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
Introduction:Premature depletion of hyperopic reserve has been demonstrated to associate with subsequent myopia development.However,the relationship between screen use and insufficient hyperopic reserve(defined as sph...Introduction:Premature depletion of hyperopic reserve has been demonstrated to associate with subsequent myopia development.However,the relationship between screen use and insufficient hyperopic reserve(defined as spherical equivalent refraction below age-specific thresholds)remains unclear,and regional heterogeneity in this association warrants investigation.Methods:This cross-sectional study(2020–2024)included 28,993 children from 9 provincial-level administrative divisions(PLADs).We assessed associations between screen exposure(time and habits)and hyperopic reserve status.Multivariable logistic regression analyses were conducted with stratified analyses based on regional gross domestic product(GDP)levels.Results:Among screened children,49.0%exhibited insufficient hyperopic reserve.High screen time[odds ratio(OR)=1.21,95%confidence interval(95%CI):1.14,1.29]and poor screen habits(OR=1.19,95%CI:1.12,1.27)were independently associated with insufficient hyperopic reserve.Low-GDP regions demonstrated significantly higher detection rates among children aged 6–9 years,whereas high-GDP regions showed accelerated increases in detection rates after age 11.Low-GDP regions exhibited heightened risks for both high screen time and poor screen habits,with this association most pronounced among girls in low-GDP areas.Conclusions:Screen exposure associates with insufficient hyperopic reserve,exhibiting notable regional and gender differences.High screen time and poor screen habits represent key risk factors for insufficient hyperopic reserve,particularly among girls residing in low-GDP areas.展开更多
Background Conventional mechanical or alcohol-assisted photorefractive keratectomy(PRK)techniques for cor‑rection of hyperopia and hyperopic astigmatism were associated with inconsistent results.The aim of this study ...Background Conventional mechanical or alcohol-assisted photorefractive keratectomy(PRK)techniques for cor‑rection of hyperopia and hyperopic astigmatism were associated with inconsistent results.The aim of this study is to evaluate the 12-month visual and refractive outcomes of the relatively new single-step transepithelial photorefractive keratectomy(TE-PRK)for moderate hyperopia and hyperopic astigmatism.Methods This is a prospective interventional study.Forty-eight eyes of 30 patients with moderate hyperopia or hyperopic astigmatism with a cycloplegic spherical equivalent refraction(SEQ)between 2.0 and 4.5 diopters(D)underwent single-step StreamLight®TE-PRK using EX500 excimer laser(Alcon Laboratories,USA).The main outcome measures were recorded at 6 and 12 months postoperatively including assessment of logarithm of the minimum angle resolution(logMAR)uncorrected and corrected distance visual acuity(UDVA,CDVA),cycloplegic refraction,corneal topographic changes as well as post-PRK peripheral haze grading.Results The mean preoperative cycloplegic SEQ was signifcantly reduced from 3.21±0.61 D to 0.35±0.04 D and 0.41±0.04 D at 6 and 12 months,respectively(P<0.001).The mean preoperative UDVA signifcantly improved from 0.53±0.02 logMAR to 0.07±0.01 logMAR and 0.08±0.01 logMAR at 6 and 12 months,respectively(P<0.001)while the mean preoperative logMAR CDVA showed non-signifcant change over time throughout the study(P=0.135).At the end of the study,41 eyes(85.4%)achieved UDVA of 20/25 or better and no eye lost any lines of CDVA.Thirty-eight eyes(79.1%)had a postoperative cycloplegic cylinder of 0.5 D or less at 12 months.The mean preoperative mean keratometry showed signifcant increase at 6 and 12 months postoperatively(P<0.001)while there was no signifcant change between the two postoperative visits denoting topographic stability(P=0.058).The mean postoperative Q value at 6 and 12 months showed a signifcant prolate shift(P<0.001).No haze was observed in 62.5%and 85.4%of the enrolled eyes at 6 and 12 months,respectively.Conclusions Single-step StreamLight®TE-PRK for moderate hyperopia and hyperopic astigmatism achieved acceptable visual and refractive outcomes.展开更多
Introduction:To investigate the distribution characteristics of hyperopic reserve across 10 PLADs in China and determine the levels and patterns of change in spherical equivalent after cycloplegic refraction among chi...Introduction:To investigate the distribution characteristics of hyperopic reserve across 10 PLADs in China and determine the levels and patterns of change in spherical equivalent after cycloplegic refraction among children and adolescents aged 5–18 years by sex.Methods:The National Disease Control and Prevention Administration of China conducted a comprehensive study between 2020 and 2024,involving 61,076 students from kindergarten through high school across 10 provincial-level administrative divisions(PLADs)in China.Median[first quartile(Q1),third quartile(Q3)]values were used to describe SE distribution,and the Mann–Whitney U test was employed to compare SE between males and females within the same age group.Results:The median SE decreased progressively with age in both sexes,with females demonstrating a more rapid decline than males.The median SE reached≤−0.5 D at age 12 for males and age 11 for females.Among non-myopic participants,both sexes exhibited a consistent decline in median SE from ages 5–12,followed by relatively stable fluctuations from ages 13–18.However,the magnitude of both decline and fluctuations was greater in females than in males.Conclusion:Hyperopic reserve among Chinese children and adolescents aged 5–18 years is substantially insufficient,with myopia onset occurring at increasingly younger ages,particularly among females approaching puberty and younger children.Early initiation of myopia prevention and control measures is essential,with timely monitoring of hyperopic reserve to prevent premature depletion.展开更多
Myopia represents a critical public health challenge with far-reaching implications for future development,as global prevalence is projected to reach 49.8%by 2050(1–2).The Chinese government has implemented comprehen...Myopia represents a critical public health challenge with far-reaching implications for future development,as global prevalence is projected to reach 49.8%by 2050(1–2).The Chinese government has implemented comprehensive policies and proactive measures(3–6)to accelerate prevention efforts through systematic interventions.Traditional monitoring approaches have focused primarily on vision screening and diopter examination following myopia onset,thereby lacking early warning systems for tracking hyperopic reserve depletion.Commissioned by the National Disease Control and Prevention Bureau,our team has spearheaded a landmark large-scale monitoring project on hyperopic reserves among children and adolescents since 2020,encompassing ten provincial-level administrative divisions(PLADs;including Beijing,Liaoning,Zhejiang,Henan,Chongqing,Shaanxi,Guangdong,Shanxi,Hunan,and Shandong).展开更多
AIM:To evaluate the visual outcomes of implantable collamer lenses(ICLs)and identify the possible risk factors for ICL axis misalignment,and consequently,repositioning,explanting,or exchanging at a specialized eye hos...AIM:To evaluate the visual outcomes of implantable collamer lenses(ICLs)and identify the possible risk factors for ICL axis misalignment,and consequently,repositioning,explanting,or exchanging at a specialized eye hospital in Saudi Arabia.METHODS:The medical records of 813 eyes with different refractive errors corrected with ICL implantation were identified and included in this single-arm retrospective cohort study.The following data were collected:demographic characteristics,primary diagnosis,preoperative refraction,anterior chamber depth(ACD),white-to-white(WTW)measurement,endothelial cell density(ECD),and axial length.Patients’satisfaction and complaints,and their postoperative refraction,vault depth,and axis alignment with the preoperative target,were reviewed during the postoperative period.Collectively,these data were correlated with symptomatic axis rotation and the need for repositioning,explantation,or exchange due to high or low ICL vaults.RESULTS:Of 813 eyes,27(3.32%),13(1.59%),and 11(1.35%)required ICL repositioning,ICL explantation only without exchange,and ICL explantation with the placement of a new ICL,respectively.The mean follow-up period was 37.5mo.The main cause of explanation or exchange was incorrect WTW measurement in seven(29.17%)eyes,followed by high vault in four(16.56%)eyes.ICL repositioning was required in 27(3.32%)eyes with considerable rotation.Only 2(0.24%)eyes developed cataracts that required ICL removal,and retinal complications were reported in 7(0.86%)eyes.Long-term glaucoma and corneal decompensation were not observed in this cohort.CONCLUSION:With a high safety profile and reversibility,ICL implantation is a good alternative to corneal-based refractive surgery in eyes unsuitable for laser vision correction.The rate of secondary procedures in our study was 6.26%.Old age is a risk factor for secondary surgical interventions in the repositioning group,whereas abnormal vault and toric ICL rotation in the explantation group necessitated subsequent surgical procedures.Overall,ICL implantation demonstrates a good efficacy index and safety profile in patients with diverse refractive errors.展开更多
BACKGROUND Myopia,as one of the common ocular diseases,often occurs in adolescence.In addition to the harm from itself,it may also lead to serious complications.Thus,prevention and control of myopia are attracting mor...BACKGROUND Myopia,as one of the common ocular diseases,often occurs in adolescence.In addition to the harm from itself,it may also lead to serious complications.Thus,prevention and control of myopia are attracting more and more attention.Previous research revealed that single-focal glasses and orthokeratology lenses(OK lenses)played an important part in slowing down myopia and preventing high myopia.AIM To compare the clinical effects of OK lenses and frame glasses against the increase of diopter in adolescent myopia and further explore the mechanism of the OK lens.METHODS Changes in diopter and axial length were collected among 70 adolescent myopia patients(124 eyes)wearing OK lenses for 1 year(group A)and 59 adolescent myopia patients(113 eyes)wearing frame glasses(group B).Refractive states of their retina were inspected through multispectral refraction topography.The obtained hyperopic defocus was analyzed for the mechanism of OK lenses on slowing down the increase of myopic diopter by delaying the increase of ocular axis length and reducing the near hyperopia defocus.RESULTS Teenagers in groups A and B were divided into low myopia(0 D--3.00 D)and moderate myopia(-3.25 D--6.00 D),without statistical differences among gender and age.After 1-year treatment,the increase of diopter and axis length and changes of retinal hyperopic defocus amount of group A were significantly less than those of group B.According to the multiple linear analysis,the retinal defocus in the upper,lower,nasal,and temporal directions had almost the same effect on the total defocus.The amount of peripheral retinal defocus(15°-53°)in group A was significantly lower than that in group B.CONCLUSION Multispectral refraction topography is progressive and instructive in clinical prevention and control of myopia.展开更多
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.
基金the Ministry of Science and Technology of the People’s Republic of China through the National Key Research and Development Program of China(Grant No.2021YFC2702102)the Beijing Municipal Health Commission High-level Public Health Technical Talent Construction Project(Leading Talent-01-09).
文摘Introduction:Premature depletion of hyperopic reserve has been demonstrated to associate with subsequent myopia development.However,the relationship between screen use and insufficient hyperopic reserve(defined as spherical equivalent refraction below age-specific thresholds)remains unclear,and regional heterogeneity in this association warrants investigation.Methods:This cross-sectional study(2020–2024)included 28,993 children from 9 provincial-level administrative divisions(PLADs).We assessed associations between screen exposure(time and habits)and hyperopic reserve status.Multivariable logistic regression analyses were conducted with stratified analyses based on regional gross domestic product(GDP)levels.Results:Among screened children,49.0%exhibited insufficient hyperopic reserve.High screen time[odds ratio(OR)=1.21,95%confidence interval(95%CI):1.14,1.29]and poor screen habits(OR=1.19,95%CI:1.12,1.27)were independently associated with insufficient hyperopic reserve.Low-GDP regions demonstrated significantly higher detection rates among children aged 6–9 years,whereas high-GDP regions showed accelerated increases in detection rates after age 11.Low-GDP regions exhibited heightened risks for both high screen time and poor screen habits,with this association most pronounced among girls in low-GDP areas.Conclusions:Screen exposure associates with insufficient hyperopic reserve,exhibiting notable regional and gender differences.High screen time and poor screen habits represent key risk factors for insufficient hyperopic reserve,particularly among girls residing in low-GDP areas.
基金Open access funding provided by The Science,Technology&Innovation Funding Authority(STDF)in cooperation with The Egyptian Knowledge Bank(EKB).
文摘Background Conventional mechanical or alcohol-assisted photorefractive keratectomy(PRK)techniques for cor‑rection of hyperopia and hyperopic astigmatism were associated with inconsistent results.The aim of this study is to evaluate the 12-month visual and refractive outcomes of the relatively new single-step transepithelial photorefractive keratectomy(TE-PRK)for moderate hyperopia and hyperopic astigmatism.Methods This is a prospective interventional study.Forty-eight eyes of 30 patients with moderate hyperopia or hyperopic astigmatism with a cycloplegic spherical equivalent refraction(SEQ)between 2.0 and 4.5 diopters(D)underwent single-step StreamLight®TE-PRK using EX500 excimer laser(Alcon Laboratories,USA).The main outcome measures were recorded at 6 and 12 months postoperatively including assessment of logarithm of the minimum angle resolution(logMAR)uncorrected and corrected distance visual acuity(UDVA,CDVA),cycloplegic refraction,corneal topographic changes as well as post-PRK peripheral haze grading.Results The mean preoperative cycloplegic SEQ was signifcantly reduced from 3.21±0.61 D to 0.35±0.04 D and 0.41±0.04 D at 6 and 12 months,respectively(P<0.001).The mean preoperative UDVA signifcantly improved from 0.53±0.02 logMAR to 0.07±0.01 logMAR and 0.08±0.01 logMAR at 6 and 12 months,respectively(P<0.001)while the mean preoperative logMAR CDVA showed non-signifcant change over time throughout the study(P=0.135).At the end of the study,41 eyes(85.4%)achieved UDVA of 20/25 or better and no eye lost any lines of CDVA.Thirty-eight eyes(79.1%)had a postoperative cycloplegic cylinder of 0.5 D or less at 12 months.The mean preoperative mean keratometry showed signifcant increase at 6 and 12 months postoperatively(P<0.001)while there was no signifcant change between the two postoperative visits denoting topographic stability(P=0.058).The mean postoperative Q value at 6 and 12 months showed a signifcant prolate shift(P<0.001).No haze was observed in 62.5%and 85.4%of the enrolled eyes at 6 and 12 months,respectively.Conclusions Single-step StreamLight®TE-PRK for moderate hyperopia and hyperopic astigmatism achieved acceptable visual and refractive outcomes.
基金the Ministry of Science and Technology of the People’s Republic of China through the National Key Research and Development Program of China(2021YFC2702102)the Beijing Municipal Health Commission High-level Public Health Technical Talent Construction Project(Leading Talent-01-09).
文摘Introduction:To investigate the distribution characteristics of hyperopic reserve across 10 PLADs in China and determine the levels and patterns of change in spherical equivalent after cycloplegic refraction among children and adolescents aged 5–18 years by sex.Methods:The National Disease Control and Prevention Administration of China conducted a comprehensive study between 2020 and 2024,involving 61,076 students from kindergarten through high school across 10 provincial-level administrative divisions(PLADs)in China.Median[first quartile(Q1),third quartile(Q3)]values were used to describe SE distribution,and the Mann–Whitney U test was employed to compare SE between males and females within the same age group.Results:The median SE decreased progressively with age in both sexes,with females demonstrating a more rapid decline than males.The median SE reached≤−0.5 D at age 12 for males and age 11 for females.Among non-myopic participants,both sexes exhibited a consistent decline in median SE from ages 5–12,followed by relatively stable fluctuations from ages 13–18.However,the magnitude of both decline and fluctuations was greater in females than in males.Conclusion:Hyperopic reserve among Chinese children and adolescents aged 5–18 years is substantially insufficient,with myopia onset occurring at increasingly younger ages,particularly among females approaching puberty and younger children.Early initiation of myopia prevention and control measures is essential,with timely monitoring of hyperopic reserve to prevent premature depletion.
文摘Myopia represents a critical public health challenge with far-reaching implications for future development,as global prevalence is projected to reach 49.8%by 2050(1–2).The Chinese government has implemented comprehensive policies and proactive measures(3–6)to accelerate prevention efforts through systematic interventions.Traditional monitoring approaches have focused primarily on vision screening and diopter examination following myopia onset,thereby lacking early warning systems for tracking hyperopic reserve depletion.Commissioned by the National Disease Control and Prevention Bureau,our team has spearheaded a landmark large-scale monitoring project on hyperopic reserves among children and adolescents since 2020,encompassing ten provincial-level administrative divisions(PLADs;including Beijing,Liaoning,Zhejiang,Henan,Chongqing,Shaanxi,Guangdong,Shanxi,Hunan,and Shandong).
文摘AIM:To evaluate the visual outcomes of implantable collamer lenses(ICLs)and identify the possible risk factors for ICL axis misalignment,and consequently,repositioning,explanting,or exchanging at a specialized eye hospital in Saudi Arabia.METHODS:The medical records of 813 eyes with different refractive errors corrected with ICL implantation were identified and included in this single-arm retrospective cohort study.The following data were collected:demographic characteristics,primary diagnosis,preoperative refraction,anterior chamber depth(ACD),white-to-white(WTW)measurement,endothelial cell density(ECD),and axial length.Patients’satisfaction and complaints,and their postoperative refraction,vault depth,and axis alignment with the preoperative target,were reviewed during the postoperative period.Collectively,these data were correlated with symptomatic axis rotation and the need for repositioning,explantation,or exchange due to high or low ICL vaults.RESULTS:Of 813 eyes,27(3.32%),13(1.59%),and 11(1.35%)required ICL repositioning,ICL explantation only without exchange,and ICL explantation with the placement of a new ICL,respectively.The mean follow-up period was 37.5mo.The main cause of explanation or exchange was incorrect WTW measurement in seven(29.17%)eyes,followed by high vault in four(16.56%)eyes.ICL repositioning was required in 27(3.32%)eyes with considerable rotation.Only 2(0.24%)eyes developed cataracts that required ICL removal,and retinal complications were reported in 7(0.86%)eyes.Long-term glaucoma and corneal decompensation were not observed in this cohort.CONCLUSION:With a high safety profile and reversibility,ICL implantation is a good alternative to corneal-based refractive surgery in eyes unsuitable for laser vision correction.The rate of secondary procedures in our study was 6.26%.Old age is a risk factor for secondary surgical interventions in the repositioning group,whereas abnormal vault and toric ICL rotation in the explantation group necessitated subsequent surgical procedures.Overall,ICL implantation demonstrates a good efficacy index and safety profile in patients with diverse refractive errors.
文摘BACKGROUND Myopia,as one of the common ocular diseases,often occurs in adolescence.In addition to the harm from itself,it may also lead to serious complications.Thus,prevention and control of myopia are attracting more and more attention.Previous research revealed that single-focal glasses and orthokeratology lenses(OK lenses)played an important part in slowing down myopia and preventing high myopia.AIM To compare the clinical effects of OK lenses and frame glasses against the increase of diopter in adolescent myopia and further explore the mechanism of the OK lens.METHODS Changes in diopter and axial length were collected among 70 adolescent myopia patients(124 eyes)wearing OK lenses for 1 year(group A)and 59 adolescent myopia patients(113 eyes)wearing frame glasses(group B).Refractive states of their retina were inspected through multispectral refraction topography.The obtained hyperopic defocus was analyzed for the mechanism of OK lenses on slowing down the increase of myopic diopter by delaying the increase of ocular axis length and reducing the near hyperopia defocus.RESULTS Teenagers in groups A and B were divided into low myopia(0 D--3.00 D)and moderate myopia(-3.25 D--6.00 D),without statistical differences among gender and age.After 1-year treatment,the increase of diopter and axis length and changes of retinal hyperopic defocus amount of group A were significantly less than those of group B.According to the multiple linear analysis,the retinal defocus in the upper,lower,nasal,and temporal directions had almost the same effect on the total defocus.The amount of peripheral retinal defocus(15°-53°)in group A was significantly lower than that in group B.CONCLUSION Multispectral refraction topography is progressive and instructive in clinical prevention and control of myopia.
