Background:To date,compliance to atropine penalization in amblyopic children has only been assessed through self-report.The goal of this pilot study is to measure compliance to atropine penalization objectively.Method...Background:To date,compliance to atropine penalization in amblyopic children has only been assessed through self-report.The goal of this pilot study is to measure compliance to atropine penalization objectively.Methods:Seven amblyopic children(3-8 years;20/40-20/125 in the amblyopic eye) were enrolled.None had been treated with atropine previously.Children were prescribed either a twice per week or daily atropine regimen by their physicians.Compliance was defined as the percentage of days in which the atropine eye drop was taken compared to the number of doses prescribed.We used medication event monitoring system(MEMS) caps to objectively measure compliance.The MEMS caps are designed to electronically record the time and date when the bottle is opened.The parents of the children were provided a calendar log to subjectively report compliance.Participants were scheduled for return visits at 4 and 12 weeks.Weekly compliance was analyzed.Results:At 4 weeks,objective compliance averaged 88%(range,57-100%),while subjective compliance was 98%(range,90-100%).The actual dose in grams and visual acuity(VA) response relationship(r=0.79,P=0.03) was significantly better than the relationship between regimen and response(r=0.41,P>0.05),or the relationship between actual dose in drops and response(r=0.52,P>0.05).Conclusions:Objective compliance to atropine penalization instructions can be monitored with MEMS,which may facilitate our understanding of the dose-response relationship.Objective compliance with atropine penalization decreases over time and varies with regimen.On average,subjective parental reporting of compliance is overestimated.展开更多
Purpose: To investigate relationship between treatment efficacy and the severity of ametropic amblyopia, the type of anisometropia and patient age. Methods:A total of 65 children with ametropic amblyopia undergoing cl...Purpose: To investigate relationship between treatment efficacy and the severity of ametropic amblyopia, the type of anisometropia and patient age. Methods:A total of 65 children with ametropic amblyopia undergoing clinical treatment in the ophthalmology department of Shaoguan Hygienic Hospital of Women and Children between June 2005 and November 2011 were enrolled in this study. The treatment efficacy for those subjects with different severities of ametropic amblyopia, types of anisometropia and ages was recorded. Results: The near-recovery/recovery rate, improvement rate and ineffectiveness rate were 70.8%, 16.9% and 12.3%, respectively. The recovery rates in mild-, moderate- and severe amblyopia groups were 97.1%, 61.1% and 8.3% respectively (P<0.05)..The recovery rate for patients with hyperopic-, astigmatic- and myopic anisometropia were 75.8%, 78.3% and 33.3% respectively. The recovery rates did not differ between hyperopic- and astigmatic- anisometropia children(P>0.05), whereas a statistically significant difference was noted between myopic children compared with their hyperopic and myopic-anisometropia counterparts (all P<0.05). The recovery rate for patients aged 3 to 6 years was 86.8% and 48.1% for those aged between 7 and 10 years (P<0.05). Conclusion: The treatment efficacy in ametropic amblyopia is associated with the severity of amblyopia, type of anisometropia and patient's age. Older patients with more severe amblyopia had poorer treatment efficacy. The efficacy in patients with hyperopic and astigmatic anisometropia was better than that for myopic anisometropia subjects.展开更多
Purpose: To research the mechanism of neurophysiological treatment of amblyopia by observing the visual cortex activation under rotating grating stimulus with functional magnetic resonance imaging (MRI), and identify ...Purpose: To research the mechanism of neurophysiological treatment of amblyopia by observing the visual cortex activation under rotating grating stimulus with functional magnetic resonance imaging (MRI), and identify the components of the activation. Methods: Nine healthy volunteers were examined using gradient-recalled echo and echo-planar imaging (GRE-EPI) pulse sequence performed at the 1.5 Tesla MRI scanner. In the block designing, rotating grating, stationary grating and luminance were plotted as task states, stationary grating, luminance and darkness as control states, respectively. The tasks of stimuli included 6 steps. Imaging processing and statistical analysis were carried out off-line using statistical parametric mapping (SPM99) software in single-subject. Results: Some individual areas of visual cortex were activated by various stimuli information supplied by rotating grating. The strong activation in the middle of occipital lobe related to the stimuli of luminance, bilateral activation of Brodmann’s 19th area related to visual motion perception, and the mild activation in the middle of occipital lobe related to form perception. Conclusion: The plotting of control state is important in bock design. The effective visual information of rotating grating includes components of luminance, visual motion perception and form perception. Functional MRI has potential as a tool for studying the physiological mechanism of visual cortex.展开更多
弱视是指视觉发育期由于形觉剥夺和(或)双眼异常的相互作用导致最佳矫正视力低于相应年龄视力或低于对侧眼视力2行及以上。2022年美国眼科学会更新了弱视临床指南(PPP)中的治疗建议,2021年我国中华医学会眼科学分会斜视与小儿眼科学组...弱视是指视觉发育期由于形觉剥夺和(或)双眼异常的相互作用导致最佳矫正视力低于相应年龄视力或低于对侧眼视力2行及以上。2022年美国眼科学会更新了弱视临床指南(PPP)中的治疗建议,2021年我国中华医学会眼科学分会斜视与小儿眼科学组也发表了《中国儿童弱视防治专家共识(2021年)》。本文将2022年版PPP与2017年版《Amblyopia Preferred Practice Pattern》以及我国2021年专家共识进行对比分析,重点解读新版PPP在治疗方面的更新内容,以及国内外在治疗方式及随访评估上的差异,以期与国内眼科同道分享弱视的最新治疗进展。展开更多
基金supported by a pilot grant from Indiana Clinical and Translational Sciences Institute Project Development Teams(PDT) to J Wanga Research to Prevent Blindness(RPB) unrestricted grant to the Glick Eye Institute at Indiana University
文摘Background:To date,compliance to atropine penalization in amblyopic children has only been assessed through self-report.The goal of this pilot study is to measure compliance to atropine penalization objectively.Methods:Seven amblyopic children(3-8 years;20/40-20/125 in the amblyopic eye) were enrolled.None had been treated with atropine previously.Children were prescribed either a twice per week or daily atropine regimen by their physicians.Compliance was defined as the percentage of days in which the atropine eye drop was taken compared to the number of doses prescribed.We used medication event monitoring system(MEMS) caps to objectively measure compliance.The MEMS caps are designed to electronically record the time and date when the bottle is opened.The parents of the children were provided a calendar log to subjectively report compliance.Participants were scheduled for return visits at 4 and 12 weeks.Weekly compliance was analyzed.Results:At 4 weeks,objective compliance averaged 88%(range,57-100%),while subjective compliance was 98%(range,90-100%).The actual dose in grams and visual acuity(VA) response relationship(r=0.79,P=0.03) was significantly better than the relationship between regimen and response(r=0.41,P>0.05),or the relationship between actual dose in drops and response(r=0.52,P>0.05).Conclusions:Objective compliance to atropine penalization instructions can be monitored with MEMS,which may facilitate our understanding of the dose-response relationship.Objective compliance with atropine penalization decreases over time and varies with regimen.On average,subjective parental reporting of compliance is overestimated.
文摘Purpose: To investigate relationship between treatment efficacy and the severity of ametropic amblyopia, the type of anisometropia and patient age. Methods:A total of 65 children with ametropic amblyopia undergoing clinical treatment in the ophthalmology department of Shaoguan Hygienic Hospital of Women and Children between June 2005 and November 2011 were enrolled in this study. The treatment efficacy for those subjects with different severities of ametropic amblyopia, types of anisometropia and ages was recorded. Results: The near-recovery/recovery rate, improvement rate and ineffectiveness rate were 70.8%, 16.9% and 12.3%, respectively. The recovery rates in mild-, moderate- and severe amblyopia groups were 97.1%, 61.1% and 8.3% respectively (P<0.05)..The recovery rate for patients with hyperopic-, astigmatic- and myopic anisometropia were 75.8%, 78.3% and 33.3% respectively. The recovery rates did not differ between hyperopic- and astigmatic- anisometropia children(P>0.05), whereas a statistically significant difference was noted between myopic children compared with their hyperopic and myopic-anisometropia counterparts (all P<0.05). The recovery rate for patients aged 3 to 6 years was 86.8% and 48.1% for those aged between 7 and 10 years (P<0.05). Conclusion: The treatment efficacy in ametropic amblyopia is associated with the severity of amblyopia, type of anisometropia and patient's age. Older patients with more severe amblyopia had poorer treatment efficacy. The efficacy in patients with hyperopic and astigmatic anisometropia was better than that for myopic anisometropia subjects.
基金supported by Nanjing Jinling Hospital ( 2004082) Basic application grant supported by The Department ofEducation of Jiangsu Province
文摘Purpose: To research the mechanism of neurophysiological treatment of amblyopia by observing the visual cortex activation under rotating grating stimulus with functional magnetic resonance imaging (MRI), and identify the components of the activation. Methods: Nine healthy volunteers were examined using gradient-recalled echo and echo-planar imaging (GRE-EPI) pulse sequence performed at the 1.5 Tesla MRI scanner. In the block designing, rotating grating, stationary grating and luminance were plotted as task states, stationary grating, luminance and darkness as control states, respectively. The tasks of stimuli included 6 steps. Imaging processing and statistical analysis were carried out off-line using statistical parametric mapping (SPM99) software in single-subject. Results: Some individual areas of visual cortex were activated by various stimuli information supplied by rotating grating. The strong activation in the middle of occipital lobe related to the stimuli of luminance, bilateral activation of Brodmann’s 19th area related to visual motion perception, and the mild activation in the middle of occipital lobe related to form perception. Conclusion: The plotting of control state is important in bock design. The effective visual information of rotating grating includes components of luminance, visual motion perception and form perception. Functional MRI has potential as a tool for studying the physiological mechanism of visual cortex.
文摘弱视是指视觉发育期由于形觉剥夺和(或)双眼异常的相互作用导致最佳矫正视力低于相应年龄视力或低于对侧眼视力2行及以上。2022年美国眼科学会更新了弱视临床指南(PPP)中的治疗建议,2021年我国中华医学会眼科学分会斜视与小儿眼科学组也发表了《中国儿童弱视防治专家共识(2021年)》。本文将2022年版PPP与2017年版《Amblyopia Preferred Practice Pattern》以及我国2021年专家共识进行对比分析,重点解读新版PPP在治疗方面的更新内容,以及国内外在治疗方式及随访评估上的差异,以期与国内眼科同道分享弱视的最新治疗进展。
