Objective To investigate the neural processing characteristics of the top-down pathway in adults with amblyopia during face perception tasks,with a focus on event-related potential components(P1,N170),thereby elucida-ting the role of top-down pathways in face cognition.Methods Sixteen amblyopic patients(amblyopia group)and fif-teen healthy controls(control group)were recruited.Participants performed a face perception task designed in E-Prime 3.0,while behavioral metrics[false alarm rate(FAR),reaction time(RT)]and neural responses were recorded using a 64-channel EEG cap.EEG data underwent time-domain analysis,comparing group differences in behavioral performance and neurophysiological responses(mean amplitudes of P1 and N170 components).Results Preliminary behavioral analy-sis showed no significant differences in FAR or RT between groups(all P＞0.05).No significant differences were observed in P1 amplitude across any main effects or interactions(all P＞0.05).The mean P1 amplitude did not differ significantly between the amblyopia and control groups(P＞0.05).For the N170 component,significant main effects and interactions were identified across electrode sites and experimental conditions:electrode main effect:F(3,63)=29.064,P=0.000,η2=0.581;condition main effect:F(2,42)=23.677,P=0.000,η2=0.530;electrode × condition interaction:F(6,126)=5.846,P=0.002,η2=0.218.Notably,the mean N170 amplitude showed no significant group difference between amblyopic patients and healthy controls(P＞0.05).Conclusion Early visual processing(P1)remains intact in amblyopic patients,where-as altered N170 dynamics across electrodes and conditions suggest compensatory engagement of top-down pathways during face recognition in amblyopia.

Objective To evaluate the long-term effects of orthokeratology(ortho-k)lenses with different back optical zone diameters(BOZD)on the quality of vision in myopic children.Methods We conducted an exploratory analysis based on a prospective,randomized,double-blind clinical trial,focusing on the parameters related to visual quality.A total of 66 myopic children aged 8 to 12 years were enrolled and randomly assigned to either a 6-mm BOZD ortho-k lens group(the 6 mm group)or a 5-mm BOZD ortho-k lens group(the 5 mm group).The participants were followed up at baseline,and at 1 day,1 week,and 1,3,6,9,and 12 months after lens wearing.Visual quality measurements included uncorrected visual acuity(VA),best corrected VA,contrast sensitivity(CS),high-order aberrations(HOA),modulation transfer function(MTF),Strayer ratio(SR),and visual quality questionnaire.Results A total of 63 children(33 children in the 6 mm group and 30 children in the 5 mm group)completed the study.There were no significant differences in baseline data between the two groups(P>0.05).There were no significant differences in subjective uncorrected VA or best corrected VA between the two groups at any follow-up visit(P>0.05).After wearing the lenses for 3 months,the CS at high spatial frequency(18 cpd)in the 5 mm group was lower than that in the 6 mm group(P=0.015).However,at 12 months,no significant differences in the CS were found between the two groups(P>0.05).The ocular and corneal total HOA,spherical aberration,and coma aberration in both groups increased after wearing the lenses,and the HOA in the 5 mm group was higher than that in the 6 mm group(all P<0.05).After wearing the lenses for 3 months,the MTF and SR values in the 5 mm group were lower than those in the 6 mm group(P<0.05).At 12 months,there was no significant difference between the two groups(P>0.05).The vision-quality-related questionnaire scores showed no significant differences between the two groups(P>0.05).Conclusion In myopic children,wearing ortho-k lenses with different BOZD results in improved subjective satisfaction,with no difference in subjective visual quality.However,objective visual quality declined in both groups,with a greater impact observed in the 5 mm group.

A growing body of evidence indicates that the visual cortex retains a considerable degree of plasticity well into adulthood,suggesting that the visual acuity and binocular visual function of adult amblyopic patients can be improved even beyond the critical period of visual development.Currently,as novel treatment options for amblyopia,pharmacological and non-invasive methods that can enhance the plasticity of the visual cortex have not yet been widely applied in clinical practice.Therefore,it is of critical importance to investigate the underlying mechanisms of visual cortex plasticity to pave the way for the development of new therapeutic strategies for amblyopia.This paper reviews current research progress on mechanisms contributing to changes in visual cortical plasticity,including the regulation of the balance between excitatory and inhibitory neural activities,extracellular matrix remodeling,inhibitory factors associated with plasticity,and neurotrophic factors.With the continued advancement of various neuroimaging technologies,future research should aim to elucidate the precise mechanisms that control the initiation and closure of the critical period,and to clarify how the various factors involved in the regulation of visual cortical plasticity act jointly across different cell types and signaling pathways.Such investigations will provide new approaches and strategies for the treatment of amblyopia.

Objective:To evaluate the effects of wearing defocus incorporated multiple segments (DIMS) spectacle lenses on binocular visual function and visual quality in myopic children.Methods:A randomized double-blind controlled study was conducted.A total of 176 children (352 eyes) with myopia aged 6 to 15 years were enrolled in the West China Hospital of Sichuan University from January 2021 to March 2022.They were randomly divided into DIMS group of 85 cases (170 eyes) and single-vision group of 91 cases (182 eyes) wearing DIMS and single-vision lenses, respectively, using the random number table method.A total of 151 cases (302 eyes) who completed follow-up visits were included in the analysis, including 72 cases (144 eyes) in the DIMS group and 79 cases (158 eyes) in the single-vision group.Before and after 6 and 12 months of lens wear, accommodation amplitude, binocular accommodative sensitivity, distance/near horizontal eye position, and accommodative convergence/accommodation (AC/A) of subjects were measured.Changes in visual function over the year were compared between the two groups.In addition, subjective contrast sensitivity (CS) was assessed at each follow-up visit to evaluate the effect of the lenses on visual quality.The study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of West China Hospital of Sichuan University (No.2020-06).Parents or legal guardians signed written informed consent before the child's participation.Results:There were significant differences in monocular accommodation amplitude and binocular accommodation sensitivity at different time points between before and after lens wear in both groups (Wald χ2time=84.435, 48.201; both P<0.001).In both groups, monocular accommodation amplitude was decreased and the biocular accommodation sensitivity was increased at 6 and 12 months after wearing glasses compared with baseline (all P<0.001).After 12 months of lens wear, the monocular accommodation amplitude decreased by 2.68 D (95% CI: 1.60-3.75 D) in DIMS group and 2.82 D (95% CI: 1.81-3.84 D) in single-vision group.There were statistically significant differences in distance and near horizontal eye position between the two groups at different time points before and after wearing glasses (Wald χtime2=10.398, 23.947; both P<0.01).In the DIMS group, after 12 months of wearing lenses, the distance horizontal eye position drifted outward by 0.68 △(95% CI: 0.06-1.25 △) compared to baseline, with a significant difference ( P<0.05).There was 1.67 △ (95% CI: 0.15-3.20 △) outward drift at near horizontal eye position in the DIMS group and 1.73 △ (95% CI: 0.49-2.96 △) outward drift in the single-vision group compared with baseline, with significant differences (both P<0.05).There were statistically significant differences in gradient AC/A values and calculated AC/A values between the two groups at different time points before and after wearing glasses (Wald χtime2=22.001, 13.411; both P<0.01).After 12 months of wearing glasses, the gradient AC/A values significantly decreased in both groups compared to respective baseline, and the calculated AC/A values in the single-vision group showed a significant decrease compared to baseline (all P<0.05).There were no significant difference in the monocular accommodation amplitude, binocular accommodation sensitivity, distance and near horizontal eye position, gradient AC/A values and calculated AC/A values between the two groups (Wald χgroup2=2.385, 2.266, 2.070, 0.571, 0.578, 0.053; all P>0.05).There was no significant difference in the CS at 3, 6, 12, and 18 cpd spatial frequencies between the two groups at different time points before and after wearing lenses (Wald χ2group=1.104, 2.263, 1.861, 3.671; all P>0.05.Wald χ2time=2.260, 5.382, 2.573, 1.637; all P>0.05). Conclusions:Visual function performance after wearing DIMS lenses is consistent with that after wearing single-vision lenses.Wearing DIMS lenses has no obvious negative effect on the long-term visual quality in children.

Botulinum toxin A (BTA), a kind of botulinum exotoxin, which may cause muscular paralysis by the impact of chemical denervation, is commonly utilized in ophthalmology, dermatology, and medical plastic surgery.In the field of ophthalmology, it was first employed to address infantile esotropia, acute concomitant esotropia, nerve paralytic strabismus, and other kinds of strabismus.In recent years, some ophthalmologists have attempted to use BTA to correct partial accommodative esotropia, restrictive strabismus and exotropia, and found that BTA may be used as an alternate approach for extraocular muscles surgery in specific forms of strabismus, such as acute concomitant esotropia, partial accommodative esotropia and infantile esotropia (≤30 prism diopter), and can enhance the effect of surgical correction in the correction of large-angle infantile esotropia and sensory exotropia.This provides a new notion for the treatment of different types of strabismus.At the same time, by improving the injection technique and using the dose increment to control the drug dosage, the local drug utilization rate has been increased, and the complications has been reduced.The mechanism, efficacy, safety, and dosage of BTA in the correction of strabismus are discussed in this article, and the efficacy of BTA in correction of various types of strabismus is analyzed and compared to provide references for the use of BTA in strabismus.

Objective To investigate the neural processing characteristics of the top-down pathway in adults with amblyopia during face perception tasks,with a focus on event-related potential components(P1,N170),thereby elucida-ting the role of top-down pathways in face cognition.Methods Sixteen amblyopic patients(amblyopia group)and fif-teen healthy controls(control group)were recruited.Participants performed a face perception task designed in E-Prime 3.0,while behavioral metrics[false alarm rate(FAR),reaction time(RT)]and neural responses were recorded using a 64-channel EEG cap.EEG data underwent time-domain analysis,comparing group differences in behavioral performance and neurophysiological responses(mean amplitudes of P1 and N170 components).Results Preliminary behavioral analy-sis showed no significant differences in FAR or RT between groups(all P＞0.05).No significant differences were observed in P1 amplitude across any main effects or interactions(all P＞0.05).The mean P1 amplitude did not differ significantly between the amblyopia and control groups(P＞0.05).For the N170 component,significant main effects and interactions were identified across electrode sites and experimental conditions:electrode main effect:F(3,63)=29.064,P=0.000,η2=0.581;condition main effect:F(2,42)=23.677,P=0.000,η2=0.530;electrode × condition interaction:F(6,126)=5.846,P=0.002,η2=0.218.Notably,the mean N170 amplitude showed no significant group difference between amblyopic patients and healthy controls(P＞0.05).Conclusion Early visual processing(P1)remains intact in amblyopic patients,where-as altered N170 dynamics across electrodes and conditions suggest compensatory engagement of top-down pathways during face recognition in amblyopia.

Objective:To evaluate the effects of wearing defocus incorporated multiple segments (DIMS) spectacle lenses on binocular visual function and visual quality in myopic children.Methods:A randomized double-blind controlled study was conducted.A total of 176 children (352 eyes) with myopia aged 6 to 15 years were enrolled in the West China Hospital of Sichuan University from January 2021 to March 2022.They were randomly divided into DIMS group of 85 cases (170 eyes) and single-vision group of 91 cases (182 eyes) wearing DIMS and single-vision lenses, respectively, using the random number table method.A total of 151 cases (302 eyes) who completed follow-up visits were included in the analysis, including 72 cases (144 eyes) in the DIMS group and 79 cases (158 eyes) in the single-vision group.Before and after 6 and 12 months of lens wear, accommodation amplitude, binocular accommodative sensitivity, distance/near horizontal eye position, and accommodative convergence/accommodation (AC/A) of subjects were measured.Changes in visual function over the year were compared between the two groups.In addition, subjective contrast sensitivity (CS) was assessed at each follow-up visit to evaluate the effect of the lenses on visual quality.The study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of West China Hospital of Sichuan University (No.2020-06).Parents or legal guardians signed written informed consent before the child's participation.Results:There were significant differences in monocular accommodation amplitude and binocular accommodation sensitivity at different time points between before and after lens wear in both groups (Wald χ2time=84.435, 48.201; both P<0.001).In both groups, monocular accommodation amplitude was decreased and the biocular accommodation sensitivity was increased at 6 and 12 months after wearing glasses compared with baseline (all P<0.001).After 12 months of lens wear, the monocular accommodation amplitude decreased by 2.68 D (95% CI: 1.60-3.75 D) in DIMS group and 2.82 D (95% CI: 1.81-3.84 D) in single-vision group.There were statistically significant differences in distance and near horizontal eye position between the two groups at different time points before and after wearing glasses (Wald χtime2=10.398, 23.947; both P<0.01).In the DIMS group, after 12 months of wearing lenses, the distance horizontal eye position drifted outward by 0.68 △(95% CI: 0.06-1.25 △) compared to baseline, with a significant difference ( P<0.05).There was 1.67 △ (95% CI: 0.15-3.20 △) outward drift at near horizontal eye position in the DIMS group and 1.73 △ (95% CI: 0.49-2.96 △) outward drift in the single-vision group compared with baseline, with significant differences (both P<0.05).There were statistically significant differences in gradient AC/A values and calculated AC/A values between the two groups at different time points before and after wearing glasses (Wald χtime2=22.001, 13.411; both P<0.01).After 12 months of wearing glasses, the gradient AC/A values significantly decreased in both groups compared to respective baseline, and the calculated AC/A values in the single-vision group showed a significant decrease compared to baseline (all P<0.05).There were no significant difference in the monocular accommodation amplitude, binocular accommodation sensitivity, distance and near horizontal eye position, gradient AC/A values and calculated AC/A values between the two groups (Wald χgroup2=2.385, 2.266, 2.070, 0.571, 0.578, 0.053; all P>0.05).There was no significant difference in the CS at 3, 6, 12, and 18 cpd spatial frequencies between the two groups at different time points before and after wearing lenses (Wald χ2group=1.104, 2.263, 1.861, 3.671; all P>0.05.Wald χ2time=2.260, 5.382, 2.573, 1.637; all P>0.05). Conclusions:Visual function performance after wearing DIMS lenses is consistent with that after wearing single-vision lenses.Wearing DIMS lenses has no obvious negative effect on the long-term visual quality in children.

Botulinum toxin A (BTA), a kind of botulinum exotoxin, which may cause muscular paralysis by the impact of chemical denervation, is commonly utilized in ophthalmology, dermatology, and medical plastic surgery.In the field of ophthalmology, it was first employed to address infantile esotropia, acute concomitant esotropia, nerve paralytic strabismus, and other kinds of strabismus.In recent years, some ophthalmologists have attempted to use BTA to correct partial accommodative esotropia, restrictive strabismus and exotropia, and found that BTA may be used as an alternate approach for extraocular muscles surgery in specific forms of strabismus, such as acute concomitant esotropia, partial accommodative esotropia and infantile esotropia (≤30 prism diopter), and can enhance the effect of surgical correction in the correction of large-angle infantile esotropia and sensory exotropia.This provides a new notion for the treatment of different types of strabismus.At the same time, by improving the injection technique and using the dose increment to control the drug dosage, the local drug utilization rate has been increased, and the complications has been reduced.The mechanism, efficacy, safety, and dosage of BTA in the correction of strabismus are discussed in this article, and the efficacy of BTA in correction of various types of strabismus is analyzed and compared to provide references for the use of BTA in strabismus.

Objective To investigate the effect of wearing dual-focus soft contact lenses(DFSCL)on the visual performance of school-age children.Methods In this randomized controlled clinical trial,64 children aged 8 to 12 years with spherical equivalent refraction between-0.75 D and-4.00 D were recruited in our hospital in October 2022.Using the envelope method,the subjects were evenly and randomly assigned to the control group wearing single vision spectacles(SVS)or the intervention group wearing MiSight dual-focus soft contact lenses(DFSCL)from CooperVision.Follow-up examinations were conducted once every 3 months.The corrected visual acuity,contrast sensitivity function(CSF),and the scores for National Eye Institute Refractive Error Quality of Life Instrument-42(NEI-RQL-42)were compared between the control and intervention groups.Results By December 2023,a total of 58 subjects completed follow-up(30 in the SVS group and 28 in the DFSCL group).No significant difference in corrected visual acuity was observed between subjects wearing DFSCL and those wearing SVS.The CSF of the DFSCL group was comparable to that of the SVS group across the spatial frequencies of 3,6,12,and 18 cpd(P＞0.05).According to the results of the NEI-RQL-42 survey at the 6-month follow-up,the score for ocular discomfort symptoms was 89±14 in the SVS group and 79±16 in the DFSCL group(P=0.008),reflecting that the DFSCL group had a 12.66％higher level of discomfort.For appearance,the score was 70±32 in the SVS group and 92±22 in the DFSCL group(P=0.002),showing a 31.43％improvement in the DFSCL group.Conclusion In addition to providing the normal visual acuity and CSF,wearing MiSight DFSCL also leads to better satisfaction with the appearance.

Objective To explore the difference in myopia control efficacy between spectacle lenses with highly aspherical lenslets(HAL)combined with 0.01％atropine eye drops and spectacle lenses with HAL alone or single vision spectacle lenses(SVL)in children and adolescents.Methods A retrospective cohort study was conducted with a total of 105 myopic children aged 6-15 years.According to the specific myopia correction and control methods of each subject,they were evenly divided into the HAL+0.01％atropine(HAL+AT)group,the HAL group,and the SVL group,with 35 subjects in each group.Relevant data,such as cycloplegic refraction and axial length(AL)at baseline and 12 months after wearing spectacles,were retrieved.One-way analysis of variance,or the Kruskal-Wallis test,was used to analyze the changes in AL and spherical equivalent refraction(SER)after wearing spectacles for 12 months in comparison to those at baseline in the three groups.Results There was no statistically significant difference in the baseline parameters and duration of wearing spectacles among the three groups(P＞0.05).After wearing spectacles for 12 months,the changes in SER were-0.13(-0.25,0.00)D,-0.25(-0.63,-0.25)D,and-0.63(-1.00,-0.25)D in the HAL+AT group,HAL group,and SVL group,respectively;AL elongation in the three groups was(0.09±0.11)mm,(0.19±0.16)mm,and(0.34±0.16)mm,respectively.The HAL+AT group exhibited slower SER changes(PHAL+AT vs.HAL=0.00 1,PHAL+AT vs.SVL=0.002)and AL elongation(PHAL+AT vs.HAL=0.009,PHAL+AT vs.SVL=0.001)than those of the HAL and the SVL groups.Compared with those of the SVL group,myopia progression was reduced by 79.4％and AL elongation was slowed down by 73.5％in the HAL+AT group,while in the HAL group,myopia progression and AL elongation were reduced by 60.3％and 44.1％,respectively.According to stratified analysis based on age and myopia progression rate,among younger children aged 6 to 8 years and older children aged 9 to 15 years,the HAL+AT group had a significantly lower proportion of subjects experiencing fast AL elongation(AL＞0.36 mm/year)and a significantly higher proportion of subjects experiencing slow AL elongation(AL≤0.18 mm/year)compared to the SVL group(P＜0.017).Conclusion The combination intervention of spectacle lenses with HAL and 0.01％atropine eye drops is effective in controlling myopia progression in children and adolescents,with better myopia control effect achieved using this combination intervention in myopic children of all ages.