in children and can persist into adulthood in the absence of effective intervention.Previous clinical and neuroimaging studies have suggested that the neural mechanism...Amblyopia is the most common cause of vision loss in children and can persist into adulthood in the absence of effective intervention.Previous clinical and neuroimaging studies have suggested that the neural mechanisms underlying strabismic amblyopia and anisometropic amblyopia may be different.Therefore,we performed a systematic review of magnetic resonance imaging studies investigating brain alterations in patients with these two subtypes of amblyopia;this study is registered with PROSPERO(registration ID:CRD42022349191).We searched three online databases(PubMed,EMBASE,and Web of Science) from inception to April 1,2022;39 studies with 633 patients(324patients with anisometropic amblyo pia and 309 patients with strabismic amblyopia) and 580 healthy controls met the inclusion criteria(e.g.,case-control designed,pee r-reviewed articles) and were included in this review.These studies highlighted that both strabismic amblyopia and anisometropic amblyopia patients showed reduced activation and distorted topological cortical activated maps in the striate and extrastriate co rtices during tas k-based functional magnetic resonance imaging with spatial-frequency stimulus and retinotopic representations,respectively;these may have arisen from abnormal visual experiences.Compensations for amblyopia that are reflected in enhanced spontaneous brain function have been reported in the early visual cortices in the resting state,as well as reduced functional connectivity in the dorsal pathway and structural connections in the ventral pathway in both anisometro pic amblyopia and strabismic amblyopia patients.The shared dysfunction of anisometro pic amblyopia and strabismic amblyopia patients,relative to controls,is also chara cterized by reduced spontaneous brain activity in the oculomotor co rtex,mainly involving the frontal and parietal eye fields and the cerebellu m;this may underlie the neural mechanisms of fixation instability and anomalous saccades in amblyopia.With regards to specific alterations of the two forms of amblyo pia,anisometropic amblyo pia patients suffer more microstructural impairments in the precortical pathway than strabismic amblyopia patients,as reflected by diffusion tensor imaging,and more significant dysfunction and structural loss in the ventral pathway.Strabismic amblyopia patients experience more attenuation of activation in the extrastriate co rtex than in the striate cortex when compared to anisometropic amblyopia patients.Finally,brain structural magnetic resonance imaging alterations tend to be lateralized in the adult anisometropic amblyopia patients,and the patterns of brain alterations are more limited in amblyopic adults than in childre n.In conclusion,magnetic resonance imaging studies provide important insights into the brain alterations underlying the pathophysiology of amblyopia and demonstrate common and specific alte rations in anisometropic amblyo pia and strabismic amblyopia patients;these alterations may improve our understanding of the neural mechanisms underlying amblyopia.展开更多
AIM:To compare the effectiveness of network-based perception learning(NBPL) and traditional training in the treatment of amblyopia children.METHODS:This randomized controlled clinical trial recruited 56 participants a...AIM:To compare the effectiveness of network-based perception learning(NBPL) and traditional training in the treatment of amblyopia children.METHODS:This randomized controlled clinical trial recruited 56 participants aged 4-12 y with anisometropic and/or strabismic amblyopia. Participants were randomly divided into two groups:the NBPL group(n=28) who received patching and NBPL for 3 mo, and the control group(n=28) who got 3 mo of patching and traditional training. Best-corrected visual acuity(BCVA) in the amblyopic eye and stereoacuity were measured and compared at baseline, 1, 2, and 3 mo post-randomization.RESULTS:There were no significant differences in age, gender ratio, and BCVA between the two groups at baseline. At 3 mo, most patients gained lines(2 log MAR lines on average) of BCVA in both groups except one 11-year-old girl in the control group(P<0.05). But no significant difference in BCVA improvement of the amblyopic eye between the two groups was found(P=0.725), and amblyopia resolved(BCVA of 0.1 log MAR or better or within 1 log MAR line of the fellow eye) for 13(46.4%) participants in both groups. The number of patients with improvement of stereoacuity was 25 and 13 in the NBPL group and control group(P=0.041), respectively, and a significant difference exists in the distribution of stereopsis at 3 mo between the two groups(P=0.015). Besides, in patients with measurable stereopsis improvement degree and space for improvement in the two groups, the NBPL group also achieved better stereoscopic improvement than the control group(10/11 vs 4/11, P<0.05).CONCLUSION:The NBPL system has a significant effect on the improvement of BCVA and stereoacuity of amblyopia children and is better than traditional training in terms of stereoacuity improvement. Perceptual learning visual training may play a more important role in the treatment of amblyopia in the future.展开更多
文摘AIM:To describe the demographics,clinical characteristics and treatment outcomes of childhood amblyopia in a tertiary eye center in western India.METHODS:This was a retrospective longitudinal hospital-based study of 1382 children aged≤12y included in the National Institute of OphthalMology AmBlyopia StUdy in Indian Paediatric EyeS(NIMBUS)Study.Data on patient demographics,treatment approach,and best-corrected visual acuity(BCVA)changes were reviewed.RESULTS:The mean age of the study cohort was 4.54±2.46y,with males constituting the majority(55.4%).The cause of amblyopia was refractive error in 73.2%,strabismus in 7.3%,and anisometropia in 6.8%of eyes.The majority of therapies comprised glasses(74.4%),followed by occlusion+glasses(10.3%),occlusion alone(7.3%),and surgery+patching+glasses(5.1%).The mean occlusion time was 2.46±1.14h.After a median follow-up of 10.00(6-85)mo,the mean BCVA significantly improved from 0.85±0.41 to 0.55±0.42 logMAR.Subgroup analysis revealed BCVA gain for all etiologies,including refractive errors(P<0.001),strabismus(P<0.001),cataract(P<0.001),and ptosis(P<0.001).Additionally,eyes with refractive errors showed significantly better BCVA than eyes with cataracts(P<0.001),strabismus(P<0.001)and marginally better BCVA than eyes with ptosis(P<0.05),both at the baseline and final visit.CONCLUSION:Refractive errors are the commonest cause of amblyopia,followed by strabismus and anisometropia.Timely detection,optimal therapy,and periodic follow-up are crucial in bettering visual acuity regardless of the cause.
基金Supported by the National Natural Science Foundation of China(No.82271100)the Jiangsu Science and Technology Support Program(No.BE2022805)the Clinical Skills Enhancement Program of Jiangsu Province Hospital(No.JSPH-MC-2022-24).
文摘AIM:To assess the visual electrophysiological outcomes in children with functional amblyopia who exhibited poor response to conventional treatment.METHODS:Twenty-one children with functional amblyopia,aged 5.7±2.1y(range:4-10y),underwent comprehensive ophthalmic and refractive evaluations.Spectral domain-optical coherence tomography(SD-OCT)and multifocal electroretinography(mfERG)were conducted to analyze the macular retinal thickness and the first-order response P1 ring of the mfERG in the amblyopic eye(AE)compared to the fellow good eye(GE).RESULTS:Initially,visual acuity in the AE ranged from 20/800 to 20/40,while the GE exhibited a range of 20/25 to 20/20(P<0.01).After 6mo of treatment,17 patients demonstrated improved visual acuity in the AE to 20/50 or better,while 4 children showed no improvement.SD-OCT revealed comparable macular and optic disc structures between the AE and GE.Prior to treatment,the mfERG P1 ring amplitude was significantly reduced in the AE compared to GE(P<0.05).The AE/GE ratio of P1 ring amplitude showed significant improvement post-treatment.However,a smaller AE/GE ratio before treatment was associated with poorer improvement post-treatment.CONCLUSION:In the management of functional amblyopia,a thorough assessment of amblyopic eye examinations is crucial.Approximately 20%of amblyopic eyes may not achieve significant improvement in visual acuity,despite the absence of detectable organic retinal abnormalities.mfERG may reveal underlying abnormalities.Integrating mfERG into initial assessments or treatment follow-ups can aid in identifying potential hidden retinal defects and predicting the prognosis of the amblyopic eye.
基金National Natural Science Foundation of China(31872764 and 82171090)Shanghai Science and Technology Committee Rising-Star Program(19QA1401600)+1 种基金Shanghai Municipal Science and Technology Major Project(2018SHZDZX01)ZJLab,Shanghai Center for Brain Science and Brain-Inspired Technology.
文摘Abnormal visual experience during the critical period can cause deficits in visual function,such as amblyopia.High magnesium(Mg^(2+))supplementary can restore ocular dominance(OD)plasticity,which promotes the recovery of amblyopic eye acuity in adults.However,it remains unsolved whether Mg^(2+)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^(2+)in amblyopic mice.Behaviorally,Mg^(2+)-treated amblyopic mice showed better depth perception.Moreover,the effect of high Mg^(2+)can be suppressed with transient receptor potential melastatin-like 7(TRPM7)knockdown.Collectively,our results demonstrate that high Mg^(2+)could restore binocular visual functions from amblyopia.TRPM7 is required for the restoration of plasticity in the visual cortex after high Mg^(2+)treatment,which can provide possible clinical applications for future research and treatment of amblyopia.
基金Supported by the Kaohsiung Chang Gung Memorial Hospital and University College of Medicine(No.CMRPG8L1231,No.CMRPG8L1232,Kaohsiung,Taiwan).
文摘AIM:To evaluate the visual outcomes of standard amblyopic treatment add-on training via perceptual learning in refractive amblyopic children and to identify the risk factors for treatment failure.METHODS:Retrospective charts were reviewed in children with refractive amblyopia who received standard treatment and add-on Cambridge Visual Stimulator(CAM)training.The add-on CAM group that was enrolled had worn full-corrected glasses for at least 2mo before training.A control group received only the standard treatment.Treatment success was defined as best-corrected visual acuity(BCVA)≥20/25.The age,sex,initial BCVA,refractive errors,sessions and duration of training,and final BCVA were recorded.RESULTS:A total of 209 children(129 children in add-on CAM group and 80 children in control group)were enrolled.Seventy-six percent of unilateral and 87%of bilateral amblyopic children achieved treatment success.In children with unilateral or bilateral moderate amblyopia,the duration to reach BCVA≥20/25 was significantly shorter in add-on CAM group than in control group.Poor initial BCVA(P<0.001)and high astigmatism(P=0.007)were risk factors for treatment failure after add-on CAM training.Age,sex,and types of refractive error were not associated with treatment success.CONCLUSION:Add-on CAM training is an effective strategy for visual improvement and can shorten the treatment course when the effect of standard treatment is limited in amblyopic children.
基金supported by the National Natural Science Foundation of China(82271115,82471115)the Natural Science Foundation Team Project of Guangdong Province Grant(2015A030312016).
文摘Amblyopia is a neurodevelopmental vision disorder resulting from abnormal visual input during the critical period of visual development,such as strabismus,uncorrected anisometropia,high refractive errors,and form deprivation.It is frequently associated with reduced visual acuity and deficits in binocular vision.Traditional occlusion therapy for amblyopia has typically been restricted to infants and young children during the critical period of visual development,as it is believed to be ineffective for older children and adults due to the decreased plasticity of the mature brain.Our research group has concentrated on pivotal scientific issues in amblyopia,including quantitative methods for detecting binocular vision,especially interocular visual suppression,the mechanisms underlying binocular vision impairment in amblyopia,treatment methods and their evaluations for amblyopia,and visual plasticity and its neural mechanisms in amblyopia.This paper summarizes the visual mechanisms and treatment modalities of amblyopia based on our research and both domestic and foreign sources,while also looking forward to the future development of this field in light of existing problems.
文摘Amblyopia is a neurodevelopmental disorder of the visual cortex arising from abnormal visual experience early in life. Amblyopia is a major cause of impaired vision in infants and young children (prevalence around 3.5%). There are different treatment options for amblyopia based on its severity and age of the patient. Traditional treatments include patching or occlusion of the dominant eye and pharmacological penalisation using Atropine (1%). Recent developments in amblyopia management have found success with the use of binocular exercises and certain modifications of glasses and contact lenses. The critical age up to which amblyopia is treatable or reversible is also being pushed up with more research. With newer advancements in amblyopia therapy, the success rate is also improving with multimodal approach.
基金Supported by the Ministry of Economy,Industry and Competitiveness of Spain within the program Ramón y Cajal(RYC-2016-20471)。
文摘Strabismic amblyopia is characterized by a distorted spatial perception.In this condition,the neurofunctional disorder occurring during first years of life provoke several monocular and binocular anomalies such as crowding,deficits in the accommodative response,contrast sensitivity,and ocular motility abilities.The inhibition of the binocular function of the brain by the misaligned amblyopic eye induces a binocular imbalance leading to interocular suppression and the reduction or lack of stereoacuity.Passive treatments such as occlusion,optical and/or pharmacological penalization,and Bangerter foils has been demonstrated to be potentially useful treatments for strabismic amblyopia.Recent researches have proved new pharmacological options to improve and maintain visual acuity af ter occlusion treatment in strabismic amblyopia.Likewise,the active vision therapy,in the last years,is becoming a very relevant therapeutic option in combination with passive treatments,especially during and after monocular therapy,in the attempt of recovering the imbalanced binocular vision.
文摘Amblyopia is a common eye d isease caught by many children. For some reason, the traditional treating method is unsatisfactory and ineffective. By connecting home and hospital through Inte rnet, patients can receive service of treatment designed for their own purpose. Thus the effectiveness of therapy is expected to have sigificent improvment. A n ew Internet based telemedicine system for amblyopia is put forward in this pape r with further discussions of its principles, framework and implementation method s.
文摘Objective To compare the differences of effect on infantile amblyopia treated with auricular point sticking therapy and regular comprehensive therapy of western medicine.Methods Two hundreds and thirty cases of amblyopia patients were randomly divided into two groups,namely the group of auricular point sticking therapy,which had 120 cases（212 eyes）,and the group of comprehensive therapy,which had 110 cases（194 eyes）.The seed of Semen Vaccariae was applied at the ear point such as the eye,ear Shenmen,the liver,the spleen and the kidney.Regular comprehensive therapy of western medicine included covering method,vision corrected with glasses and fine exercise.Vision improvements of the two groups were observed with a three-year follow up.Results The effective rates of the auricular point sticking therapy group and comprehensive therapy group of ametropic amblyopia were 81.0%（64/79） and 52.2%（36/69）,respectively.The effective rates of anisometropic amblyopia of the two groups were 73.1%（49/67） and 47.7%（31/65）,respectively.And the effective rates of the two groups of strabismic amblyopia were 71.2%（47/66） and 45.0%（27/60）,respectively.The therapeutic effects of auricular point sticking therapy on all kinds of amblyopia were better than those of the comprehensive therapy（all P0.05）.Conclusion The effect of auricular point sticking therapy on infantile amblyopia is better than that of regular comprehensive therapy of western medicine,which can obviously improve the vision of the patients with easy manipulations.
文摘Objective:To explore the changes of lateral geniculate body and visual cortex in monocular strabismus and form deprived amblyopic rat,and visual development plastic stage and visual plasticity in adult rats.Methods:A total of 60 SD rats ages 13 d were randomly divided into A,B,C three groups with 20 in each group,group A was set as the normal control group without any processing,group B was strabismus amblyopic group,using the unilateral extraocular rectus resection to establish the strabismus amblyopia model,group C was monocular form deprivation amblyopia group using unilateral eyelid edge resection+lid suture.At visual developmental early phase(P2S),meta phase(P3S),late phase(P45)and adult phase(P120),the lateral geniculate body and visual cortex area 17 of five rats in each group were exacted for C-fos Immunocytochemistry.Neuron morphological changes in lateral geniculate body and visual cortex was observed,the positive neurons differences of C-fos expression induced by light stimulation was measured in each group,and the condition of radiation development of P120 amblyopic adult rats was observed.Results:In groups B and C,C-fos positive cells were significantly lower than the control group at P25(P<0.05),there was no statistical difference of C-fos protein positive cells between group B and group A(P>0.05),C-fos protein positive cells level of group B was significantly lower than that of group A(P<0.05).The binoculus C-fos protein positive cells level of groups B and C were significantly higher than that of control group at P35,P4S and P120 with statistically significant differences(P<0.05).Conclusions:The increasing of C-fos expression in geniculate body and visual cortex neurons of adult amblyopia suggests the visual cortex neurons exist a certain degree of visual plasticity.
基金Grant from Major Scientific Research Program of Medical Treatment and Public Health of Guangxi Zhuang Autonomous Region, No.200730
文摘BACKGROUND： Conventional methods （such as occlusion therapy, fine manipulation, complementary, and alternative medicine） take effects slowly, are time and labor consuming, and have uncertain curative effects in the treatment of amblyopia. Perceptual learning, a new method for treating amblyopia, improves the ability to process signals from the cerebral optic nerve system by specific visual stimulation and visual learning, as well as activation of the visual signal pathway utilizing brain nervous system plasticity. OBJECTIVE： This study investigated and evaluated the curative effects of perceptual learning, which can directionally increase brain plasticity, on the treatment of amblyopia in children. The relationship between curative effect and time was also analyzed. DESIGN： A self-control experiment. SETTING： Visual Science and Optometry Center, People＇s Hospital of Guangxi Zhuang Autonomous Region. PARTICIPANTS： A total of 125 amblyopic children （250 amblyopic eyes）, 73 males, 52 females, averaging （6±2） years of age, received treatment at the Visual Science and Optometry Center, People＇s Hospital of Guangxi Zhuang Autonomous Region between September 2006 and February 2007 and were recruited for this study. All children presented with no structural disease of the eyeballs. Written informed consent for therapeutic regiments was obtained from each child＇s parent. The protocol received approval from the Hospital＇s Ethics Committee. METHODS： Visual function was tested with a perceptual learning system （Research Center for Human Health and Development of Sun Yat-sen University, National Engineering Technique Research Center for Medical Care Implement） for visual noise, position noise, contour discrimination, contrast sensitivity, grating stereogram, and random-dot fusion. These tests helped to evaluate the efficiency of visual information processing of these children, and to determine the degree of defects of the optic nerve cells and the connections of visual cortical neurons. According to results of visual function tests, individualized treatment was adopted for each amblyopia patient using perceptual learning system. One course of treatment lasted one month, and treatment was performed twice every day with two training procedures （each training procedure lasted for ten minutes）. There was a ten-minute time interval between the two training procedures. The training treatment was performed in a quiet and dark environment. Visual acuity and recovery of visual function were tested every month. Original training procedure was continued or adjusted according to the results of visual function. MAIN OUTCOME MEASURES： Visual function change; relationship of curative effects and curative time. RESULTS： A total of 125 amblyopia children were included in the final analysis. The total efficiency of perceptual learning for treating amblyopia in children was 75.2%. Visual acuity began to greatly increase 3 months after treatment （P 〈 0.05）. Visual acuity was best corrected from 0.60 ± 0.23 before treatment to 0.86 ± 0.26 after treatment （P 〈 0.05）. The mean time to reach improved levels with curative effects was （2.82 ± 1.30） months, and to reach a basically cured level was （2.87 ±1.40） months. Percentage of improved visual acuity was the highest [98% （39/40）] in children that received 3 months of treatment and the lowest [55% （31/56）] in children that received 1 month of treatment （P 〈 0.05）. The percentage of basically cured levels with curative effects increased with length of learning time and was the greatest in children that received 4 months of treatment [67% （31/46）, P 〈 0.05]. CONCLUSION： Perceptual learning rapidly and remarkably improves visual function of amblyopia children; however, the curative effects are first apparent two and three months after intervention.
基金Supported by chia funding of Yale-China Association, the National Natural Science Foundation of China (No.81570847)the Natural Science Foundation of Hunan Province (No.2016JJ4095)+1 种基金the Programs ofScience-Technology Commission of Hunan Province (No.2015JC3036)Department of Science and Technology, Hunan (No. 2015TP2007)
文摘AIM: To determine the prevalence and factors associated with amblyopia among children aged 30-83 mo in central south of China.METHODS: A population-based, cross-sectional study was conducted in children aged 30-83 mo in Changsha(an urban city) and Zhangjiajie(a rural area) in central south of China. Clinical examinations including ocular alignment, ocular motility, visual acuity(VA), prism cover test, cycloplegic refraction, slit lamp examination and fundus examination were performed by trained study ophthalmologists and optometrists. Unilateral amblyopia was defined as a 2-line difference between eyes with VA<20/32 in the worse eye and with coexisting anisometropia [≥1.00 D spherical eutivalent(SE) for hyperopia, ≥3.00 D SE for myopia, and ≥1.50 D for astigmatism], strabismus, or past or present visual axis obstruction. Bilateral amblyopia was defined as VA in both eyes <20/40(≥ 48-month-old) and <20/50(< 48-month-old), with coexisting hyperopia ≥4.00 D SE, myopia ≤-6.00 D SE, and astigmatism ≥2.50 D, or past or present visual axis obstruction.RESULTS: There were 8042 children enrolled and 7713 children were screened. The amblyopia prevalence in children aged 30-83 mo was 1.09%(95% confidence interval, 0.86%-1.35%) with no age(P=0.81), gender(P=0.46) or area distribution(P=0.93) differences. Of these, 0.68% were unilateral cases and 0.41% were bilateral cases. Underlying causes included anisometropia(40%), binocular refractive error(36%), strabismus(14%) and deprivation(10%). Hyperopia combined with astigmatism was the frequent refractive error for ametropic and anisometropic amblyopia.CONCLUSION: In this rural and urban Chinese population, 1.09% of children with 30-83 mo of age had amblyopia, a prevalence rate similar to that of many other studies. Anisometropia and refractive error are the most common causes of unilateral and bilateral amblyopia respectively.
文摘AIM:To compare the retinal nerve fiber layer (RNFL) thickness and macular thickness in the amblyopic eye with that in the sound eye of children with hyperopic anisometropic amblyopia using optical coherence tomography (OCT). METHODS:A prospective, nonrandom, intraindividual comparative cohort study includes 72 children with hyperopic anisometropic amblyopia in a single center. Macular thickness, macular foveola thickness, and peripapillary RNFL thickness were compared between the amblyopia eyes and the contralateral sound eyes. ·RESULTS:There were 38 male and 34 female patients, with a mean age as 9.7 ±1.9 years (range, 5-16 years). Hyperopic was +3.62±1.16D (range +2.00D to +6.50D) in the amblyopic eyes, which was significantly higher in the control eyes with +0.76±0.90D (range 0D to +2.00D) (P 【 0.01). The mean peripapillary RNFL thickness was 113.9± 7.2μm and 109.2 ±6.9μm in the amblyopic eye and the normal eye, respectively, reaching statistical significance (P = 0.02). The mean macular foveola thickness was significantly thicker in the amblyopic eyes than the contralateral sound eyes (181.4±14.2μm vs 175.2±13.3μm, P 【0.01), but the 1mm, 3mm or 6mm macular thickness central macular thickness was not significantly different. Degree of anisometropia in the contralateral eyes was not significantly correlated with differences of peripapillary RNFL, macular foveola thickness or central macular thickness. CONCLUSION:Eyes with hyperopic anisometropic amblyopia are found thicker macular foveola and peripapillary RNFL than the contralateral eyes in children.
文摘AIM： To assess the outcomes of posterior chamber implantable collamer lens （ICL） implantation in Chinese pediatric patients with unilateral high myopic amblyopia.METHODS： Eleven eyes of 11 amblyopic patients aged 11.02±3.34y underwent ICL （model V4, Staar Surgical Inc.） implantation to treat unilateral anisometropia were studied. Visual acuity, cycloplegic refraction, contrast sensitivity, stereopsis, intraocular pressure （IOP）, vaulting, corneal endothelial cell count and complications were evaluated. Patients completed follow-up at 3d, 1, 3mo and the last follow-up time （mean 8.18±2.82mo） after surgery.RESULTS： The mean myopic anisometropia was -13.70±3.25 D preoperatively and ＋0.69±2.63 D at 8mo postoperatively. The logMAR corrected distance visual acuity （CDVA） of the amblyopic eye was 1.51±0.72 preoperatively and 0.75±0.40 at 8mo postoperatively. The logMAR CDVA at 3d, 1, 3 and 8mo postoperatively improved by a mean of 0.64, 1.55, 1.82 and 2.64 lines and gained more than 2 lines accounted for 18%, 45%, 45%, 64%, respectively. The contrast sensitivity of 0.5, 1 and 2 cpd in amblyopic eyes was significantly increased after surgery. No patient had near stereopsis recovery. The vaulting at 3 and 8mo was significantly lower than that at 1mo postoperatively. No other intraoperative or postoperative complications were observed, except an acute pupillary block glaucoma happened in a patient at two weeks postoperatively.CONCLUSION： This short-term results indicate that ICL implantation can be a promising alternative therapy for high myopic anisometropic amblyopia in pediatric patients who have failed with conventional treatments and not suitable to corneal refraction surgery.
文摘AIM:To investigate peripapillary retinal nerve fiber layer (RNFL), macula and ganglion cell layer thicknesses (GCC) in amblyopic eyes with spectral domain optical coherence tomography (SD-OCT). METHODS:Thirty six patients with a history of unilateral amblyopia and thirty two children who had emmetropia without amblyopia were included in this study. In this institutional study, 36 eyes of 36 patients with amblyopia (AE), 36 fellow eyes without amblyopia (FE), and 32 eyes of 32 normal subjects (NE) were included. RNFL, GCC and macular thickness measurements were performed with RS-3000 OCT Retina Scan (Nidek Inc CA. USA). RESULTS:The mean global thicknesses of the RNFL were 113.22 ±21.47, 111.57 ±18.25, 109.96 ±11.31μm in the AE, FE, and NE, respectively. There was no statistically significant difference for mean global RNFL thickness among the eyes (P =0.13). The mean thicknesses of the macula were 258.25±18.31, 258.75±19.54, 248.62±10.57μm in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of macula among the eyes (P =0.06). The GCC was investigated into two parts:superior and inferior. The mean thicknesses of superior GCC were 102.57 ±13.32, 103.32 ±10.64, 100.52 ± 5.88μm in the AE, FE, and NE, respectively. The mean thicknesses of inferior GCC were 103.82 ±12.60, 107.82 ± 12.33, 105.86±10.79μm in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of superior and inferior GCC between the eyes (P =0.63, P =0.46). ·CONCLUSION:The macular thicknesses of AE and FE were greater than the NE, although it was not statistically significant. Amblyopia does not seem to have a profound effect on the RNFL, macula and GCC.
基金Supported by the National Natural Science Foundation of China(No.81870688)Shanghai Science and Technology Commission Natural Science Foundation(No.16ZR1419600)the Science and Technology Commission of Shanghai(No.17DZ2260100)
文摘AIM: To conduct a systematic review and Meta-analysis of the published literature to evaluate the pooled prevalence rate of amblyopia in patients with congenital ptosis.METHODS: We searched the PubMed, Embase, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang Data, and Chongqing VIP databases for studies reporting the prevalence of amblyopia in patients with congenital ptosis. The reference lists of relevant studies were scanned. Heterogeneity of effect sizes across studies was tested. We calculated prevalence ratios to compare prevalence estimates for different causes of amblyopia in patients with congenital ptosis, as well as for different geographical regions, year of publication and sample size in subgroup analyses. A systematic review and Meta-analysis were performed.RESULTS: We identified 29 eligible surveys with a total population of 2436. Prevalence rates of amblyopia ranged from 13.8% to 69%. We noted substantial heterogeneity in prevalence estimates for amblyopia in congenital ptosis(Cochran’s χ2 significant at P<0.0001; I2=90%). The pooled prevalence using random-effects models of 29 studies was 32.8%(95%CI: 27.3%-38.4%) in the overall population. Compared to the overall pooled prevalence, amblyopia prevalence was higher in studies in which only subjects with blepharophimosis syndrome were included.CONCLUSION: We confirm that nearly one-third of congenital ptosis patients are suffering from or at risk for amblyopia. Patients with blepharophimosis syndrome are more likely to develop amblyopia. The identificationand management of amblyopia should be integral to the treatment of congenital ptosis.
基金Chinese Medicine Science and Technology Development Project of Shandong Province:2019-0196,2019-1060Ji’nan Municipal Science and Technology Project:201907105。
文摘The article introduced the application of Tuina at"Simingxue"(four points named after"ming")and pressing therapy at auricular points in treatment of 17 cases of anisometropic amblyopia in children.The methods:pressing and kneading with the thumb at Jingming(睛明BL1),Shangming(上明Extra),Yiming(翳明EX-HN14)and Guangming(光明GB37).Pressing with the finger digital at Yintang(印堂EX-HN3),Cuanzhu(攒竹BL2),Yuyao(鱼腰EX-HN4),Taiyang(太阳EX-HN5),Yingbai(阳白GB14),Sizhukong(丝竹空TE23),Tongziliao(瞳子髎GB1),Qiuhou(球后EX-HN7)and Chengqi(承泣ST1).Scraping the upper and lower orbits,nipping the eyebrows,pushing the orbits,pushing baoping and warming the eyes.Pressing Quchi(曲池LI11),Hegu(合谷LI4),GB37,Zusanli(足三里ST36),Xuehai(血海SP10)and Sanyinjiao(三阴交SP6).Rolling on the bilateral distributions of bladder meridian on the back.Pressing and kneading at Touwei(头维ST8),Qucha(曲差BL4),Baihui(百会GV20),Sishencong(四神聪EX-HN1),Fengchi(风池GB20)and Dazhui(大椎GV14).Grasping five meridians,scattering bilateral temporal regions,grasping and kneading the neck and nape region and holding Jianjing(肩井GB21).Auricular pressing therapy was exerted at Yan(眼eye,LO5),Gan(肝liver,CO12),Shen(肾kidney,CO10),Pi(脾spleen,CO13),Wei(胃stomach,CO4),Pizhixia(皮质下subcortex,AT4),Pingjianqian(屏间前anterior intertragic notch,TG21)and Pingjianhou屏间后(posterior intertragic notch,AT11).The treatment was given 3 times a week,6 treatments made one course and 4 courses of treatment were required.Of 17 patients,2 cases were cured,13 cases cured basically,1 case improved and 1 case failed.The total effective rate was 88.2%.
基金Zhejiang Province Science Foundation of Health Bureau of China(No.2012KYA102)
文摘AIM:To assess the quantitative association between anisometropia magnitude(AM) and the losses of resolution and contrast sensitivity;and to exemplify how the function of fusion and stereopsis vary with AM in previously untreated anisometropic amblyopia. METHODS:A total of 57 patients with previously untreated anisometropic amblyopia without strabismus(range:8-35 years),were measured refractive error,best corrected visual acuity(BCVA),fusion and stereopsis,and 48 patients have completed contrast sensitivity function test.AM was determined by dioptric vector addition model,and the amblyopia depth was determined by the difference of BCVA in logMAR units between the amblyopic and fellow eyes.RESULTS:AM was significantly correlated with both amblyopia depth(Pearson R=0.728,P【0.001) and the inter-ocular difference of the area under the log contrast sensitivity function(AULCSF)(R=0.505,P【0.001).Depth of amblyopia and the inter-ocular difference of AULCSF was also significantly correlated(R=0.761,P【0.001).The more severity of amblyopia,the poorer levels of contrast sensitivity.Most pure anisometropes with AM was less than 3.0D retain fusion and some stereopsis,but when AM were more than 3.0D,especially for the anisometropes whose AM was more than 6.0D,fusion and stereopsis function were seriously impaired.CONCLUSION:In the patients with previously untreated anisometropic amblyopia,higher degree of anisometropia is significantly associated with deeper amblyopia,worse contrast sensitivity,fusion and stereopsis functions.
文摘Amblyopia is the most common cause of vision loss in children and can persist into adulthood in the absence of effective intervention.Previous clinical and neuroimaging studies have suggested that the neural mechanisms underlying strabismic amblyopia and anisometropic amblyopia may be different.Therefore,we performed a systematic review of magnetic resonance imaging studies investigating brain alterations in patients with these two subtypes of amblyopia;this study is registered with PROSPERO(registration ID:CRD42022349191).We searched three online databases(PubMed,EMBASE,and Web of Science) from inception to April 1,2022;39 studies with 633 patients(324patients with anisometropic amblyo pia and 309 patients with strabismic amblyopia) and 580 healthy controls met the inclusion criteria(e.g.,case-control designed,pee r-reviewed articles) and were included in this review.These studies highlighted that both strabismic amblyopia and anisometropic amblyopia patients showed reduced activation and distorted topological cortical activated maps in the striate and extrastriate co rtices during tas k-based functional magnetic resonance imaging with spatial-frequency stimulus and retinotopic representations,respectively;these may have arisen from abnormal visual experiences.Compensations for amblyopia that are reflected in enhanced spontaneous brain function have been reported in the early visual cortices in the resting state,as well as reduced functional connectivity in the dorsal pathway and structural connections in the ventral pathway in both anisometro pic amblyopia and strabismic amblyopia patients.The shared dysfunction of anisometro pic amblyopia and strabismic amblyopia patients,relative to controls,is also chara cterized by reduced spontaneous brain activity in the oculomotor co rtex,mainly involving the frontal and parietal eye fields and the cerebellu m;this may underlie the neural mechanisms of fixation instability and anomalous saccades in amblyopia.With regards to specific alterations of the two forms of amblyo pia,anisometropic amblyo pia patients suffer more microstructural impairments in the precortical pathway than strabismic amblyopia patients,as reflected by diffusion tensor imaging,and more significant dysfunction and structural loss in the ventral pathway.Strabismic amblyopia patients experience more attenuation of activation in the extrastriate co rtex than in the striate cortex when compared to anisometropic amblyopia patients.Finally,brain structural magnetic resonance imaging alterations tend to be lateralized in the adult anisometropic amblyopia patients,and the patterns of brain alterations are more limited in amblyopic adults than in childre n.In conclusion,magnetic resonance imaging studies provide important insights into the brain alterations underlying the pathophysiology of amblyopia and demonstrate common and specific alte rations in anisometropic amblyo pia and strabismic amblyopia patients;these alterations may improve our understanding of the neural mechanisms underlying amblyopia.
基金Shanghai Health Situation Project (No.201540252)Shanghai Tongji Hospital Clinical Research Incubation Project [No.ITJ(QN)1812]Shanghai Science and Technology Committee (STCSM) Science and Technology Innovation Program (No.20S31906000)。
文摘AIM:To compare the effectiveness of network-based perception learning(NBPL) and traditional training in the treatment of amblyopia children.METHODS:This randomized controlled clinical trial recruited 56 participants aged 4-12 y with anisometropic and/or strabismic amblyopia. Participants were randomly divided into two groups:the NBPL group(n=28) who received patching and NBPL for 3 mo, and the control group(n=28) who got 3 mo of patching and traditional training. Best-corrected visual acuity(BCVA) in the amblyopic eye and stereoacuity were measured and compared at baseline, 1, 2, and 3 mo post-randomization.RESULTS:There were no significant differences in age, gender ratio, and BCVA between the two groups at baseline. At 3 mo, most patients gained lines(2 log MAR lines on average) of BCVA in both groups except one 11-year-old girl in the control group(P<0.05). But no significant difference in BCVA improvement of the amblyopic eye between the two groups was found(P=0.725), and amblyopia resolved(BCVA of 0.1 log MAR or better or within 1 log MAR line of the fellow eye) for 13(46.4%) participants in both groups. The number of patients with improvement of stereoacuity was 25 and 13 in the NBPL group and control group(P=0.041), respectively, and a significant difference exists in the distribution of stereopsis at 3 mo between the two groups(P=0.015). Besides, in patients with measurable stereopsis improvement degree and space for improvement in the two groups, the NBPL group also achieved better stereoscopic improvement than the control group(10/11 vs 4/11, P<0.05).CONCLUSION:The NBPL system has a significant effect on the improvement of BCVA and stereoacuity of amblyopia children and is better than traditional training in terms of stereoacuity improvement. Perceptual learning visual training may play a more important role in the treatment of amblyopia in the future.
