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.

Early diagnosis and appropriate intervention of strabismus are crucial for improving patient outcomes.Currently, strabismus screening and diagnosis rely on manual examination, which is challenged by limited human resources and the risk of misdiagnosis.Recently, artificial intelligence (AI) has made rapid progress in strabismus, covering screening, diagnosis, surgical parameter estimation and prognosis prediction.Deep learning models based on video, eye and fundus photographs show great potential.Despite significant achievements, AI studies often exclude complex strabismus types and rely on static, unimodal data, which limits practicality.Future integration of large model technology and multimodal data into intelligent diagnostic platforms will improve strabismus management and eye care, enabling personalized and precise treatment.

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.

Objective To investigate the mechanism of electroacupuncture in relieving the apoptosis of retinal cells in experimental myopia based on mitochondrial dynamics.Methods In the study,140 two-week-old tricolor guinea pigs were divided into the normal control(NC)group,lens-induced myopia(LIM)group,LIM+sham acupoint(LIM+SHAM)group,and LIM+electroacupuncture intervention(LIM+EA)group,with 35 guinea pigs in each group.Guinea pigs in the NC group were fed normally,and those in the LIM group,LIM+SHAM group and LIM+EA group wore a-6.0D lens on the right eye to induce myopia.Guinea pigs in the LIM+EA group were treated at Hegu and Taiyang acupoints,while those in the LIM+SHAM group were treated at sham acupoints.After 2-and 4-week myopia induction,the diopter and axial length of the guinea pigs were measured,and the messenger ribonucleic acid(mRNA)and protein levels of dynam in-related pro-tein 1(DRP1),optic atrophy 1(OPA1),Bcl-2 associated X protein(BAX)and B cell lymphoma-2(BCL-2)in the retinas of the guinea pigs in each group were detected by quantitative PCR and Western blot,respectively.Meanwhile,HE staining was taken to observe the morphological changes in the retina of the guinea pigs in each group,and TUNEL staining was used to detect apoptosis.Results After 2-and 4-week myopic induction,compared with the NC group,the differences in diopter and axial length between the right and left eyes of guinea pigs in the LIM and the LIM+SHAM groups significantly increased(all P＜0.001).Compared with the LIM group,the differences in diopter and axial length between both eyes of guinea pigs in the LIM+EA group significantly decreased(all P＜0.01).At 4 weeks after myopic induction,HE staining re-sults showed that the retinas of the guinea pigs in the NC group were evenly arranged,and the morphology of inner and out-er nuclear layer cells was normal.Compared with the NC group,the retinas of the guinea pigs in the LIM and the LIM+SHAM groups were significantly thinner and disorderly arranged.Compared with the LIM group,the retinal thickness of guinea pigs in the LIM+EA group slightly increased,and the arrangement was relatively regular.The TUNEL staining re-sults showed that compared with the NC group,the green fluorescence of the guinea pig retina in the LIM group and LIM+SHAM group was significantly enhanced;compared with the LIM group,the green fluorescence of the guinea pig retina in the LIM+EA group was significantly weaken.After 2-and 4-week myopic induction,the mRNA and protein expression lev-els of DRP1 and BAX in the LIM and the LIM+SHAM groups were significantly higher than those in the NC group(all P＜0.05),while the mRNA and protein expression levels of OPA1 and BCL-2 were significantly lower(all P＜0.05).The mR-NA and protein expression levels of DRP1 and BAX in the LIM+EA group were significantly lower than those in the LIM group(all P＜0.05),while the mRNA and protein expression levels of OPA1 and BCL-2 were significantly higher(all P＜0.05).Conclusion Experimental myopia can enhance retinal mitochondrial fission.Electroacupuncture intervention can alleviate retinal cell apoptosis and improve the morphological structure of the retina by inhibiting retinal mitochondrial fis-sion and increasing mitochondrial fusion,thereby delaying myopia development.

Amblyopia is a visual development deficit caused by abnormal visual experience in early life, mainly manifesting as defected visual acuity and binocular visual impairment, which is considered to reflect abnormal development of the brain rather than organic lesions of the eye. Previous studies have reported abnormal spontaneous brain activity in patients with amblyopia. However, the location of abnormal spontaneous activity in patients with amblyopia and the association between abnormal brain function activity and clinical deficits remain unclear. The purpose of this study is to analyze spontaneous brain functional activity abnormalities in patients with amblyopia and their associations with clinical defects using resting-state functional magnetic resonance imaging (fMRI) data. In this study, 31 patients with amblyopia and 31 healthy controls were enrolled for resting-state fMRI scanning. The results showed that spontaneous activity in the right angular gyrus, left posterior cerebellum, and left cingulate gyrus were significantly lower in patients with amblyopia than in controls, and spontaneous activity in the right middle temporal gyrus was significantly higher in patients with amblyopia. In addition, the spontaneous activity of the left cerebellum in patients with amblyopia was negatively associated with the best-corrected visual acuity of the amblyopic eye, and the spontaneous activity of the right middle temporal gyrus was positively associated with the stereoacuity. This study found that adult patients with amblyopia showed abnormal spontaneous activity in the angular gyrus, cerebellum, middle temporal gyrus, and cingulate gyrus. Furthermore, the functional abnormalities in the cerebellum and middle temporal gyrus may be associated with visual acuity defects and stereopsis deficiency in patients with amblyopia. These findings help explain the neural mechanism of amblyopia, thus promoting the improvement of the treatment strategy for amblyopia.
Adult ; Amblyopia/pathology* ; Brain ; Brain Mapping ; Humans ; Magnetic Resonance Imaging/methods* ; Visual Acuity

Objective:To conduct a systematic review of clinical manifestations, treatment, and associated genotyping of Sorsby fundus dystrophy (SFD).Methods:An evidence-based medicine study. Sorsby fundus dystrophy, anti-vascular endothelial growth factor therapy, choroidal neovascularization, macular neovascularization, and TIMP3 gene were hereby used as search terms. Relevant literature was searched in CNKI, Wanfang, PubMed of the National Library of Medicine, and Embase of the Netherlands. The time span for literature searching ranged from the establishment of the database to April 2022, and two reviewers independently screened the literature and extracted relevant data, with duplicates, incomplete or irrelevant articles, and review articles excluded. SPSS26.0 software was used for analysis. The 95% confidence interval ( CI) was used as an estimate of the effect size. The clinical manifestations, treatment and related pathogenic genes of SFD were counted and recorded. Results:According to the search strategy, 157 pieces of literature were initially retrieved, and 49 eyes of 35 patients from 16 articles were finally included for analysis, among which, 17 patients were male, 13 patients were female, and 5 patients were unknown gender; 16 involved left eyes, 19 involved right eyes, and 14 involved unidentified eyes. The age of the disease onset was 42.33±2.19 years (28-59) years old. There were 19 cases with a positive family history, and the total positive rate was 54.3% (19/35, 95% CI 36%-72%). There were 31 cases of gene mutation, all of which were TIMP3. In the included literature, there were 2 and 2 cases with no mutation and unreported loci, respectively, with a total positive rate of 93.9% (31/33, 95% CI 85%-100%). Among the 31 cases with gene mutation, 22, 4, 1, and 4 cases were in the UK, Germany, Switzerland, and Chinese, respectively, and the detection rates were all 100% (22/22, 4/4, 1/1, 4/4). The clinical manifestations of SFD were mainly yellow-white deposits in the fundus and choroidal neovascularization (CNV) in the macula, thereby leading to a decrease in central vision, followed by the expansion of the deposits to the periphery, the further development of CNV, and a severe decline in vision caused by peripheral retinal and choroidal atrophy. The treatment methods for SFD include photodymatic therapy, anti-VEGF drugs, glucocorticoids, vitamin A, etc., among which, anti-VEGF drugs were considered the first-line treatment, and the combined treatment was provided with a better prognosis than a single treatment. Conclusions:Variations in the TIMP3 gene cause SFD, the fundus characteristic manifestations of which, are yellowish-white deposits and CNV, which develop from the center to the periphery, thus resulting in progressive decline of visual acuity. Current studies have shown that combined therapy presents a better prognosis than monotherapy.

At present, the contents and class hours of contact lens course cannot meet the teaching and clinical requirements. Therefore, the curriculum of contact lens on practical operation was optimized, the number of practice hours was increased, and various models for practice course were applied, including problem-based learning, community practice course, and practice enhancement course, to improve students' learning interest and initiative. A variety of evaluation models were used to help teachers understand the performances of their students and make adjustments in the process of teaching and evaluation, so as to improve students' score of practical test, help them better master the practical skills and enter clinical practice without difficulties. The feedback scores of teachers in clinical practice have also been improved compared with the former ones.

The aim of this study was to investigate the feasibility of anterior segment optical coherence tomography to assess the anterior segment morphology of hyperopia in school-aged children. 320 eyes of 160 school-aged children, 6-12 years of age, were examined with anterior segment optical coherence tomography and were divided into four groups according to the cycloplegic spherical equivalence of refractive error. The mentioned four groups were: emmetropia group, low hyperopia group, moderate hyperopia group and high hyperopia group. The measurements of central corneal thickness, anterior chamber depth, angle opening distance, trabecular iris space area and scleral angle were compared in pairs among objects in the four groups. The results showed that high hyperopia and moderate hyperopia had shallower anterior chamber depth and narrower anterior chamber angle compared to those in emmetropia group. The study also showed that anterior segment optical coherence tomography as a non-contact technology could become a new technology for accessing the anterior segment morphology of hyperopia in school-aged children.
Anterior Chamber ; pathology ; Child ; Eye Diseases, Hereditary ; diagnosis ; Humans ; Hyperopia ; diagnosis ; Tomography, Optical Coherence