Search

BACKGROUND: Plusoptix photoscreeners are capable of measuring refractive errors of children from 1 meter distance, without cyloplegia. We aimed to compare refractive data obtained from the newest version of Plusoptix (model 12) with cycloplegic autorefraction. METHODS: We examined 111 consecutive children aged 3-7 years first by Plusoptix A12C under manifest condition and subsequently for cycloplegic refraction by Topcon KR-1 tabletop autorefractometer. Sphere, spherical equivalent, cylinder and axis of astigmatism measured by the two methods were analyzed to determine correlation, agreement and differences. RESULTS: Binocular examination of 111 children aged 4.86±1.27 years revealed good agreement between refractive data obtained by Plusoptix and cycloautorefraction, according to Bland-Altman plots. Significant (p < 0.001) and strong correlation was found between all refractive measurements (Pearsons r value of 0.707 for sphere, 0.756 for pherical equivalent, and 0.863 for cylinder). Plusoptix mean sphere, spherical equivalent and cylinder were 1.22, 0.56, and -1.32 D, respectively. Corresponding values for cycloautorefraction were 1.63, 1.00, and -1.26 D. The difference between axis of cylinder measured by the two methods was < 10° in 144 eyes (64.9%). CONCLUSIONS: Considering the significant agreement and correlation between Plusoptix photoscreener and cycloplegic autorefraction, the need for cycloplegic drops in refractive examination of children may be obviated. The mean difference between cylinder measurements are considerably trivial (0.06 D), but sphere is approximately 0.4 D underestimated by Plusoptix compared to cycloautorefraction, on average.

IntroductionThe purpose of this study is to assess the prevalence of comprehensive eye examinations in multiethnic preschool children, including children with visually significant eye conditions, and identify factors associated with comprehensive eye examinations.MethodsA sample of 9,197 African American, Hispanic, Asian American, and non-Hispanic White children aged 6-72 months was recruited for the Multi-Ethnic Pediatric Eye Disease Study from 2003 to 2011. Logistic regression performed in 2022 identified independent factors associated with parent-reported history of comprehensive eye examinations. The proportion of children with previous comprehensive eye examinations and the proportion with undetected amblyopia or strabismus were measured.ResultsThe prevalence of comprehensive eye examinations was 6.3% overall and 38.3%, 24.8%, 19.1%, 15.1%, and 9.8% among children with strabismus, amblyopia, significant anisometropia, hyperopia, and astigmatism, respectively. Children without prior comprehensive eye examinations were more likely to have undetected amblyopia or strabismus than those with comprehensive eye examination history (ps

PURPOSE: The aim of this pilot study was to determine whether viewing an immersive 3D movie with large disparities in a cinema resulted in improved visual acuity (VA), stereoscopic depth perception (ST), and improved eye alignment in residual amblyopic children and children without amblyopia. METHODS: A total of 24 children aged between 5 and 12 years with a history of anisometropic and/or strabismic amblyopia, that had been previously treated and who currently have residual amblyopia (N = 14), and in children with typical development without amblyopia (N = 10) viewed the movie in 3D Sing 2 in a cinema for 110 minutes. Visual acuity, stereoacuity and ocular deviation were assessed before viewing the movie, and three months later. Stereoacuity and ocular deviation were also measured immediately after viewing the movie. RESULTS: We observed an improvement in visual acuity in the non-dominant (amblyopic) eye 3 months after viewing the movie in the amblyopic group (P

Introduction: The ORTHOPHTALMO study aims to evaluate the diagnostic parameters of the screening protocol for amblyopia and risk factors for amblyopia in 3-year-olds recommended in 2019 by the French Association for Pediatric Ophthalmology and Strabismus (AFSOP). This protocol uses visual acuity, photoscreening refraction, and cover test examination performed by an orthoptist. Patient referral to an ophthalmologist is only according to recommended referral criteria. Methods: A prospective, single-center study was performed between September 2020 and June 2021 on a consecutive series of 3-year-olds consulting the Ophthalmology Centre of Clinique Rive Gauche, Toulouse, France, for vision screening. Patients were first examined by an orthoptist following the screening protocol recommended by AFSOP. All patients were then systematically examined by an ophthalmologist for cycloplegic refraction measurement (reference examination). The ophthalmologist was blinded to the referral conclusion and refraction measurements of the orthoptist. Results: A total of 300 patients (149 girls and 151 boys) were included. Examination by an orthoptist was unreliable/incomplete in 7% of cases. An abnormality was detected by the orthoptist in ≥1 of the screening tests among 42% of patients; these patients were thus considered as requiring referral to an ophthalmologist. Reference ophthalmological examination found 41% of patients required treatment. The diagnostic parameters of this screening protocol were 90% for sensitivity and 89% for specificity. Discussion: We validate the effectiveness and feasibility of the AFSOP screening protocol for detection of amblyopia and risk factors for amblyopia in 3-year-olds as well as the recommended criteria for referral to an ophthalmologist.ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/NCT04395560.Number: NCT04395560. [ABSTRACT FROM AUTHOR]

Introduction: Social media is a widely-used avenue for the public to find health information. In particular, Instagram is a popular social media platform among adults who may have children within the amblyogenic age range, and it may be used to find amblyopia-related information. The purpose of this study is to assess the quality of the amblyopia information on Instagram. Methods: The top 200 publicly available Instagram posts about amblyopia from October to December 2022 were reviewed and scored using the Currency, Reliability, Authority, and Purpose (CRAP) test. Results: A quarter of posts were from healthcare providers (ophthalmologists, optometrists, opticians), and only 3% of posts were specifically from pediatric ophthalmologists. Most posts, however, were from businesses (51%), which were of lower quality than posts by providers. Discussion: Instagram represents a tremendous opportunity to educate the public. Better utilizing this resource may allow medical professionals to broadly spread accurate, unbiased data. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to explore potential discrepancies in contrast sensitivity in the ON and OFF visual pathways among individuals with amblyopia compared to controls. Methods: Eleven adult amblyopes (26.2 ± 4.4 [SD] years old) and 10 controls (24.6 ± 0.8 years old) with normal or corrected to normal visual acuity (logMAR VA ≤ 0) participated in this study. Using the quick contrast sensitivity function (qCSF) algorithm, we measured balanced CSF which would stimulate the ON and OFF pathways unselectively, and CSFs for increments and decrements that would selectively stimulate the ON and OFF visual pathways. Contrast sensitivity and area under log contrast sensitivity function were extracted for statistical analysis. Results: For the balanced CSF, we found significant interocular differences in sensitivity and area under log contrast sensitivity function in both amblyopes [F(1,10) = 74.992, p < 0.001] and controls [F(1,9) = 35.6, p < 0.001], while such differences were more pronounced in amblyopes than in controls. For increment and decrement CSFs, we found that the increment sensitivity (p = 0.038) and area under log contrast sensitivity function (p = 0.001) were significantly lower than the decrement in the amblyopic eye. Such differences between increment and decrement CSFs were not observed in the fellow eye of the amblyopes or in the controls. Conclusion: There is a subtle difference in the contrast sensitivity of the amblyopic eye when exposed to stimulation in the ON and OFF pathways. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationship between pregnancy and myopia onset or progression in young adult women, utilizing a longitudinal cohort design with a substantial sample size. Myopia is a prevalent refractive error with significant public health and economic implications. There are genetic and environmental risk factors for myopia; however, the role of pregnancy in the development of myopia is unknown. No longitudinal studies with extensive sample sizes have clarified the relationship between pregnancy and myopia. This study included 100 women aged 20-50 years, who were followed up biennially for up to 14 years. Pregnancy occurrences and myopia assessments were recorded. A comparison of individuals with and without pregnancies revealed differences in the incidence of myopia and amblyopia, their ages, and body mass index. Hazard ratios for myopia onset or progression were significantly lower in individuals with at least one pregnancy, particularly during the early follow-up periods. Sensitivity analyses and adjustments for confounders supported these findings. This study demonstrated that pregnancy may prevent myopia onset or progression, particularly during early adulthood. Future research should confirm these findings and investigate the underlying mechanisms, informing clinical decisions, including refractive surgery timing in women of childbearing age. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Active vision therapy for amblyopia shows good results, but there is no standard vision therapy protocol. This study compared the results of three treatments, two combining patching with active therapy and one with patching alone, in a sample of children with amblyopia.Two protocols have been developed: (a) perceptual learning with a computer game designed to favour the medium‐to‐high spatial frequency‐tuned achromatic mechanisms of parvocellular origin and (b) vision therapy with a specific protocol and 2‐h patching. The third treatment group used patching only. Fifty‐two amblyopic children (aged 4–12 years), were randomly assigned to three monocular treatment groups: 2‐h patching (n = 18), monocular perceptual learning (n = 17) and 2‐h patching plus vision therapy (n = 17). Visual outcomes were analysed after 3 months and compared with a control group (n = 36) of subjects with normal vision.Visual acuity (VA) and stereoacuity (STA) improved significantly after treatment for the three groups with the best results for patching plus vision therapy, followed by monocular perceptual learning, with patching only least effective. Change in the interocular difference in VA was significant for monocular perceptual learning, followed by patching. Differences in STA between groups were not significant. For VA and interocular differences, the final outcomes were influenced by the baseline VA and interocular difference, respectively, with greater improvements in subjects with poorer initial values.Visual acuity and STA improved with the two most active treatments, that is, vision therapy followed by perceptual learning. Patching alone showed the worst outcome. These results suggest that vision therapy should include monocular accommodative exercises, ocular motility and central fixation exercises where the fovea is more active. [ABSTRACT FROM AUTHOR]

Ocular strabismus, a common condition in the present generation is an absolute risk factor for amblyopia and blinding premorbid visual loss. Despite the availability of new optometry tools with eye-tracking data, the issues persist in attaining accuracy and reliability in diagnosing strabismus. These two concerns are specifically accommodated in this study by the proposed novel approach that involves CNNs with eye-tracking datasets from subjects. The presented work aims to improve the accuracy of diagnostics in ophthalmology utilizing the integration of the further proposed algorithms into an automatic strabismus detection system. For this purpose, the proposed FedCNN model combines the CNN with eXtreme Gradient Boosting (XGBoost) and uses the Gaze deviation (GaDe) images to capture dynamic eye movements. This method tries to make the feature extraction as accurate as possible in its best working state to enhance the diagnosis precision. The model proves to be accurate, reaching 95.2%, which is even more prominent because of the more or less detailed connection layer of the CNN, which is used for the selection of features designated for such tasks of strabismus recognition. The presented method has the potential of shifting the approach to diagnosing diseases of the eyes in more or less half of the patients. [ABSTRACT FROM AUTHOR]

Introduction: Reduction in visual acuity and glare are common indications for cataract surgery in patients with strabismus. The amblyopic eye is particularly sensitive to blur, despite reduced visual acuity and contrast sensitivity. However, the impact of cataracts on visual functions in strabismus patients is not well documented. Aim: To evaluate the Vision-related Quality of Life (VRQoL) after cataract surgery in strabismus patients. Materials and Methods: The present quasi-experimental study was conducted in the Department of Ophthalmology, RL Jalappa Hospital and Research Centre, Kolar, Karnataka, India, from August 2023 to September 2023. Study included 44 strabismus patients, which was assessed by Hirschberg and alternate cover tests. All patients underwent unilateral manual small incision cataract surgery on the worse eye. VRQoL was assessed using the Indian Vision-related Quality of Life Functioning Questionnaire-33 (IND-VFQ-33) questionnaire preoperatively and postoperatively. Statistical significance was determined using paired t-tests (p-value<0.05). Results: In the present study, the mean±Standard Deviation (SD) age of patients was 64.34±8.09 years (range: 42-79 years), with a predominance of females, 29 (66%). All patients underwent unilateral manual small incision cataract surgery on their worse eye. The degree of strabismus among the patients varied: 27 (61.36%) exhibited a 15° deviation, 12 (27.27%) had a 30° deviation and 5 (11.36%) exhibited a 45° deviation. A total of 41 (93.1%) patients presented with exotropia, while 3 (6.9%) exhibited esotropia. The results demonstrated significant improvements in Corrected Distance Visual Acuity (CDVA) from the preoperative to postoperative period. The IND-VFQ-33 questionnaire revealed substantial reductions in scores for general functioning, mobility, activity limitation, psychosocial impact and visual symptoms across the entire study population and in all strabismus groups (15°, 30° and 45° deviations), with a p-value of <0.05. Overall, 84.09% of patients had no to mild visual impairment postoperatively, with 27 (100%) patients with 15° strabismus, 7 (58.3%) patients with 30° strabismus, and 3 (60%) patients with 45° strabismus reporting no to mild visual impairment. 3 (25%) patients with 30° strabismus and 1 (20%) patient with 45° strabismus had moderate vision impairment postoperatively. Two (16.66%) patients with 30° strabismus and one patient with 45° strabismus had severe vision impairment postoperatively. Conclusion: A significant proportion of strabismus patients with cataracts were elderly, predominantly females. Exotropia and 15° strabismus were the most common findings. Cataract surgery significantly improved VRQoL, with the most substantial benefits observed in patients with a 15° deviation and the least in those with a 45° deviation. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionTo characterize the prevalence of astigmatism among the heretofore largest published sample of preschool children and to do so among different age, gender, and racial and ethnic subgroups.This study included data from 79,330 preschoolers (49.0% female, 79.4% Latino, mean age 4.29 ± 0.66 years) who were screened using a Retinomax autorefractor between 2012 and 2017. Cylindrical power and astigmatism defined as 1.50 D or more of cylinder were the dependent variables. Children were stratified by age, race/ethnicity, and gender. T-test and chi-square analyses were performed.The average cylinder of the sample was found to be 0.65 ± 0.78 D and 11% of the children were astigmatic. Among all children, these values remain stable from age 3 (0.66 ± 0.76 D, 11.2%) to age 4 (0.66 ± 0.79 D, 11.4%, p = .53), but they decrease significantly from age 4 to age 5 (0.61 ± 0.80 D, 10.%, p < .01). Latinos have the highest average cylinder power and prevalence of astigmatism at 0.68 ± 0.82 D and 12.3%, and unlike most other race/ethnic subgroups, they do not experience an age-dependent decrease in astigmatism. While female and male students have equivalent cylindrical refractions broadly, Asian and African American females have higher levels of astigmatism than their male counterparts.The data further demonstrate that Latino children in Los Angeles have significantly higher rates of astigmatism, which does not decrease during preschool years. These results emphasize the need for comprehensive school-based screening, especially among Latino enclaves in Los Angeles. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Vision screening programs can provide epidemiological information regarding visual impairment in children. This study aims to report the characteristics of visual abnormalities diagnosed through the Primary School Nurse Health Readiness Program (PSNHRP) in Queensland, Australia.A retrospective review of vision screening records from the PSNHRP between January 2017 and December 2020 was undertaken. Children aged between 4 and 7 who underwent vision screening were included for review. Children with a visual acuity of worse than 6/9–1 using the Parr 4 m letter‐matching chart or those who failed the SPOT Vision Screener were referred to an optometrist or ophthalmologist for review.164 890 children underwent vision screening. 12148 children failed visual screening (7.4%) and were referred for an eye assessment. 6011 (69.4%) of the 8659 children who attended ophthalmic review had a confirmed visual abnormality. Of 164 890 screened children, 1187 (0.72%) were confirmed to have anisometropia, 3843 (2.33%) had refractive error, 194 (0.12%) had strabismus, 755 (0.46%) had anisometropic amblyopia, 136 (0.08%) had strabismic amblyopia, and 1356 (0.82%) had an unspecific abnormality. There was no statistically significant difference in the age at screening between any visual abnormality (p = 0.94). Anisometropia, refractive error, and strabismus were significantly more common in females than males (p = 0.03, p < 0.01, and p = 0.03 respectively), whereas anisometropic amblyopia was more common in males (p < 0.01).We report the prevalence of visual abnormalities detected through the PSNHRP vision screening program. Identification of medical or socioeconomic risk factors that are likely to be associated with visual abnormalities can help to optimise vision screening programs. [ABSTRACT FROM AUTHOR]

Background and Objective: The therapeutic outcomes of amblyopia after the age range of 8-10 years are poor, and amblyopia in older individuals is resistant to treatment. Repetitive Transcranial Magnetic Stimulation (rTMS), among the efforts intended to modulate cortical excitability in the treatment of psychiatric disorders, has been believed to be associated with a specific disease. This study aimed to determine the effect of rTMS on the treatment of treatment-resistant amblyopia in adult patients. Methods: This clinical trial was conducted on 16 patients (12 males and 4 females) with unilateral amblyopia, with a mean age of 30±5 years referring to the clinics of Khatam al-Anbia Eye Hospital, Mashhad, Iran, during 2016-17. Patients were randomly selected from those with unilateral amblyopia (refractive, strabismic, or mixed) who had not responded to conventional treatments (patching or penalization). The healthy eye was considered a control. The therapeutic intervention consisted of four rTMS sessions at two-week intervals. Visual acuity and contrast sensitivity were measured and compared three times: Before the intervention, at the first session of intervention, and at the fourth session of intervention. Results: The mean visual acuity at baseline (0.36±0.19) was not significantly different compared to the first treatment session (0.41±0.1); however, a significant increase was observed compared to the fourth session (0.45±0.23) (P<0.05). The mean contrast sensitivity at baseline (2.02±0.74) was not significantly different compared to the first (1.97±0.63) and the fourth (2.16±0.94) treatment sessions. Conclusion: In most follow-ups, improvement in contrast was not observed in patients with treatment-resistant amblyopia at older ages using rTMS. Only an improvement in visual acuity was observed in the last follow-up compared to the baseline in the patient group [ABSTRACT FROM AUTHOR]

This study aims to investigate how indoor lighting (natural and artificial) and distances (3 m and 5 m) affect color recognition in visually impaired children. Ten participants from a special education school were selected to identify the brightness of five colors at varying lighting and distance circumstances. Each color was presented at six different brightness levels, classified into the low-brightness, the standard-color, and the high-brightness groups. Participants were directed to assess the top three brightness levels they considered most attractive, and each rating was assigned a weighted score. The findings revealed that: (1) Visually impaired children can recognize color brightness in both natural and artificial lighting situations. In indoor conditions, the low-brightness group exhibited greater recognition ability compared to the high-brightness group. Purple did not exhibit a clear pattern, as colors from the high-brightness, the low-brightness, and the standard-color groups were all preferred. (2) Significant differences were observed in the brightness recognition among visually impaired children at distances of 3 m and 5 m. Recognition for low-brightness colors improved with distance, contrasting high-brightness scores that declined. However, there was no significant variation in the perception of green with distance changes. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionInterventions such as eye exams and glasses are used to correct visual problems that may lead to amblyopia, an irreversible decrease in visual acuity. Children with limited access to these interventions are more likely to have unaddressed visual problems that can lead to amblyopia or negatively impact school performance. This study compared vision screening results of children in schools with Title 1 or Non-Title 1 designation to investigate the link between poverty and vision.Data from KidsFIRST vision screenings conducted with the SPOTTM photoscreener performed in Rapid City Area elementary schools were compared across multiple parameters. Students were referred for eye examinations based on identifying the following problems: anisometropia, anisocoria, astigmatism, myopia, hyperopia, gaze misalignment, or a combination.Overall, eye exam referral rates have increased since 2012 (11.9% in 2012, 19.7% in 2023), with a disproportionate increase in referrals from Title 1 schools (25.2% in 2023) vs. Non-Title 1 schools (11.9% in 2023) (p < 0.001). This is largely due to a significantly higher prevalence of astigmatism referrals in Title 1 students (20.9%) compared to Non-Title 1 students (7.5%). Although a higher percentage of Title 1 students are reported to have eye correction (24.4% vs 16.6%), only a slightly higher percentage of Title 1 students wore eye correction during screening (11.5% vs 10.5%).Students at Title 1 schools may have a higher rate of amblyopia risk factors. Additional eye care-based interventions should be taken to reduce the risk of amblyopia in this population. [ABSTRACT FROM AUTHOR]

Purpose: The treatment of unilateral amblyopia involves refractive adaptation, occlusion therapy or penalization with atropine drops. However, in recent years, the use of binocular digital therapy has shown promising results. Aim of this systematic review was to evaluate the effectiveness of binocular treatment of amblyopia compared with standard treatments or placebo therapy. Methods: This systematic review was conducted in accordance to PRISMA statement. Electronic literature was thoroughly searched for articles published between 2013 and May 2024, in the following electronic database; Pubmed, CENTRAL, MedlinePlus, Medline Europe, PLOS, Scopus, Clinicaltrials.gov. The review comprised randomized control trials (RCTs) including patients with unilateral amblyopia, who received binocular therapy or standard amblyopia or placebo treatment for more than two weeks and who had visual acuity assessment pre- and post-treatment. Only articles written in English were included. Risk of bias was assessed with the Rob2 tool, while study quality was evaluated with the modified Jadad scale. Results: Twenty RCTs, including 1769 patients, were incorporated into this systematic review. Twelve different types of binocular amblyopia treatments were identified and categorized into two main types. The first type involves the presentation of low-contrast images in the fellow eye, including stimuli presented only in the amblyopic eye. The second type combines this approach with complementary dichoptic deficits in the images presented to both eyes to encourage their simultaneous use. Conclusion: Binocular amblyopia treatment has shown promising results in addressing unilateral anisometropic, strabismic or mixed type of amblyopia. Nevertheless, further randomized controlled trials are essential to establish the exact dosage, type and duration of binocular therapy as a standard component of amblyopia care. [ABSTRACT FROM AUTHOR]

Objective: To compare the effects of occlusion and pharmacological penalization on visual acuity in the treatment of amblyopia. Material and Method: Thirty-nine patients followed up in our strabismus unit due to amblyopia were included in our study. The patients were randomly divided into two groups as occlusion and pharmacological penalization. and visual acuities of both groups were compared before and after treatment. All patients underwent a complete ophthalmological examination. In the occlusion group, alternating occlusion for 3 days in the healthy eye and 1 day in the amblyopic eye (3:1) for 6 months was applied for 1 to 6 hours, depending on the degree of amblyopia and the age of the patient, while pharmacological penalization was applied once a day to the healthy eyes of the patients with 1%. Atropine sulfate was instilled dropwise and continued for one month. Then, intermittent treatment was started and atropine was dripped into the healthy eye twice a week, and this treatment was continued for 6 months. Results: Pharmacological penalization therapy was applied to 19 of the patients (8 girls, 11 boys), and occlusion therapy was applied to 20 (8 girls, 12 boys). While the mean visual acuity of amblyopic eyes in the pharmacological penalization group was 0.15±0.07 according to the Snellen chart before the treatment, it was 0.41±0.17 at the 6th month after the treatment. The mean visual acuity of the amblyopic eye was increased by 0.26±0.13 with treatment (p <0.001). The visual acuity in amblyopic eyes in the occlusion group was 0.27±0.18 according to the Snellen chart before the treatment, and 0.40±0 .25 at the 6th month after the treatment. A mean increase of 0.22±0.11 was detected in the visual acuity of the amblyopic eyes (p <0.001). There was no statistically significant difference between the visual acuity improvement rates of the two groups (p >0.05). Conclusion: In our study, occlusion and pharmacological penalization applied in the treatment of amblyopia were found to be effective at a rate similar to the increase in visual acuity, Penalization of atropine should be kept in mind in children who do not comply with occlusion therapy. [ABSTRACT FROM AUTHOR]

(1) Background: This study aims to analyze the bioelectrical activity of the masticatory and cervical muscles in a subject with anisometropia. (2) Methods: A female patient aged 23 years with a best-corrected visual acuity of 1.0 in the right eye and 0.1 in the left eye, a refractive error of −2.25 Dsph in the right eye and +4.25 Dsph in the left eye, and astigmatism of −1.75 Dcyl axis 24° was examined. A comprehensive ophthalmological examination and the study of the bioelectrical activity of the muscles were carried out. During the ophthalmological examination, best-corrected visual acuity was determined, refractive error (spherical equivalent) was assessed, and additionally, retinal thickness, choroidal thickness, axial length, and intraocular pressure were measured. (3) Results: It was demonstrated that higher tension in the resting mandibular position and pain-free maximum unassisted opening were observed on the right side (myopia). Conversely, higher tension during maximum voluntary clenching in the intercuspal position and maximum voluntary clenching on dental cotton rolls in the intercuspal position was observed on the left side (hyperopia and astigmatism). (4) Conclusions: In the case study, muscle asymmetry was demonstrated, which is likely associated with anisometropia. This phenomenon requires further investigation. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the effectiveness of a visual rehabilitation method for anisometropic amblyopia that uses visual evoked potential (VEP) parameters and sound biofeedback to increase objectiveness. Design: an observational, case-controlled trial. Setting: Ophthalmology Clinic, Emergency County Hospital, Cluj-Napoca, Romania. Participants: Sixteen subjects with amblyopic anisometropia, aged 15–57, and sixteen controls, aged 24–33, were included. Interventions: Subjects were divided into two groups. The control group, composed of normal-vision subjects, and the amblyopic group received 10 training sessions. The rehabilitation program lasted 10 min, took place twice a week, and ran over five consecutive weeks. During each session, the subjects were asked to fixate on a target on the computer screen and were instructed to keep the fixation and maintain the sound of the biofeedback at high frequency. Main Measures: The study assessed the main visual parameters at baseline, after 10 sessions, and 1, 3, 6, and 12 months after treatment. Performance was evaluated by measuring visual acuity, contrast sensitivity, and reading velocity (words/minute). Results: In the experimental group, mean BCVA improved with two rows, which means an improvement in the LogMARLogMAR scale with an average of nine letters. These values tended to be maintained over time. Both groups showed better reading velocities after training, but this parameter has undergone large variability during follow-ups. Contrast sensitivity was also improved and stable. Conclusions: Visual rehabilitation with the Retimax Vision Trainer can improve visual performance in patients with amblyopia after the critical period, an improvement that is maintained in most cases for at least one year after treatment. [ABSTRACT FROM AUTHOR]

Purpose: To assess the possible benefits of the use of perceptual learning and dichoptic therapy combined with patching in children with amblyopia over the use of only patching. Methods: Quasi-experimental multicentric study including 52 amblyopic children. Patients who improved their visual acuity (VA) by combining spectacles and patching were included in patching group (PG: 20 subjects), whereas those that did not improved with patching performed visual training (perceptual learning + dichoptic therapy) combined with patching, being assigned to the visual treatment group (VT: 32 subjects). Changes in VA, contrast sensitivity (CS), and stereopsis were monitored during a 6-month follow-up in each group. Results: Significant improvements in VA were found in both groups at 1 month (p < 0.01). The total improvement of VA was 0.18 ± 0.16 and 0.31 ± 0.35 logMAR in PG and VT groups, respectively (p = 0.317). The Wilcoxon effect size was slightly higher in VT (0.48 vs. 0.54) at 6 months. An enhancement in CS was observed in the amblyopic eye of the VT group for all spatial frequencies at 1 month (p < 0.001). Likewise, the binocular function score also increased significantly in VT group (p = 0.002). A prediction equation of VA improvement at 1 month in VT group was obtained by multiple linear regression analysis (p < 0.001, R2 = 0.747). Conclusions: A combined treatment of visual training and patching is effective for obtaining a predictable improvement of VA, CS, and binocularity in patching-resistant amblyopic children. [ABSTRACT FROM AUTHOR]

Neural activity can increase the length of nodes of Ranvier (NOR) and slow impulse transmission; however, little is known about the biologically and clinically important recovery process. Sensory deprivation promotes neural plasticity in many phenomena, raising the question of whether recovery of NOR morphology is influenced by sensory deprivation. The results show that NOR gap length recovery in mouse optic nerve was not affected significantly by binocular visual deprivation imposed by maintaining mice in 24 hr dark for 30 days compared to mice recovering under normal visual experience. The findings provide insight into the cellular mechanism of NOR plasticity. • Recovery of node of Ranvier morphology in adult mouse optic nerve is not altered by binocular visual deprivation. • Node of Ranvier morphology is reversibly altered by exocytosis from astrocytes. • This form of node of Ranvier plasticity can take place in adult mice. [ABSTRACT FROM AUTHOR]

Amblyopia is a form of visual cortical impairment that arises from abnormal visual experience early in life. Most often, amblyopia is a unilateral visual impairment that can develop as a result of strabismus, anisometropia, or a combination of these conditions that result in discordant binocular experience. Characterized by reduced visual acuity and impaired binocular function, amblyopia places a substantial burden on the developing child. Although frontline treatment with glasses and patching can improve visual acuity, residual amblyopia remains for most children. Newer binocular-based therapies can elicit rapid recovery of visual acuity and may also improve stereoacuity in some children. Nevertheless, for both treatment modalities full recovery is elusive, recurrence of amblyopia is common, and improvements are negligible when treatment is administered at older ages. Insights derived from animal models about the factors that govern neural plasticity have been leveraged to develop innovative treatments for amblyopia. These novel therapies exhibit efficacy to promote recovery, and some are effective even at ages when conventional treatments fail to yield benefit. Approaches for enhancing visual system plasticity and promoting recovery from amblyopia include altering the balance between excitatory and inhibitory mechanisms, reversing the accumulation of proteins that inhibit plasticity, and harnessing the principles of metaplasticity. Although these therapies have exhibited promising results in animal models, their safety and ability to remediate amblyopia need to be evaluated in humans. [ABSTRACT FROM AUTHOR]

Amblyopia is the most frequent cause of monocular vision loss. Transcranial Magnetic Stimulation (TMS) has been used to improve several vision parameters of the amblyopic eye in adulthood. This study is relevant in order to evaluate TMS effects and to raise awareness of the need for further research. Transcranial Magnetic Stimulation (TMS) is a neuromodulation technique capable of changing cortical excitability. In the last decade, it has been used to improve visual parameters in amblyopic patients. The main goal of this systematic review is to evaluate the influence of TMS in the amblyopic eye, in the visual parameters of amblyopic patients. Searches were done in PubMed and Embase databases, and a combined search strategy was performed using the following Mesh, EMBASE, and keywords: 'Amblyopia', 'Transcranial Magnetic Stimulation', and 'theta burst stimulation'. This review included randomised controlled studies, descriptive cases, and clinical case studies with adult amblyopes. All articles that had any of the following characteristics were excluded: children or animal studies, reviews, pathologies other than amblyopia, and other techniques rather than repetitive TMS (rTMS), or Theta Burst Stimulation (TBS). A total of 42 articles were found, of which only four studies (46 amblyopes) meet the criteria above. Three of the articles found significant improvement after one session of continuous TBS (cTBS) in visual parameters like visual acuity, contrast sensitivity, suppressive imbalance, and stereoacuity. One study found a significant visual improvement with 10 Hz rTMS. Only one stimulation-related dropout was reported. The few existing studies found in this review seem to show that through the usage of high-frequency rTMS and cTBS, it is possible to re-balance the eyes of an adult amblyope. However, despite the promising results, further research with larger randomised double-blind studies is needed for a better understanding of this process. [ABSTRACT FROM AUTHOR]