Add-on perceptual learning on refractive amblyopia in children

AIM:To evaluate the visual outcomes of standard amblyopic treatment add-on training via perceptual learning in refractive amblyopic children and to identify the risk factors for treatment failure.METHODS:Retrospective charts were reviewed in children with refractive amblyopia who received standard treatment and add-on Cambridge Visual Stimulator(CAM)training.The add-on CAM group that was enrolled had worn full-corrected glasses for at least 2mo before training.A control group received only the standard treatment.Treatment success was defined as best-corrected visual acuity(BCVA)≥20/25.The age,sex,initial BCVA,refractive errors,sessions and duration of training,and final BCVA were recorded.RESULTS:A total of 209 children(129 children in add-on CAM group and 80 children in control group)were enrolled.Seventy-six percent of unilateral and 87%of bilateral amblyopic children achieved treatment success.In children with unilateral or bilateral moderate amblyopia,the duration to reach BCVA≥20/25 was significantly shorter in add-on CAM group than in control group.Poor initial BCVA(P<0.001)and high astigmatism(P=0.007)were risk factors for treatment failure after add-on CAM training.Age,sex,and types of refractive error were not associated with treatment success.CONCLUSION:Add-on CAM training is an effective strategy for visual improvement and can shorten the treatment course when the effect of standard treatment is limited in amblyopic children.

Femtosecond laser corneal refractive surgery for the correction of high myopic anisometropic amblyopia in juveniles

AIM： To evaluate the effects of femtosecond laser-assisted in situ keratomileusis（FS-LASIK） and small-incision lenticule extraction（SMILE） to correct high myopic anisometropic amblyopia in juvenile patients. METHODS： From November 2013 to January 2015, 33 amblyopic patients with high myopic anisometropic amblyopia were studied. FS-LASIK（30 eyes） or SMILE（3 eyes） was performed in the amblyopic eyes. Visual acuity, refraction, contrast sensitivity, stereoacuity and complications were evaluated. Patients completed followup examinations at 3 d, 1 mo, 3 mo and the last follow-up time（mean 8.17±3.23 mo） after surgery. RESULTS： The mean age at surgery was 9.04±3.04 y（range 6-16 y）. The mean spherical equivalent in the amblyopic eyes was significantly decreased from-10.00±2.39 D preoperatively to-0.06±1.06 D at 1 mo,-0.19±1.33 D at 3 mo and-0.60±1.43 D at approximately 8 mo postoperatively（P〈0.05 for all）. The mean myopic anisometropia was significantly decreased from-9.45±2.33 D preoperatively to ＋0.37±1.48 D at 1 mo,-0.46±1.47 D at 3 mo and-0.09±1.83 D at approximately 8 mo（P〈0.05 for all）. The logarithm of the minimum angle of resolution（log MAR） for uncorrected and corrected distance visual acuity（UDVA and CDVA, respectively） of the amblyopic eye improved from 1.74±0.35 and 0.98±0.63 preoperatively to 0.45±0.31 and 0.41±0.33 at approximately 8 mo after surgery, respectively. The logM AR CDVA at 3 d, 1, 3 and 8 mo postoperatively improved by means of 1.42, 2.22, 2.96, and 4.39 lines, and a gain of more than two lines accounted for 45%, 50%, 74% and 86% of all patients, respectively. The contrast sensitivity of both amblyopic eyes and dominant eyes at 0.5, 2, 8 cycles perdegree was significantly improved postoperatively（P〈0.05 for all）. Of the 33 pediatric patients, no patients had near stereopsis preoperatively and seven patients（21.2%） recovered near stereopsis（400″ to 60″） at approximately 8 mo after surgery. No intraoperative or postoperative complications occurred in any patient.CONCLUSION： FS-LASIK or SMILE can be promising alternative methods to correct high myopic anisometropic amblyopia in juvenile patients who have failed with traditional approaches.

Prevalence of visual impairment and estimation of refractive errors among school children in Kakamega,Kenya

AIM:To investigate the prevalence of visual impairment(VI)and provide an estimation of uncorrected refractive errors in school-aged children,conducted by optometry students as a community service.METHODS:The study was cross-sectional.Totally 3343 participants were included in the study.The initial examination involved assessing the uncorrected distance visual acuity(UDVA)and visual acuity(VA)while using a+2.00 D lens.The inclusion criteria for a subsequent comprehensive cycloplegic eye examination,performed by an optometrist,were as follows:a UDVA<0.6 decimal(0.20 logMAR)and/or a VA with+2.00 D≥0.8 decimal(0.96 logMAR).RESULTS:The sample had a mean age of 10.92±2.13y(range 4 to 17y),and 51.3%of the children were female(n=1715).The majority of the children(89.7%)fell within the age range of 8 to 14y.Among the ethnic groups,the highest representation was from the Luhya group(60.6%)followed by Luo(20.4%).Mean logMAR UDVA choosing the best eye for each student was 0.29±0.17(range 1.70 to 0.22).Out of the total,246 participants(7.4%)had a full eye examination.The estimated prevalence of myopia(defined as spherical equivalent≤-0.5 D)was found to be 1.45%of the total sample.While around 0.18%of the total sample had hyperopia value exceeding+1.75 D.Refractive astigmatism(cil<-0.75 D)was found in 0.21%(7/3343)of the children.The VI prevalence was 1.26%of the total sample.Among our cases of VI,76.2%could be attributed to uncorrected refractive error.Amblyopia was detected in 0.66%(22/3343)of the screened children.There was no statistically significant correlation observed between age or gender and refractive values.CONCLUSION:The primary cause of VI is determined to be uncorrected refractive errors,with myopia being the most prevalent refractive error observed.These findings underscore the significance of early identification and correction of refractive errors in school-aged children as a means to alleviate the impact of VI.

Brain mechanism of acupuncture for children with anisometropic amblyopia: a resting functional magnetic resonance imaging study based on voxel-mirrored homotopic connectivity

AIM:To explore the brain mechanism of acupuncture for children with anisometropic amblyopia using the voxelmirror homotopic connectivity(VMHC)analysis method of resting functional magnetic resonance imaging(rs-fMRI)technology based on clinical effectiveness.METHODS:Eighty children with anisometropic monocular amblyopia were randomly divided into two groups:control(40 cases,1 case of shedding)and acupuncture(40 cases,1 case of shedding)groups.The control group was treated with glasses,red flash,grating,and visual stimulations,with each procedure conducted for 5min per time.Based on routine treatment,the acupuncture group underwent acupuncture of“regulating qi and unblocking meridians to bright eyes”,Jingming(BL1),Cuanzhu(BL2),Guangming(GB37),Fengchi(GB20)acupoints were taken on both sides,with the needle kept for 30min each time.Both groups were treated once every other day,three times per week,for a total of 4wk.After the treatment,the overall curative effect of the two groups and the latency and amplitude changes of P100 wave of pattern visual-evoked potential were counted.At the same time,nine children with left eye amblyopia were randomly selected from the two groups and were scanned with rsfMRI before and after treatment.The differences in the brain regions between the two groups were compared and analyzed with VMHC.RESULTS:Chi-square test showed a notable difference in the total efficiency rate between the acupuncture(94.87%)and control groups(79.49%).Regarding the P100 wave latency and amplitude,the acupuncture group had significantly shorter latency and higher amplitude of P100 wave than the control group.Moreover,the VMHC values of the bilateral temporal lobe,superior temporal gyrus,and middle temporal gyrus were notably increased in the acupuncture group after treatment.CONCLUSION:Acupuncture combined with conventional treatment can significantly improve the corrected visual acuity and optic nerve conduction in children with anisometropic amblyopia.Compared with the conventional treatment,the regulation of acupuncture on the functional activities of the relevant brain areas in the anterior cerebellum may be an effective acupuncture mechanism for anisometropic amblyopia.

Prevalence of Refractive Errors among School Children Aged 5 to 15 Years Old at CHU-IOTA

Introduction: Undetected refractive errors constitute a health problem among school children who cannot take advantage of educational opportunities. The authors studied the prevalence of refractive errors in school children aged 5 to 15 at CHU-IOTA. Patients and Method: This is a prospective, descriptive cross-sectional study carried out in the ophthalmic-pediatrics department of CHU-IOTA, from October to November 2023. Results: We received 340 school children aged 5 to 15, among whom 111 presented ametropia, i.e. a prevalence of 32.65%. The average age was 11.42 ± 2.75 years and a sex ratio of 0.59. The average visual acuity was 4/10 (range 1/10 and 10/10). We found refractive defects: astigmatism 73.87%, hyperopia 23.87% of cases and myopia 2.25%. The decline in distance visual acuity was the most common functional sign. Ocular abnormalities associated with ametropia were dominated by allergic conjunctivitis (26.13%) and papillary excavation (6.31%) in astigmatics;allergic conjunctivitis (9.01%) and papillary excavation (7.20%) in hyperopic patients;turbid vitreous (0.90%), myopic choroidosis (0.45%) and allergic conjunctivitis (0.45%) in myopes. Conclusion: Refractive errors constitute a reality and a major public health problem among school children.

A Transparent Photoresist Made of Titanium Dioxide Nanoparticle-Embedded Acrylic Resin with a Tunable Refractive Index for UV-Imprint Lithography

Transparent photoresists with a high refractive index(RI)and high transmittance in visible wavelengths have promising functionalities in optical fields.This work reports a kind of tunable optical material composed of titanium dioxide nanoparticles embedded in acrylic resin with a high RI for ultraviolet(UV)-imprint lithography.The hybrid film exhibits a tunable RI of up to 1.67(589 nm)after being cured by UV light,while maintaining both a high transparency of over 98%in the visible light range and a low haze of less than 0.05%.The precision machining of optical microstructures can be imprinted easily and efficiently using the hybrid resin,which acts as a light guide plate(LGP)to guide the light from the side to the top in order to conserve the energy of the display device.These preliminary studies based on both laboratory and commercial experiments pave the way for exploiting the unparalleled optical properties of nanocomposite resins and promoting their industrial application.

Surface phonon resonance:A new mechanism for enhancing photonic spin Hall effect and refractive index sensor

Metal-based surface plasmon resonance(SPR)plays an important role in enhancing the photonic spin Hall effect(SHE)and developing sensitive optical sensors.However,the very large negative permittivities of metals limit their applications beyond the near-infrared regime.In this work,we theoretically present a new mechanism to enhance the photonic SHE by taking advantage of SiC-supported surface phonon resonance(SPhR)in the mid-infrared regime.The transverse displacement of photonic SHE is very sensitive to the wavelength of incident light and the thickness of SiC layer.Under the optimal parameter setup,the calculated largest transverse displacement of SiC-based SPhR structure reaches up to 163.8 ym,which is much larger than the condition of SPR.Moreover,an NO_(2) gas sensor based on the SPhR-enhanced photonic SHE is theoretically proposed with the superior sensing performance.Both the intensity and angle sensitivity of this sensor can be effectively manipulated by varying the damping rate of SiC.The results may provide a promising paradigm to enhance the photonic SHE in the mid-infrared region and open up new opportunity of highly sensitive refractive index sensors.

Prevalence and Factors Associated with Refractive Errors among University Students at Mbarara University of Science and Technology, Uganda

Introduction: WHO estimated that uncorrected refractive errors are the leading cause of visual impairment and second leading cause of blindness globally. University students are prone to developing refractive errors due to their curriculum that requires a lot of near work affecting their performance and quality of life unknowingly. Genetic and environmental factors are thought to play a role in the development of refractive errors. This study addresses the paucity of knowledge about refractive errors among university students in East Africa, providing a foundation for further research. Objectives: To determine the prevalence and factors associated with refractive errors among students in the Faculty of Medicine at Mbarara University of Science and Technology. Methodology: This was a cross-sectional descriptive and analytical study in which 368 undergraduate students selected using random sampling were assessed for refractive errors from March 2021-July 2021. Eligible participants were recruited and their VA assessment done after answering a questionnaire. Students whose VA improved on pin hole had subjective retinoscopy and results were compiled and imported to STATA 14 for analysis. Results: The prevalence of refractive errors was 26.36% with (95% CI) among university students especially myopia. Myopia is most predominant at 60%, followed by 37% Astigmatism and hyperopia of 3% among medical students. Astigmatism consisted of largely myopic astigmatism 72% (26) and 28% (10) compound/mixed astigmatism only. Student positive family history of refractive error was found to have a statistically significant relationship with refractive errors with AOR 1.68 (1.04 - 2.72) (95% CI) and P (0.032). Conclusion: The prevalence of refractive errors among university students, especially myopia, was found to be high and family history was associated with students having refractive errors.

Fabrication of UV-Curing Linalool-Polysiloxane Hybrid Films with High Refractive Index and Transparency

In this article,a series of high refractive indices(1.50-1.53)thiol phenyl polysiloxane(TPS)were synthesized via hydrolytic sol-gel reaction.The Fourier transform infrared spectra(FT-IR)and nuclear magnetic resonance spectra(NMR)results showed that TPS conformed to the predicted structures.Natural terpene linalool was exploited as photocrosslinker to fabricate UV-curing linalool-polysiloxane hybrid films(LPH)with TPS via photoinitiated thiol-ene reaction.LPH rapidly cured under UV irradiation at the intensity of 80 mW/cm^(2) in 30 s,exhibiting good UV-curing properties.The optical transmittance of LPH in the wavelength of 300-800 nm was over 90%,exhibiting good optical transparency.The water contact angle and water vapor permeability results showed that the introduction of phenyl groups enhance the hydrophobicity and water vapor barrier properties of LPH.The results indicated the potential of LPHs in the applications of optical functional coatings.

Relative peripheral refraction in school children with different refractive errors using a novel multispectral refraction topographer

AIM:To compare relative peripheral refraction(RPR)in Chinese school children with different refractive errors using multispectral refraction topography(MRT).METHODS:A total of 713 eyes of primary school children[172 emmetropia(E),429 low myopia(LM),80 moderate myopia(MM),and 32 low hypermetropia(LH)]aged 10 to 13y were analyzed.RPRs were measured using MRT without mydriasis.MRT results showed RPR at 0-15°(RPR 0-15),15°-30°(RPR 15-30),and 30°-45°(RPR 30-45)annular in the inferior(RPR-I),superior(RPR-S),nasal(RPR-N),and temporal(RPR-T)quadrants.Spherical equivalent(SE)was detected and calculated using an autorefractor.RESULTS:There were significant differences of RPR 15-30 between groups MM[0.02(-0.12;0.18)]and LH[-0.13(-0.36;0.12)](P<0.05),MM and E[-0.06(-0.20;0.10)](P<0.05),and LM[-0.02(-0.15;0.15)]and E(P<0.05).There were also significant differences of RPR 30-45 between groups MM[0.45(0.18;0.74)]and E[0.29(-0.09;0.67)](P<0.05),and LM[0.44(0.14;0.76)]and E(P<0.001).RPR values increased from the hyperopic to medium myopic group in each annular.There were significant differences of RPR-S between groups MM[-0.02(-0.60;0.30)]and E[-0.44(-0.89;-0.04)](P<0.001),and LM[-0.28(-0.71;0.12)]and E(P<0.05).There were also significant differences of RPR-T between groups MM[0.37(0.21;0.78)]and LH[0.14(-0.52;0.50)](P<0.05),LM[0.41(0.06;0.84)]and LH(P<0.05),and LM and E[0.29(-0.10;0.68),P<0.05].A Spearman’s correlation analysis showed a negative correlation between RPR and SE in the 15°-30°(P=0.005),30°-45°(P<0.05)annular(P=0.002),superior(P<0.001),and temporal(P=0.001)quadrants.CONCLUSION:Without pupil dilation,values for RPR 15-30,30-45,RPR-S,and T shows significant differences between myopic eyes and emmetropia,and the differences are negatively correlated with SE.

Determination of the time of refractive stability after uneventful phacoemulsification in Indian eyes

BACKGROUND Knowledge about refractive stabilization and the accuracy of postoperative refractive error measurements are crucial for improved patient outcomes after phacoemulsification.Existing guidelines typically recommend waiting 4-6 wk before prescribing corrective lenses.Our research focused on identifying factors that influence refractive errors in the early stages of post-cataract surgery,thus contributing to the existing literature on this topic.AIM To investigate the time required for refraction stability after uneventful phacoemulsification surgery.METHODS We compared the variation and statistical significance of the difference in spherical,cylindrical components,and the spherical equivalent between the 1-and 6-wk follow-up period in a group of 257 eyes that underwent uneventful phacoemulsification with foldable intraocular lens implantation,all performed by a single experienced surgeon.The Wilcoxon-Signed Rank Test was utilized to assess the magnitude of the change and determine its statistical significance.The refractive stability was defined as the point at which the change in spherical equivalent was within±0.5 dioptres for two consecutive visits.RESULTS The average age of the patients was 64.9±8.9 yr.The differences observed in both the visits in spherical power(0.1±0.2),cylinder power(0.3±0.4),and spherical equivalent(0.2±0.2)were minimal and not statistically significant.The majority of eyes(93.4%)achieved refractive stability within 6 wk after the surgery.The cylindrical power differed between age groups at the 6th wk post-operative and the difference was statistically significant(P value 0.013).There were no significant differences in refractive stability when considering sex and axial length.CONCLUSION Phacoemulsification with foldable intraocular lens implantation results in no significant changes in refraction for the majority of cases during the 6-wk follow-up period.Therefore,a spectacle prescription can be given at the completion of 1 wk.

Uncorrected refractive errors are important causes of avoidable visual impairment in Hungary: re-evaluation of two existing national data sets

·AIM: To review existing data for the prevalence of corrected, uncorrected, and inadequately corrected refractive errors and spectacle wear in Hungary.·METHODS: Data from two nationwide cross-sectional studies were analysed. The Rapid Assessment of Avoidable Blindness study collected population-based representative national data on the prevalence of visual impairment due to uncorrected refractive errors and spectacle coverage in 3523 people aged ≥50y(Group I). The Comprehensive Health Test Program of Hungary provided data on the use of spectacles in 80 290 people aged ≥18y(Group Ⅱ).·RESULTS: In Group I, almost half of the survey population showed refractive errors for distant vision, about 10% of which were uncorrected(3.2% of all male participants and 5.0% of females). The distance spectacle coverage was 90.7%(91.9% in males;90.2% in females). The proportion of inadequate distance spectacles was found to be 33.1%. Uncorrected presbyopia was found in 15.7% of participants. In all age groups(Group Ⅱ), 65.4% of females and 56.0% of males used distance spectacles,and approximately 28.9% of these spectacles were found to be inappropriate for dioptric power(with 0.5 dioptres or more). The prevalence of inaccurate distance spectacles was significantly higher in older age groups(71y and above) in both sexes.·CONCLUSION: According to this population-based data, uncorrected refractive errors are not rare in Hungary. Despite recent national initiatives, fur ther steps are required to reduce uncorrected refractive errors and associated negative effects on vision, such as avoidable visual impairment.

A 3-month comparison study of subjective and objective visual quality of small incision lenticule extraction and transepithelial photorefractive keratectomy in patients with low and moderate myopia

AIM:To compare the subjective and objective visual quality between small incision lenticule extraction(SMILE)and transepithelial photorefractive keratectomy(t PRK)in patients with low and moderate myopia.METHODS:Patients undertaking SMILE or t PRK for the correction of low and moderate myopia were consecutively recruited in this prospective cohort study with a 3-month follow-up period.Objective evaluation[visual acuity test,manifest refraction,wavefront aberrations,the total cut-off value of the total modulation transfer function(MTFcut-off),and Strehl ratio(SR)]and subjective evaluation of visual quality(quality-of-life questionnaire)were conducted before surgery and at days 1,7,30,and 90 after surgery.RESULTS:A total of 47 patients(94 eyes)with SMILE and 22 patients(22 eyes)with t PRK were enrolled.The uncorrected visual acuity(UCVA)was better in SMILE patients on day 7 after surgery(1.13±0.13 vs 0.99±0.17,t=4.85,P<0.001)but was comparable at days 30 and 90.At day 90,the SMILE group had a lower spherical equivalent(SE)than the t PRK group(0.04±0.31 vs 0.19±0.43,t=2.08,P=0.042).Total higher order aberrations(HOAs)were induced in both surgical types,which were more evident in the t PRK group with 3-mm pupil diameter(0.16±0.07 vs0.11±0.05,t=4.27,P<0.001)and 5-mm pupil diameter(0.39±0.17 vs 0.36±0.11,t=2.33,P=0.022).The MTFcut-offand SR showed a trend of improvement in both SMILE and t PRK patients but were statistically better in the SMILE group with both pupil diameters.There was a significant improvement of contrast sensitivity(CS)over baseline levels at the spatial frequency of 18 cycles/degree(c/d)in the SMILE group(F=2.72,P=0.033)and at 3 c/d(F=3.03,P=0.031),12 c/d(F=3.72,P=0.013),and 18 c/d(F=4.62,P=0.004)in the t PRK group.The subjective quality of life questionnaire showed a steady improvement in the SMILE group(F=8.31,P<0.001)but not the t PRK group.CONCLUSION:SMILE and t PRK are both safe and effective ways to correct low and moderate myopia.A generally better and quicker recovery of visual quality favors the application of SMILE in qualified patients.

Prevalence of refractive errors in children of Puerto Rico

AIM:To determine the prevalence of refractive error in 5-to 17-year-old schoolchildren in Puerto Rico.METHODS:A quantitative descriptive study of 2867 children aged 5 to 17y from all seven educational regions of Puerto Rico was conducted from 2016–2019.Refractive error was determined via static and subjective refraction.Children with distance acuity≤20/40 or near visual acuity≤20/32 had a cycloplegic refraction.Data analysis included descriptive statistics,correlation coefficient,Kruskal-Wallis,Chi-square,and t test calculations.RESULTS:Twenty percent of the children had a spherical equivalent refractive error≤-0.50 D,3.2%had a spherical equivalent≥+2.00 D,and 10.4%had astigmatism≥1 D.There was a statistically(but non-clinically)significant myopic change in spherical equivalent refractive error with age(P<0.001).The prevalence of myopia increased with age(P<0.001)but not hyperopia(P=0.59)or astigmatism(P=0.51).Males had a significantly higher hyperopic spherical equivalent than females(P<0.001).Females had a higher prevalence of myopia(P<0.001)than males,but there was no difference in the hyperopia(P=0.74)or astigmatism prevalence(P=0.87).CONCLUSION:The prevalence of a spherical equivalent equal to or less than-0.50 D(myopia,20.7%)is one of the highest among similar-aged children worldwide.Further studies should explore the rate of myopia progression in children in Puerto Rico.Individual children must be monitored to examine the need for treatment of myopia progression.

Predictive methods for density and refractive index of naphthenic lubricating oils during solvent extraction process

Lubricating oils are usually produced by solvent extraction to separate aromatics in order to achieve the desired specifications and better quality products.Among the different properties of lubricating oils,density and refractive index are some of the most important properties which can both be used for petroleum fluid characterization.Predictions of density and refractive index for naphthenic oils during solvent extraction by DMSO obtained by the pseudo-component approach and the quadratic correlation were both examined.The pseudo-component approach is a method to predict density and refractive index from composition while the latter merely relates density to refractive index.Results indicated that the predictions yielded by the pseudo-component method were in good agreement with experimental data for naphthenic oils.And the use of a function of refractive index(FRI_(20))as a pseudo-component property remarkably improved n_(20)predictions for the naphthenic mixtures.However,the density and refractive index predictions obtained by the quadratic correlation exhibited significantly higher de-viations for naphthenic oils than those for paraffinic oils.Thus a new modified correlation of the same functional form was proposed for naphthenic oils.The modification significantly improved predictions for naphthenic oils,which presented similar accuracy as the pseudo-component approach.And the previous correlation was still used for paraffinic oils.Additionally,effect of temperature on density and refractive index of naphthenic oils was examined.Results showed that the modified quadratic correlation was accurate for describing the relationship between density and refractive index of naphthenic oils at 20-90℃.The temperature dependence of density and refractive index for the raffinates and the extracts could be accurately described by the thermal coefficients for saturates and aromatics,respectively.Regarding the refractive index variation of the extracts with temperature,the empirical equation was proved to be a better option compared with the method using the thermal coefficient for aromatics.

Bibliometric analysis of research relating to refractive cataract surgery over a 20-year period:from 2003 to 2022

AIM:To investigate the research trend on refractive cataract surgery,compare the contributions of different countries,institutions,journals,and authors in the past 20y,and explore its potential research hotspots.METHODS:All publications were extracted relating to refractive cataract surgery from 2003 to 2022 from Web of Science.Document types were limited to original articles and reviews,and the language was limited to English.Quantitatively and qualitatively of the publications were analyzed through Microsoft Excel and GraphPad Prism.VOSviewer and CiteSpace were used for bibliometric and visualized analysis.RESULTS:A total of 2090 publications were enrolled.The United States contributed the most publications(434,20.8%),followed by China(345,16.5%)and England(163,7.80%).Publications from the United States were cited more frequently(9552 citations)with the highest H-index of 48.China ranked second in the total number of publications,the papers were not cited that frequently(3237 citations),and the H-index ranked sixth(H-index=29).Journal of Cataract and Refractive Surgery published the most papers(333,15.9%),and the University of London had the highest number of publications(75,3.59%).Dick HB from Germany published the most papers.Corneal astigmatism-related research,cataract surgery methodrelated research,postoperative visual-quality relate to research,and postoperative complications-relate research are the hotspots in this field.The most significant limitation was that the database was updated frequently and the latest publications were not included.CONCLUSION:The bibliometric analysis shows a brief summarization of the contribution of the authors,institutions,countries,and journals.Corneal astigmatism,cataract surgery method,postoperative visual-quality and postoperative complications related researches have become the emerging hotspots,which can give a direction in the future researches.

Structural and functional alterations in the brains of patients with anisometropic and strabismic amblyopia:a systematic review of magnetic resonance imaging studies

Amblyopia is the most common cause of vision loss in children and can persist into adulthood in the absence of effective intervention.Previous clinical and neuroimaging studies have suggested that the neural mechanisms underlying strabismic amblyopia and anisometropic amblyopia may be different.Therefore,we performed a systematic review of magnetic resonance imaging studies investigating brain alterations in patients with these two subtypes of amblyopia;this study is registered with PROSPERO(registration ID:CRD42022349191).We searched three online databases(PubMed,EMBASE,and Web of Science) from inception to April 1,2022;39 studies with 633 patients(324patients with anisometropic amblyo pia and 309 patients with strabismic amblyopia) and 580 healthy controls met the inclusion criteria(e.g.,case-control designed,pee r-reviewed articles) and were included in this review.These studies highlighted that both strabismic amblyopia and anisometropic amblyopia patients showed reduced activation and distorted topological cortical activated maps in the striate and extrastriate co rtices during tas k-based functional magnetic resonance imaging with spatial-frequency stimulus and retinotopic representations,respectively;these may have arisen from abnormal visual experiences.Compensations for amblyopia that are reflected in enhanced spontaneous brain function have been reported in the early visual cortices in the resting state,as well as reduced functional connectivity in the dorsal pathway and structural connections in the ventral pathway in both anisometro pic amblyopia and strabismic amblyopia patients.The shared dysfunction of anisometro pic amblyopia and strabismic amblyopia patients,relative to controls,is also chara cterized by reduced spontaneous brain activity in the oculomotor co rtex,mainly involving the frontal and parietal eye fields and the cerebellu m;this may underlie the neural mechanisms of fixation instability and anomalous saccades in amblyopia.With regards to specific alterations of the two forms of amblyo pia,anisometropic amblyo pia patients suffer more microstructural impairments in the precortical pathway than strabismic amblyopia patients,as reflected by diffusion tensor imaging,and more significant dysfunction and structural loss in the ventral pathway.Strabismic amblyopia patients experience more attenuation of activation in the extrastriate co rtex than in the striate cortex when compared to anisometropic amblyopia patients.Finally,brain structural magnetic resonance imaging alterations tend to be lateralized in the adult anisometropic amblyopia patients,and the patterns of brain alterations are more limited in amblyopic adults than in childre n.In conclusion,magnetic resonance imaging studies provide important insights into the brain alterations underlying the pathophysiology of amblyopia and demonstrate common and specific alte rations in anisometropic amblyo pia and strabismic amblyopia patients;these alterations may improve our understanding of the neural mechanisms underlying amblyopia.

Axial length,vitreoretinal pathology,and anterior chamber depth can predict postoperative refractive outcomes in phacovitrectomy/silicone oil removal

AIM:To evaluate the postoperative refractive prediction error(PE)and determine the factors that af fect the refractive outcomes of combined pars plana vitrectomy(PPV)or silicone oil removal(SOR)with cataract surgery.METHODS:The study is a retrospective,case-series study.Totally 301 eyes of 301 patients undergoing combined PPV/SOR with cataract surgery were enrolled.Eligible individuals were separated into four groups according to their preoperative diagnoses:silicone oil-filled eyes after PPV(group 1),epiretinal membrane(group 2),macular hole(group 3),and primary retinal detachment(RD;group 4).The variables af fecting postoperative refractive outcomes were analyzed,including age,gender,preoperative best-corrected visual acuity(BCVA),axial length(AL),keratometry average,anterior chamber depth(ACD),intraocular tamponade,and vitreoretinal pathology.The outcome measurements include the mean refractive PE and the proportions of eyes with a PE within±0.50 diopter(D)and±1.00 D.RESULTS:For all patients,the mean PE was-0.04±1.17 D,and 50.17%of patients(eyes)had a PE within±0.50 D.There was a significant difference in refractive outcomes among the four groups(P=0.028),with RD(group 4)showing the least favorable refractive outcome.In multivariate regression analysis,only AL,vitreoretinal pathology,and ACD were strongly associated with PE(all P<0.01).Univariate analysis revealed that longer eyes(AL>26 mm)and a deeper ACD were correlated with hyperopic PE,and shorter eyes(AL<26 mm)and a shallower ACD were correlated with myopic PE.CONCLUSION:RD patients have the least favorable refractive outcome.AL,vitreoretinal pathology,and ACD are strongly associated with PE in the combined surgery.These three factors affect refractive outcomes and thus can be used to predict a better postoperative refractive outcome in clinical practice.

Defects and asymmetries in the visual pathway of non-human primates with natural strabismus and amblyopia

Strabismus and amblyopia are common ophthalmologic developmental diseases caused by abnormal visual experiences. However, the underlying pathogenesis and visual defects are still not fully understood. Most studies have used experimental interference to establish diseaseassociated animal models, while ignoring the natural pathophysiological mechanisms. This study was designed to investigate whether natural strabismus and amblyopia are associated with abnormal neurological defects. We screened one natural strabismic monkey(Macaca fascicularis) and one natural amblyopic monkey from hundreds of monkeys, and retrospectively analyzed one human strabismus case. Neuroimaging, behavioral,neurophysiological, neurostructural, and genovariation features were systematically evaluated using magnetic resonance imaging(MRI), behavioral tasks, flash visual evoked potentials(FVEP),electroretinogram(ERG), optical coherence tomography(OCT), and whole-genome sequencing(WGS), respectively. Results showed that the strabismic patient and natural strabismic and amblyopic monkeys exhibited similar abnormal asymmetries in brain structure, i.e., ipsilateral impaired right hemisphere. Visual behavior, visual function, retinal structure, and fundus of the monkeys were impaired. Aberrant asymmetry in binocular visual function and structure between the strabismic and amblyopic monkeys was closely related, with greater impairment of the left visual pathway.Several similar known mutant genes for strabismus and amblyopia were also identified. In conclusion,natural strabismus and amblyopia are accompanied by abnormal asymmetries of the visual system,especially visual neurophysiological and neurostructural defects. Our results suggest that future therapeutic and mechanistic studies should consider defects and asymmetries throughout the entire visual system.

Refractive State and Macular Abnormalities at Oct in Albino at Chu Iota

Introduction: A rare genetic disease, albinism is globally characterized by specific deficits of the visual system associated with a variable hypopigmentation phenotype depending on the disruption of melanin production [1]. It is linked to a hereditary defect in the biosynthesis of melanin. Disease results in a generalized decrease in the pigmentation of the appendages, skin and eyes [2]. The aim of this study is to determine the different refractive errors and the different macular anomalies during the OCT examination in oculocutaneous albinism at the CHU-IOTA. Patients and Method: We conducted a prospective study in patients over 10 years of age with oculocutaneous or ocular albinism who consulted at the CHU-IOTA between July 1, 2020, and September 30, 2021. Results: Over the period, 105 cases of oculocutaneous albinism were collected out of a total of 42,024 consultations, which corresponds to a frequency of 0.2%. The average age was 26.2 years, (11 years to 48 years). The sex ratio was 1.6. Astigmatism was the most found refractive error in 50.48% of cases, followed by myopia in 29.52% of cases and farsightedness in 20% of cases. The macular thickness between 251 - 350 was the most commonly found in both eyes, i.e. 47.25% on the right and 53.55% on the left. The bulging macula was the most frequent pathology on the OCT at the level of the two eyes, i.e. 41.42% on the right and 50.6% on the left. Conclusion: Following the visual impairments linked to albinism, early optical care and access to OCT are necessary. Thus the accompaniment of a subject with albinism and associations of albinism must be global and meet specific needs, in order to prevent or avoid ocular complications.