Effect of changing mesopic and photopic light conditions on visual functions

AIM:To determine the effects of change in light conditions on refractive error and visual functions including visual acuity,stereopsis and contrast sensitivity.METHODS:This cross-sectional study was conducted in the optometry clinic of the Shahid Beheshti School of Rehabilitation on 48 students in 2021-2022.All of them had eye health and normal visual function and could have refractive errors or not.Light intensity of 4 lx was considered equivalent to photopic light condition and light intensity of 1 lx was considered to be equivalent to mesopic light condition.The amount of refractive error was checked by auto refractometer and its changes in mesopic light condition were subjectively measured.Also,visual acuity,stereopsis and contrast sensitivity(in five spatial frequencies of 1.5,3,6,12,and 18 cycles per degree),were measured first in photopic light condition and then in mesopic light condition,by Snellen control vision chart,stereo butterfly test and the M&S technology monitor test respectively.RESULTS:In the 48 student subjects with an average age of 22.69±3.56y,mean of refractive error as sphere equivalent,visual acuity and stereopsis were-1.25±1.74 diopters,0 logMAR,44.37±13.03 seconds of arc,respectively in photopic light condition while in mesopic light was equal to-1.56±1.75 diopters,0.12±0.09 logMAR and 50.62±33.35 seconds of arc,respectively.The mean of contrast sensitivity measured at spatial frequencies of 1.5,3,6,12,and 18 cycles per degree in photopic condition was equal to 2.38±0.04,2.37±0.07,2.04±0.21,1.27±0.32,0.82±0.27 logarithm of contrast sensitivity,respectively and in mesopic lighting condition was equal to 2.34±0.12,2.30±0.16,1.84±0.28,1.02±0.28,0.63±0.24 logarithm of contrast sensitivity,respectively.Statistical analysis showed a significant difference between the two lighting conditions in all evaluated variables[refractive error(P<0.001),visual acuity(P<0.001),stereopsis(P=0.008)and contrast sensitivity(P<0.001)].CONCLUSION:The refractive error of the student subjects in mesopic light condition change towards myopia,and its amount is clinically significant.Also,the examination and comparison of the factors of visual acuity,stereopsis and contrast sensitivity in these two lighting conditions show that the decrease in brightness level to the mesopic level causes a decrease in the aforementioned visual functions.

Effect of visual perception training on binocular visual function reconstruction in patients after strabismus surgery

AIM:To explore the effect of visual perception learning software training(VPT)on binocular visual function reconstruction in children with intermittent exotropia after strabismus surgery.METHODS:Ninety children with intermittent exotropia admitted to our hospital from June 2018 to December 2018 were included,and randomly divided into VPT and control groups.Children in the control group received basic binocular vision training,while those in the VPT group received VPT after strabismus surgery.Tertiary visual function,visual perception function,Newcastle Control Score(NCS),and ocular position retraction rate were compared at 3 and 12mo after the surgery.RESULTS:At 3 and 12mo after the surgery,the proportion of simultaneous perception,binocular fusion version and binocular stereo vision in the VPT group was conspicuously higher than that in the control group(P<0.05).After the vision training,the binocular visual perception functions of children in both groups were significantly improved compared with that before training(P<0.05).Interestingly,the grating sharpness,texture perception and texture motion perception in the VPT group were dramatically better than control group(P<0.01).The NCS in the VPT group was significantly lower than that in the control group(P<0.05).The ocular position retraction rate in the VPT group was significantly lower than that in the control group at 12mo(8.89%vs 26.67%,P=0.03).CONCLUSION:VPT effectively promotes binocular visual function reconstruction in intermittent exotropia children after strabismus surgery and reduces the strabismus severity and ocular position retraction rate.

Development of an Arabic version of the National Eye Institute Visual Function Questionnaire as a tool to study eye diseases patients in Egypt

AIM:To develop and test an Arabic version of the National Eye Institute Visual Function Questionnaire-25(NEI-VFQ-25).METHODS:NEI-VFQ-25 was translated into Arabic according to WHO translation guidelines. We enrolled adult consenting patients with bilateral chronic eye diseases who presented to 14 hospitals across Egypt from October to December 2012, and documented their clinical findings. Psychometric properties were then tested using STATA.RESULTS:We recruited 379 patients, whose mean age was(54.5±15)y. Of 46.2% were males, 227 had cataract,31 had glaucoma, 23 had retinal detachment, 37 had diabetic retinopathy, and 61 had miscellaneous visual defects. Non-response rate and the floor and ceiling numbers of the Arabic version(ARB-VFQ-25) were calculated. Internal consistency was high in all subscales(except general health), with Cronbach-α ranging from0.702-0.911. Test-retest reliability was high(intraclass correlation coefficient 0.79).CONCLUSION:RB-VFQ-25 isareliableandvalidtool for assessing visual functions of Arabic speaking patients. However, some questions had high non-response rates and should be substituted by available alternatives. Our results support the importance of including self-reported visual functions as part of routine ophthalmologic examination.

Visual function and vision-related quality of life after vitrectomy for idiopathic macular hole: a 12mo followup study

· AIM: To investigate the visual function and the relationship with vision-related quality of life(VRQOL)after macular hole repair surgery.· METHODS: Prospective case series. Thirty-six consecutive eyes in 36 patients who underwent pars plana vitrectomy(PPV) and internal limiting membrane(ILM) peeling were included. The 25-item National Eye Institute Visual Function Questionnaire(VFQ-25) was answered by the participants before and 3 and 12 mo after operation. Follow-up visits examinations included best-corrected visual acuity(BCVA), clinical examination,and central macular thickness(CMT) measured by optical coherence tomography(OCT).·RESULTS: Macular-hole closure was achieved in 35 of36 eyes(97.2%). At baseline and months 3 and 12, the log MAR BCVAs(mean±SD) were 1.15±0.47, 0.68±0.53(P 【0.0001 versus baseline), and 0.55 ±0.49(P 【0.001 versus baseline, P =0.273 versus month 3), respectively; the CMTs(μm) were 330 ±81, 244 ±62(P 【0.001 versus baseline), and 225±58(P 【0.001 versus baseline, P =0.222 versus month 3), respectively; the median preoperative VFQ-25 composite score of 73.50(63.92-81.13) increased postoperatively to 85.50(80.04-89.63) at 3mo(P 【0.001)and 86.73(82.50-89.63) at 12mo(P 【0.001) respectively.The improved BCVA was correlated with improvements in five subscales(r =-0.605 to-0.336, P 【0.001 to P =0.046) at 12 mo.· CONCLUSION: PPV with ILM peeling improved anatomic outcome, visual function, and VRQOL. Theimproved BCVA was an important factor related to the improved VRQOL.

Visual function alterations in cavernous hemangioma of the orbital apex after surgery

Dear Editor,I am Dr.Kang Xue,from the Department of Ophthalmology at the Eye,Ear,Nose and Throat Hospital of Fudan University in Shanghai,China.I am writing to present three case reports of the removal of visual function alterations in cavernous hemangioma of the orbital apex after surgery.Cavernous hemangioma is a relatively common primary benign orbital tumor in adults.

Altered intrinsic functional connectivity of the primary visual cortex in youth patients with comitant exotropia: a resting state fMRI study

AIM： To evaluate the differences in the functional connectivity（FC） of the primary visual cortex（V1） between the youth comitant exotropia（CE） patients and health subjects using resting functional magnetic resonance imaging（f MRI） data.METHODS： Totally, 32 CEs（25 males and 7 females） and 32 healthy control subjects（HCs）（25 males and 7 females） were enrolled in the study and underwent the MRI scanning. Two-sample t-test was used to examine differences in FC maps between the CE patients and HCs. RESULTS： The CE patients showed significantly less FC between the left brodmann area（BA17） and left lingual gyrus/cerebellum posterior lobe, right middle occipital gyrus, left precentral gyrus/postcentral gyrus and right inferior parietal lobule/postcentral gyrus. Meanwhile, CE patients showed significantly less FC between right BA17 and right middle occipital gyrus（BA19, 37）.CONCLUSION： Our findings show that CE involves abnormal FC in primary visual cortex in many regions, which may underlie the pathologic mechanism of impaired fusion and stereoscopic vision in CEs.

The Study of Relationships between the Damage of Visual Function and Hemorrheology, Ocular Rheography, as well as Other Related Factors in Patients with Primary Open Angle Glaucoma (POAG)

Researches of glaucoma visual function damage, hemorrheololgy, ocular rheography and other related multiplex factors, with computed multifactorial stepwise regresion analysis, indicate that the elevation of intraocular pressure (IOP) is not the only factor to induce visual impairment. POAG patients are shown to have markedly reduced diastolic purfussion pressure in ophthalmic artery, besides prolonged filling time of the retinal artery and vein, diminished erythrocyte deformability and increased platele...

THE SIGNIFICANCE OF TESTING PREOPERATIVE VISUAL FUNCTION IN CATARACT USING LASER INTERFEROMETRIC VISUAL ACUITY AND ERG

Tests of preoperative visual function and prediction of postoperative E chart visual acuity(ECVA) using laser interferometric visual acuity(LIVA) and electroretinogram(ERG) were performed in 16 cases(19 eyes) of cataract. The results showed that the coincident rate between preoperative LIVA and postoperative ECVA was 63.2%, and there was a parallel correlation between preoperative amplitude of photopic ERG b-wave and postoperative ECVA in 79.0% of the eyes. Comparing these two methods, the test of LIVA ...

Frequency cumulative effect of subthreshold energy laser-activated remote phosphors irradiation on visual function in guinea pigs

AIM:To explore the effects of laser-activated remote phosphors(LARP)on visual function in guinea pigs.METHODS:Electroretinogram(ERG)of guinea pigs were observed after LARP irradiation at different frequencies and irradiation times.We evaluated the expression of rhodopsin,β-catenin,connexin36,calretinin,and calbindin in the retina of guinea pigs and measured the density of photoreceptor cells after high-frequency LARP irradiation.RESULTS:After LARP irradiation,the ERG results showed that the amplitude of the dark-adapted 3.0 b-wave of the model eye was lower than that of the control eye after high-frequency irradiation(P<0.05).The expression of rhodopsin,β-catenin,connexin36,calretinin,and calbindin in the retina of guinea pig declined.CONCLUSION:There is frequency cumulative damage effect on the retina that relates to LARP illumination frequency.This has significance for staff visual protection policies under LARP lighting conditions.

AB006.Longitudinal effects of an optic nerve injury on behavioural measures of visual functions

Background:Visual deficits,caused by ocular disease or trauma,can cause lasting damage.However,recent research has focused on neural plasticity as a means to regain visual functions.In order to better understand the involvement of neural plasticity and reorganization in partial vision restoration,we aim to evaluate the partial recovery of a visual deficit over time using two behavioural tests.In our study,a partial optic nerve crush(pONC)serves as an induced visual deficit,allowing for residual vision from surviving cells.Methods:Visual functions in C57BL/6 mice was measured using two behavioural tests prior to a bilateral pONC,then at various time points after the pONC.In this study,two injury intensities were used:a high intensity pONC with the full force of self-closing forceps,and a low intensity pONC,in which a calibrated space was left between the forceps at the closed position.The two behavioural tests consisted of the optomotor reflex(OMR)and the visual cliff(VC)tests.The OMR test measures the mouse’s tracking reflex in response to moving sinusoidal gratings.The VC test,on the other hand,evaluates exploratory behaviour,by simulating a cliff to observe the animal’s sense of depth perception.After the behavioural evaluation,surviving retinal ganglion cells were counted.Results:The high intensity pONC resulted in a total loss of visual acuity as measured by the OMR test,with no improvement in the following 4 weeks.However,the light intensity pONC showed the same initial loss,but recovery was observed as of day 3,and results in 40-60%recovery after 4 weeks.With the VC test,mice with intact vision will avoid the deep end,opting to spend more time in the shallow end.However,after both high and low intensity pONCs,this preference is no longer observed.Both groups show a return to the shallow end preference at day 14,though the low intensity pONC group showed a stronger preference similar to baseline performance.The percentage of surviving retinal ganglion cells was higher with the low intensity(68%)than with the high intensity(17%)pONC.Conclusions:There is evidence of visual recovery at the behavioural level following a pONC,though very little recovery was observed following a high intensity pONC,and only with the VC test.Therefore,a certain amount of residual retinal input may be required for recovery at the behavioural level.

AB088.Quality of life and visual function in patients with Boston type I keratoprosthesis

Background:To determine patient-reported vision-related quality of life(VR-QoL)following Boston type I keratoprosthesis(BI-KPro)surgery and its association with postoperative best-corrected visual acuity(BCVA).Methods:Descriptive cross-sectional study.Consecutive consenting patients with BI-KPro were included.The French National Eye Institute Visual Function Questionnaire-25 administered at 51±18 months postoperatively measured VR-QoL.Clinical charts were reviewed for demographics,indications for BI-KPro,baseline and postoperative(at time of interview)BCVA.For patients operated unilaterally,stratification of VR-QoL scores based on BCVA in the non-operated eye was performed.Multivariate linear regression was carried out,using VR-QoL scores as dependent variables,and demographics and postoperative BCVA as covariates.For patients operated bilaterally,Spearman correlation between VR-QoL scores and BCVA was performed.P<0.05 indicated statistical significance.Results:Sixty-four patients,aged 59±14 years,52%male,with a follow-up of 54±19 months,were included.Postoperative BCVA increased from baseline in all operated eyes(P=0.000).In patients with unilateral BI-KPro(n=52),the VR-QoL overall score was 70.7±25.1.Scores on all questionnaire subscales were greater when BCVA in the non-operated eye was>20/200 compared to 20/200(P=0.000).BCVA in the non-operated eye was positively associated with all subscales(P<0.01)independently of age,sex,follow-up duration and postoperative BCVA in the operated eye.In patients with bilateral BI-KPro(n=12)the VR-QoL overall score was 63.0±18.7.BCVA in the best eye positively correlated with Near/Distance activities,and social functioning subscales(P<0.05).There was no significant difference between VR-QoL scores of patients operated unilaterally vs.bilaterally.Conclusions:We describe VR-QoL more than 4 years after BI-KPro surgery.Compared to data at 1 year previously reported,our results suggest that,as vision progressively deteriorates in the operated eye,patients increasingly rely on their non-operated eye.VR-QoL after bilateral BI-KPro is assessed for the first time,and appears comparable to that after unilateral surgery.Larger,prospective,long-term studies,with assessment at baseline,are warranted.

A New Classification for Retinitis Pigmentosa Including Multifocal Electroretinography to Evaluate the Disease Severity

Aim: To establish a useful and objective classification for retinitis pigmentosa (RP) to evaluate the disease severity. Methods: This is a retrospective cross-sectional study. Visual acuity (VA), visual field (VF) width, ellipsoid zone width on optic cohorence tomography (OCT) and multifocal electroretinography (mf ERG) values were obtained from medical records of patients with RP. A scoring criterion was developed wherein each variable was assigned a score from 0 to 5 depending on its distribution. The cumulative score (from 0 to 20) was used to classify disease severity from grade 0 to 5. The scores were correlated with each other and the final grade. Results: Data of 152 eyes of 92 patients who had the results of all tests were reviewed. The mean age was 41.2 years. The mean VA of the patients was 0.13 ± 0.16 Snellen lines. The majority of patients had a VA less than 20/40 (88.6%), a visual field smaller than 20˚ (78%), and an ellipsoid zone width smaller than 7˚ (84.4%). The majority of the patients (85.4%) were in advanced stage of the disease (Grade 4 and 5). Conclusions: We present a simple, objective and easy to use disease severity classification for RP which can be used to categorize patients and to evaluate and compare treatment results.

An effective pharmacological hydrogel induces optic nerve repair and improves visual function

Irreversible eye lesions, such as glaucoma and traumatic optic neuropathy, can cause blindness;however, no effective treatments exist. The optic nerve, in particular, lacks the capacity to spontaneously regenerate, requiring the development of an effective approach for optic nerve repair, which has proven challenging. Here, we demonstrate that a combination of the small molecules 3BDO and trichostatin A(TSA)—which regulate mTOR and HDAC, respectively—packaged in thermosensitive hydrogel for 4-week-sustained release after intravitreal injection, effectively induced optic nerve regeneration in a mouse model of optic nerve crush injury. Moreover, this combination of 3BDO and TSA also protected axon projections and improved visual responses in an old mouse model(11 months old) of glaucoma. Taken together, our data provide a new, local small molecule-based treatment for the effective induction of optic nerve repair, which may represent a foundation for the development of pharmacological methods to treat irreversible eye diseases.

Evaluation and application of a Chinese version symptom questionnaire for visual dysfunctions(CSQVD)in school-age children

Objective:To develop and evaluate a Chinese version of the Symptom Questionnaire for Visual Dysfunctions(CSQVD)to quantify visual dysfunction symptoms in school-age children with various eye diseases,and to explore the relationship between ophthalmological disorders and visual dysfunction symptoms.Methods:Following standard scale adaptation procedures,the Symptom Questionnaire for Visual Dysfunctions(SQVD)was translated into Chinese(CSQVD).We employed random sampling to survey 198 outpatients aged 7–18 to assess the psychometric properties of the CSQVD.Using the reliable and validated questionnaire,we evaluated the determinants of visual dysfunction symptoms among 406 school-age patients at an eye center.The CSQVD scores were correlated with demographic and clinical variables,including gender,age,eye position,refractive power,and best-corrected visual acuity.Univariate analysis identified potential risk factors,followed by binary logistic regression and multiple linear regression analysis on factors with a P-value<0.05.Results:The CSQVD scale's critical ratio(CR)values ranged from 6.028 to 10.604.The Cronbach's Alpha coeffi-cient was 0.779,and Spearman-Brown split-half reliability was also 0.779.The I-CVI varied from 0.83 to 1.000,the S-CVI/Ave was 0.857,and the KMO value was 0.821.Multifactorial regression analysis indicated that high myopia(OR=5.744,95%CI[1.632,20.218],P=0.006)and amblyopia(OR=9.302,95%CI[1.878,46.058],P=0.006)were significant predictors of CSQVD symptoms.Multiple linear regression analysis showed that BCVA of amblyopic eyes(B=5.052,95%CI[7.779,2.325],P=0.000)and SE power(B=0.234,95%CI[0.375,0.205],P=0.001)significantly affected the CSQVD scale scores.Conclusions:The Chinese version of the SQVD scale(CSQVD)demonstrates good feasibility,discriminatory power,validity,and reliability in assessing Chinese school-aged children.Furthermore,those who have severe myopia and amblyopia reported more visual dysfunction symptoms.

Comparison of visual outcomes with implantation of trifocal versus bifocal intraocular lens after phacoemulsification: a Meta-analysis

AIM： To compare a trifocal intraocular lens （IOL） and a bifocal IOL implantation in improving visual function after cataract surgery. METHODS： Eligible literatures were systematically searched through EMBASE and PubMed databases. The inclusion criteria were prospective comparative clinical trials on cataract surgery comparing trifocal IOL with bifocal IOL implantation that assessed visual acuity, contrast sensitivity and subjective vision quality. The effects were computed as standardized mean differences and pooled using fixed-effect or random-effect models. RESULTS： Four prospective randomized controlled trials （RCTs） and five cohorts provided data were included by a systematic review, comprising 265 eyes implanted with trifocal IOLs and 264 eyes implanted with bifocal IOLs. Monocular distance visual acuity （VA） showed a statistically significant but small difference that favored trifocal IOLs （MD=.0.06; 95%CI, -0.10 to -0.02; Z=2.90, P=0.004 for uncorrected distance VA, and MD- -0.02; 95%CI, -0.03 to .0.00; Z=2.02, P=0.04 for corrected distance VA）, but the data did not suggest that the effect of trifocal IOL implantation would clinically outperform bifocal IOL implantation. There was no significant difference in monocular near VA （MD=.0.01; 95%CI, -0.07 to 0.04; Z=0.42, P=-0.68 for distance-corrected near VA, and MD=-0.01; 95%CI, -0.06 to 0.03; Z=0.55, P=0.58 for corrected near VA） or refraction between two groups. Contrast sensitivity and subjective visual quality had no conclusive results. CONCLUSION： All results indicate that trifocal IOL and bifocal IOL had similar levels of monocular distance and near VA.

Six-year outcomes in neovascular age-related macular degeneration with ranibizumab

AIM： To evaluate the outcomes of （6y ranibizumab therapy in neovascular age-related macular degeneration （AMD）.METHODS： HELIX was a retrospective, observational effectiveness study using medical records of patients treated in three clinics in Belgium. Patients had neovascular AMD and were initially treated with intravitreal ranibizumab （0.5 mg） between November 1, 2007 and October 31, 2008, had （6y of data available, and were treated on an ongoing, as-needed basis. Outcomes included best-corrected visual acuity （BCVA） and central retinal thickness （CRT）.RESULTS： The sample consisted of 88 eyes from 69 patients. Mean age was 76.4±6.5y, most patients were female （62.3%）. Most eyes （62.5%） were treatment-naive, 33 previously treated eyes had received predominantly other anti-vascular endothelial growth factor agents and verteporfin. Mean baseline BCVA was 57.4±12.7 ETDRS letters and CRT was 291.5±86.1 （m. On average, patients received 20.6±11.9 ranibizumab injections over the （6y. Intervals between injections were on average 12.7±16.1wk. Mean change in BCVA from baseline to last observation for the sample was less than one letter （-0.9±17.3 letters）, with an average loss of -3.2±15.6 letters in previously treated eyes versus a gain of 0.6±18.4 letters in treatment-na？ve eyes. When considering a loss of 〈15 letters over 6y as stabilization of disease, 75.9% of all eyes showed a positive （improvement or stabilization） outcome. Mean change in CRT from baseline to last observation for the sample was -26.9±148.4 （m with the greatest reduction observed in treatment-naive eyes.CONCLUSION： This retrospective study of 69 neovascular AMD patients treated for （6y with ranibizumab demonstrates long-term visual stabilization. In light of the natural evolution of the disease, these data confirm that ranibizumab is effective long-term under real-world conditions of heterogeneity of patients, clinicians, and centers.

Structural impairment patterns in peripapillary retinal fiber layer and retinal ganglion cell layer in mitochondrial optic neuropathies

AIM：To evaluate the structural injure patterns in peripapillary retinal fiber layer （pRNFL）, retinal ganglion cell layer （RGCL） and their correlations to visual function in various mitochondrial optic neuropathies （MON） to offer help to their differential diagnosis.METHODS：Totally 32 MON patients （60 eyes） were recruited within 6mo after clinical onsets, including 20 Leber hereditary optic neuropathy （LHON） patients （37eyes）, 12 ethambutol-induced optic neuropathy （EON）patients （23 eyes）, and 41 age-gender matched healthy controls （HC, 82 eyes）. All subjects had pRNFL and RGCL examinations with optic coherence tomography （OCT） and visual function tests.RESULTS：In the early stages of MON, the temporal pRNFL thickness decreased （66.09±22.57μm）, but increased in other quadrants, compared to HC （76.95±14.81μm）. The other quadrants remaining stable for LHON and EON patients besides the second hour sector of pRNFL thickness reduced and the temporal pRNFL decreased （56.78±15.87μm） for EON. Total macular thickness in MON reduced remarkably（279.25±18.90μm; P=0.015）, which mainly occurring in the inner circle （3 mm diameter of circle） and the nasal temporal sectors in the outer circle （5.5 mm diameter of circle）, in contrast to those in HC. RGCL thickness reduced in each sector of the macula （61.90±8.73μm; P≤0.001）. It strongly showed the correlationship of best corrected visual acuity （R=0.50, P=0.0003） and visual field injury （R=0.54,P=0.0002） in MON patients.CONCLUSION：OCT is a potential tool for detecting structural alterations in the optic nerves of various MON. Different types of MON may have different damage patterns.

Umbilical cord derived mesenchymal stem cell implantation in retinitis pigmentosa: a 6-month follow-up results of a phase 3 trial

AIM:To investigate the efficacy and the safety of umbilical cord derived mesenchymal stem cell(UC-MSC)implantation in patients with retinitis pigmentosa(RP).METHODS:This prospective,single-center,phase 3 clinical study enrolled 124 eyes of 82 RP patients.The patients received 5 million UC-MSCs to the suprachoroidal area with a surgical procedure.Patients were evaluated on the 1st day,1st,and 6th months postoperatively.Best corrected visual acuity(BCVA),anterior segment and fundus examinations,color photography,optical coherence tomography(OCT),and visual field(VF)tests were carried out at each visit.Fundus fluorescein angiography(FFA)and multifocal electroretinography(mfERG)recordings were performed at the end of the 6th month.Ocular and systemic adverse events of the surgical procedure were also noted.RESULTS:All of the 82 patients completed the 6-month follow-up period.None of them had any serious systemic or ocular complications.There were statistically significant improvements in BCVA and VF during the study(all P<0.05).The amplitudes of the P1 waves in the central areas showed significant improvements in mfERG recordings.There were also significant increases in implicit times of P1 waves in the central areas.CONCLUSION:Suprachoroidal administration of UC-MSCs has beneficial effect on BCVA,VF,and mfERG measurements during the 6-month follow-up period.Cell mediated therapy based on the secretion of growth factors(GFs)seems to be an effective and safe option for degenerative retinal diseases.

Clinical efflcacy of botulinum toxin type A on acute acquired comitant esotropia

AIM: To investigate the effects of micro-injection of botulinum toxin A(BTXA) on acute acquired comitant esotropia(AACE). METHODS: A total of 33 AACE patients who underwent BTXA micro-injection at Renmin Hospital of Wuhan University from September 1^(st), 2019 to July 1^(st), 2021 were retrospective analyzed. Esotropia, eye alignment, stereopsis, and complications were examined at baseline(except complications), 1wk, 1, 3, and 6mo after injection. RESULTS: The average angle of deviation before injection was(+20.24±6.80)^(Δ) at near and(+24.76±6.43)^(Δ) at distance, while(+5.15±5.85)^(Δ) at near and(+7.30±6.17)^(Δ) at distance 6mo after treatment(P<0.05). Six months after injection, the stereopsis of patients had improved. The number of patients having no stereopsis(>800 seconds of arc) decreased from 11 to 3. The number of patients having peripheral stereopsis(300-800 seconds of arc), macular stereopsis(70-200 seconds of arc) and central concave stereopsis(≤60 seconds of arc) increased from 10 to 11, 10 to 12, and 2 to 7, respectively. At the follow-ups at 1wk, 1, 3, and 6mo after injection, success rates were 96.97%, 96.97%, 93.94% and 87.88%, respectively. One week after injection, two patients(6.07%) showed subconjunctival hemorrhage;three patients(9.09%) showed limited eye movement and one patient(3.03%) showed mild vertical strabismus. All the symptoms disappeared by the final follow-up.CONCLUSION: Micro-injection of BTXA can reduce diplopia and improve binocular vision function of AACE patients. Furthermore, the operation is relatively safe with few complications, making it an ideal treatment modality for AACE.

Virtual reality training improves accommodative facility and accommodative range

AIM: To evaluate the effects of virtual reality(VR) training on different parameters of vision.METHODS: Sixty individuals ranged 18-60 years old with asthenopia were randomly divided into short-term(n=40) and long-term(n=20) treatment groups. They were given a specially designed VR training device only once for 15 min or 3-4 times a day for 15 min each time for 1 mo. The visual acuity, spherical equivalent, accommodative range, accommodative facility, pupil size, and visual fatigue were evaluated before(control) and after VR training. RESULTS: The visual acuity, accommodative range, and accommodative facility increased in subjects of the shortterm treatment group, whereas their pupil size contracted significantly. No significant changes in spherical equivalent and visual fatigue were observed. The changes in distant vision and corrected visual acuity were positively correlated with those in pupil size, but not with spherical equivalent. The accommodative range and accommodative facility improved significantly in subjects of the long-term treatment group. No significant changes in visual acuity, spherical equivalent, pupil size, and visual fatigue were noted. CONCLUSION: VR training can improve the accommodative range and accommodative facility of human eyes. Although short-term VR training can transiently improve vision, which probably due to bright light adaptation, there is no evidence that it can improve myopia.