Journal of Optometry最新文献_第4页

Comparison of corneal reconstruction between CASIA2 and Pentacam: Impact on IOL power calculation CASIA2与Pentacam角膜重建的比较：对IOL度数计算的影响

IF 1.8 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-08-05 DOI: 10.1016/j.optom.2025.100573

Iñaki Blanco-Martínez , Juan Queiruga-Piñeiro , Ignacio Rodríguez-Uña , Miguel Faria-Ribeiro , José Manuel González-Méijome

Purpose

This research aims to comprehensively compare the outcomes of anterior segment optical coherence tomography (CASIA2) and Scheimpflug imaging (Pentacam) for computational reconstruction of the anterior and posterior corneal surfaces. A secondary objective is to evaluate their clinical relevance in estimating intraocular lens (IOL) power. Through this analysis, the distinct advantages of each technology are highlighted, providing insights into their complementary roles in enhancing ophthalmic modelling capabilities.

Methods

A total of 65 right eyes of 65 subjects (52 females and 13 males) with a mean age of 34 ± 8 years were studied across two separate sessions. Geometric parameters were extracted by fitting a biconic surface to the elevation maps obtained from both devices. Intra- and inter-session variability, as well as inter-device variability, were analyzed. Additionally, IOL power calculations were performed to evaluate the clinical applicability of each imaging system.

Results

For the anterior corneal surface, CASIA2 showed greater intra-session variability compared to Pentacam, whereas Pentacam demonstrated higher variability for the posterior surface. However, inter-session variability was similar for both devices on both surfaces.

Inter-device variability revealed close agreement for the anterior surface, while the posterior surface exhibited more variability. On the other hand, while IOL power calculations showed statistically significant differences (Δ = 0.35 D; p < 0.001), these were not clinically significant.

Conclusions

Pentacam may offer greater precision in reconstructing the anterior corneal surface. However, its clinical impact on both anterior and posterior corneal surface reconstruction appears minimal, with both devices providing comparable results for IOL power calculations.

目的综合比较前段光学相干断层扫描（CASIA2）和Scheimpflug成像（Pentacam）对角膜前后表面的计算重建效果。第二个目的是评估它们在估计人工晶状体（IOL）度数方面的临床意义。通过这一分析，突出了每种技术的独特优势，并提供了它们在增强眼科建模能力方面的互补作用的见解。方法对65名平均年龄34±8岁的受试者（女性52人，男性13人）的65只右眼进行两期研究。几何参数的提取是通过拟合双曲面对两个设备获得的高程图。分析了会话内和会话间的可变性以及设备间的可变性。此外，进行人工晶状体度数计算以评估各成像系统的临床适用性。与Pentacam相比，CASIA2在角膜前表面表现出更大的治疗过程内变异性，而Pentacam在角膜后表面表现出更高的变异性。然而，两种设备在两个表面上的会话间变异性是相似的。器械间的可变性显示前表面的一致性，而后表面表现出更多的可变性。另一方面，人工晶状体度数计算差异有统计学意义(Δ = 0.35 D；p & lt;0.001)，这些没有临床意义。结论spentacam在角膜前表面重建中具有较高的精度。然而，它对前、后角膜表面重建的临床影响似乎很小，两种设备在人工晶状体度数计算方面的结果相当。

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引用次数: 0

Efficacy of a progressive multifocal soft contact lens in myopia management in Caucasian children: A two-year follow-up 渐进式多焦点软性接触镜治疗高加索儿童近视的疗效：两年随访

IF 2.2 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-07-01 DOI: 10.1016/j.optom.2025.100567

Sergio Díaz-Gómez , Amaia Urkia-Solorzano , José A. López-Garrido , Mercedes Burgos-Martínez , Jesús Carballo-Álvarez

Purpose

To evaluate myopia progression as assessed by changes in axial length (AL) and spherical equivalent (SE) from baseline in Caucasian children wearing multifocal soft contact lenses (MCL) compared to single-vision distance spectacles. Methods: Forty progressing (at least -0.75D increase in previous 12 months) myopic children (7–12 years old) with SE ranging from -0.75 to -4.50 D were recruited in a longitudinal prospective non-randomized study. 20 were fitted with MCL (+2.50D add), whereas 20 wore single-vision distance spectacles. Cycloplegic refraction was measured with an auto-refractometer (Topcon TRK-2P, Japan) and AL with IOLMaster 700 (Carl Zeiss, Germany). Subjective responses related to vision and comfort of MCL wear were determined with a questionnaire scaled from 0 (very poor) to 10 (excellent). Results: After 2 years, mean change in SE/AL in the MCL group was - 0.82±0.25D/0.51±0.02 mm and -1.12±0.14D/0.66±0.03 mm in the spectacles group (all p < 0.001). Cumulative Absolute Reduction in Axial Elongation (CARE) was 0.15 mm. Difference in SE change was 0.30D. 97.5 % of children in the spectacles group showed an AL increase of between 0.61 and 0.70, and 70 % of eyes showed an SE increase of −1.00 D. In the MCL group, there was no case with an elongation >0.60 mm, with 67.5 % of eyes being between 0.51 and 0.60 mm. In contrast, over half of the MCL group exhibited lower SE progression, from 0.50 to 0.75 D. Conclusion: A slower myopia progression rate was achieved with a centre distance MCL with +2.50D addition after two years of wear compared with the spectacles group.

目的评价高加索儿童配戴多焦软性隐形眼镜（MCL）与单视距眼镜的眼轴长度（AL）和球面等效（SE）的变化情况。方法：选取40例进展性（前12个月至少-0.75D增加）近视儿童（7-12岁），SE范围为-0.75至-4.50 D，进行纵向前瞻性非随机研究。20人戴MCL (+2.50D)，而20人戴单视距眼镜。使用自动折射仪（Topcon TRK-2P，日本）和ai仪（IOLMaster 700，卡尔蔡司，德国）测量睫状体麻痹性屈光。对MCL佩戴的视觉和舒适度的主观反应进行问卷调查，评分范围从0（非常差）到10（优秀）。结果：2年后，MCL组SE/AL平均变化为- 0.82±0.25D/0.51±0.02 mm，眼镜组SE/AL平均变化为-1.12±0.14D/0.66±0.03 mm(均p <；0.001)。累积绝对轴向伸长率降低（CARE）为0.15 mm。SE变化差异为0.30D。眼镜组97.5%的儿童的AL增加在0.61 - 0.70之间，70%的眼睛的SE增加在- 1.00 d之间。MCL组没有出现0.60 mm的延长，67.5%的眼睛在0.51 - 0.60 mm之间。相比之下，超过一半的MCL组表现出较低的SE进展，从0.50到0.75 d。结论：与眼镜组相比，佩戴两年后，中心距MCL +2.50D的近视进展速度较慢。

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引用次数: 0

Effect of gradient-index lenses on the optical performance of SyntEyes 梯度折射率透镜对SyntEyes光学性能的影响

IF 2.2 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-07-01 DOI: 10.1016/j.optom.2025.100568

Veronica Lockett-Ruiz , Rafael Navarro , Jos Rozema

This study analyzes the effect of two different gradient index (GRIN) crystalline lens models on ocular optical performance compared to that of a homogeneous lens. Using the biometric data of 200 SyntEyes (synthetically generated eyes), we implemented three lens models: homogeneous, GRIN, and GRINCU (gradient index and gradient curvature of the isoindicial surfaces). Using the three lens models, we conducted finite ray tracing on the SyntEyes samples, incorporating five different curvature gradients into the GRINCU setup. We calculated the average cardinal points and Zernike aberration coefficients for each SyntEyes sample, along with the cardinal points for each lens model. GRINCU lens configurations with increased IIS curvature toward the center result in an average forward shift of the lens principal planes, leading to increased ocular power relative to the homogeneous lens model. Steeper curvature gradients of the IIS towards the lens center result in reduced astigmatism, defocus, lateral coma, and primary spherical aberration. The interplay between the lens’s gradient index and IIS curvature gradient alters the optical properties of the eye as a whole, highlighting the crucial role of the lens’s internal properties in optical performance.

本研究分析了两种不同梯度指数（GRIN）晶体透镜模型与均匀透镜模型对人眼光学性能的影响。利用200只合成眼（SyntEyes）的生物特征数据，我们实现了三种透镜模型：均匀、GRIN和GRINCU（等斜面的梯度指数和梯度曲率）。使用三种透镜模型，我们对SyntEyes样品进行了有限光线追踪，将五种不同的曲率梯度纳入GRINCU设置。我们计算了每个SyntEyes样本的平均基点和泽尼克像差系数，以及每个镜头模型的基点。GRINCU透镜配置增加了IIS向中心的曲率，导致透镜主平面的平均前移，导致相对于均匀透镜模型增加的目镜功率。IIS朝向透镜中心的陡峭曲率梯度导致散光、离焦、侧彗差和初级球差的减少。晶状体的梯度指数和IIS曲率梯度之间的相互作用改变了整个眼睛的光学特性，突出了晶状体内部特性在光学性能中的关键作用。

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引用次数: 0

Evidence on the parameters of oculomotor skills and normative values: A systematic review 关于动眼力技能参数和规范值的证据：系统回顾

IF 2.2 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-07-01 DOI: 10.1016/j.optom.2025.100570

Mario Cantó-Cerdán , Carlos Javier Hernández-Rodríguez , Antonio Martínez-Abad

Purpose

To evaluate the current evidence on oculomotor measurement parameters and their normative values through a systematic review.

Methods

A search of primary studies was conducted using a search equation with free language. Original articles analyzing normal oculomotor function parameters in healthy populations of any age, studies that included a clearly differentiated healthy control group, and articles using any oculomotor measurement test were included. The QUADAS-2 tool was used to assess the risk of bias, applicability, and quality of the studies. The review was conducted independently by the authors and then pooled to determine the final inclusion.

Results

A total of 915 articles were identified, of which 750 were excluded after the first review of the title and abstract. In the second step, 133 out of 165 investigations were discarded. Ultimately, 32 articles from the initial search were included, along with 10 additional articles identified through a manual search. The findings revealed variations in how oculomotor skills are measured, including differences in stimuli, measurement distances, and parameters assessed. A high risk of bias was observed (≥50 % in the areas of “flow and timing”, “reference standard” and “patient selection”) along with poor applicability (≥50 % in all aspects).

Conclusions

There is no clear evidence on normative values for oculomotor skills, nor is there a consensus on the measurement methods, stimulus used, or working distance. Furthermore, there is no agreement on which aspects of oculomotor skills should be assessed. To enhance reliability and applicability, measurement criteria should be standardized, and normative values should be established.

目的通过系统综述，评价目前有关动眼肌测量参数及其规范性值的证据。方法利用自由语言检索方程对初步研究进行检索。分析任何年龄健康人群正常动眼肌功能参数的原创文章，包括明确区分的健康对照组的研究，以及使用任何动眼肌测量测试的文章。使用QUADAS-2工具评估研究的偏倚风险、适用性和质量。该综述由作者独立进行，然后汇总以确定最终的纳入。结果共筛选到915篇文献，其中750篇经标题和摘要一审后被排除。在第二步中，165个调查中有133个被放弃。最终，从最初的搜索中包含了32篇文章，以及通过手动搜索确定的另外10篇文章。研究结果揭示了动眼肌技能测量方法的差异，包括刺激、测量距离和评估参数的差异。观察到高偏倚风险（在“流量和时机”、“参考标准”和“患者选择”领域≥50%）以及较差的适用性（在所有方面≥50%）。结论没有明确的证据表明动眼肌技能的规范性值，在测量方法、使用的刺激或工作距离上也没有共识。此外，对于动眼力技能的哪些方面应该进行评估，目前还没有达成一致意见。为提高可靠性和适用性，应规范计量标准，建立标准值。

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引用次数: 0

Status of continuation of spectacle use among school children in selected districts of eastern Nepal: A retrospective study 尼泊尔东部选定地区学童继续使用眼镜的现状：一项回顾性研究

IF 2.2 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-07-01 DOI: 10.1016/j.optom.2025.100564

Ranjan Shah , Anil Paudel , Sailesh Kumar Mishra , Pathiyil Ravi Shankar , Pankaj Ray Adhikari , Amit Kumar Singh , Anup Subedi , Rishi Raj Borah , Sabina Shrestha , Yuddha Dhoj Sapkota , Radha Devi Ghimire

Purpose

Many school-going children experience physical, social, and academic challenges due to uncorrected refractive errors. This study aims to uncover the prevalence of spectacle compliance, identify factors that encourage regular use, and explore the barriers that lead to non-compliance.

Methods

A retrospective exploratory study assessed compliance with free spectacles provided through the REACH project after three months of spectacles being dispensed. Unannounced visits were conducted across schools to check the compliances of the spectacles. Additional variables influencing compliance were assessed through digitized questionnaires administered. The project targeted students of grade 1–12, ranging from 6 to 18 years of age.

Results

Among the 18,205 children diagnosed with significant refractive error, most of them were myopic, 16,634 were provided with free spectacles, while the remaining children were advised to continue the same spectacles. A total of 10,469 children were present in the school, 62.8 % were compliant with spectacle use. Compliance was notably higher among students with purchased spectacles (77.8 %) compared to those provided free spectacles (55.6 %). Bivariate analysis showed that younger children (ages 6–10 years), private school students, and those with severe refractive errors (high myopia and hypermetropia) had significantly higher compliance rates (p < 0.001). Key barriers included broken lenses/frames (27.7 %), wearing spectacles occasionally (27.1 %), discomfort (10.7 %), forgetfulness (7.5 %), loss (5 %), disliking spectacles (4.1 %), teasing (2.1 %), and parental disapproval (1.7 %).

Conclusion

These findings underscore the need for durable, comfortable, and appealing spectacles, as well as targeted awareness programs for parents and students to address stigma and improve compliance, maximizing the benefits of vision correction for children’s educational and personal development.

许多学龄儿童由于未矫正的屈光不正而经历身体、社交和学业上的挑战。本研究旨在揭示眼镜依从性的普遍程度，确定鼓励经常使用眼镜的因素，并探讨导致不依从性的障碍。方法回顾性探索性研究评估通过REACH项目提供的免费眼镜配发三个月后的依从性。为了检查眼镜的使用情况，他们对学校进行了不事先通知的访问。通过管理的数字化问卷评估影响依从性的其他变量。该项目针对6 - 18岁的1-12年级学生。结果在18205名诊断为明显屈光不正的儿童中，大多数为近视，为16634名儿童提供免费眼镜，其余儿童建议继续使用相同的眼镜。学校共有10,469名学生，62.8%的学生符合眼镜使用要求。购买眼镜的学生（77.8%）的依从性明显高于免费眼镜的学生（55.6%）。双变量分析显示，年龄较小的儿童（6-10岁）、私立学校学生和严重屈光不正（高度近视和远视）患者的依从率明显更高(p <；0.001)。主要障碍包括镜片/镜框破碎（27.7%）、偶尔戴眼镜（27.1%）、不舒服（10.7%）、健忘（7.5%）、丢失（5%）、不喜欢眼镜（4.1%）、取笑（2.1%）和父母不赞成（1.7%）。结论这些研究结果强调了耐用、舒适和吸引人的眼镜的必要性，以及家长和学生有针对性的意识项目，以解决耻辱感和提高依从性，最大限度地提高视力矫正对儿童教育和个人发展的益处。

{"title":"Status of continuation of spectacle use among school children in selected districts of eastern Nepal: A retrospective study","authors":"Ranjan Shah , Anil Paudel , Sailesh Kumar Mishra , Pathiyil Ravi Shankar , Pankaj Ray Adhikari , Amit Kumar Singh , Anup Subedi , Rishi Raj Borah , Sabina Shrestha , Yuddha Dhoj Sapkota , Radha Devi Ghimire","doi":"10.1016/j.optom.2025.100564","DOIUrl":"10.1016/j.optom.2025.100564","url":null,"abstract":"<div><h3>Purpose</h3><div>Many school-going children experience physical, social, and academic challenges due to uncorrected refractive errors. This study aims to uncover the prevalence of spectacle compliance, identify factors that encourage regular use, and explore the barriers that lead to non-compliance.</div></div><div><h3>Methods</h3><div>A retrospective exploratory study assessed compliance with free spectacles provided through the REACH project after three months of spectacles being dispensed. Unannounced visits were conducted across schools to check the compliances of the spectacles. Additional variables influencing compliance were assessed through digitized questionnaires administered. The project targeted students of grade 1–12, ranging from 6 to 18 years of age.</div></div><div><h3>Results</h3><div>Among the 18,205 children diagnosed with significant refractive error, most of them were myopic, 16,634 were provided with free spectacles, while the remaining children were advised to continue the same spectacles. A total of 10,469 children were present in the school, 62.8 % were compliant with spectacle use. Compliance was notably higher among students with purchased spectacles (77.8 %) compared to those provided free spectacles (55.6 %). Bivariate analysis showed that younger children (ages 6–10 years), private school students, and those with severe refractive errors (high myopia and hypermetropia) had significantly higher compliance rates (<em>p</em> < 0.001). Key barriers included broken lenses/frames (27.7 %), wearing spectacles occasionally (27.1 %), discomfort (10.7 %), forgetfulness (7.5 %), loss (5 %), disliking spectacles (4.1 %), teasing (2.1 %), and parental disapproval (1.7 %).</div></div><div><h3>Conclusion</h3><div>These findings underscore the need for durable, comfortable, and appealing spectacles, as well as targeted awareness programs for parents and students to address stigma and improve compliance, maximizing the benefits of vision correction for children’s educational and personal development.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"18 3","pages":"Article 100564"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preliminary evaluation of smartphone-based addition measurement in a presbyopic population 基于智能手机的老花眼人群加法测量的初步评估

IF 2.2 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-06-13 DOI: 10.1016/j.optom.2025.100561

Rosa M. Salmerón-Campillo , Jose A. Diaz-Guirado , Gines Martinez-Ros , Mateusz Jaskulski , Norberto López-Gil

Purpose

To evaluate the viability and accuracy of a mobile application (app) for subjective measurement of presbyopic addition, comparing its performance with standard clinical methods.

Methods

Twenty presbyopic subjects (aged 52 to 64) participated in the study. Clinical measurements of sphero-cylindrical refraction and its correction was achieved using trial lenses. Addition was also clinically measured using a standard and a tentative method. A set of 12 trial lenses ranging from 0 to 2.75 D were randomly put on top of the far distance correction, generating the correction addition correction or different levels of under/over correction of the addition. Participants then used a smartphone-based app to subjectively determine binocularly their near point (NP) using a push-up method while looking at a blue stimulus that rescaled as a function of the face-device distance measured using the front camera of the device. For each induced level of under/over correction of the addition, participants completed three measurements of their near point.

Results

Linear regression analysis showed a strong correlation (R² = 0.82) between app-measured and clinical addition values. Bland-Altman analysis revealed a mean over estimation of -0.22± 0.38 D with a limit of agreement of ±0.74 D of the near correction. Cumulative error analysis indicated that 61.7 % of app measurements were within 0.25 D of clinical values, and 82.5 % within 0.50 D

Conclusions

A smartphone-based subjective measurement of presbyopic addition can potentially be used to assess the addition needed to detect the under or over corrected addition in full presbyopic subjects.

目的评价一种主观测量老花眼度数的移动应用程序（app）的可行性和准确性，并将其与标准临床方法进行比较。方法老花眼受试者20例，年龄52 ~ 64岁。临床测量球柱面折射和它的校正使用试验镜片。此外，还采用标准方法和试探性方法进行了临床测定。将一组12块0 ~ 2.75 D的试镜随机放置在远距校正的上方，产生校正附加校正或不同程度的附加下/上校正。然后，参与者使用一款基于智能手机的应用程序，通过俯俯撑方法主观地确定他们的近点（NP），同时观看蓝色刺激，该刺激根据面部设备的前置摄像头测量的距离重新缩放。对于每个诱导水平下/超过修正的添加，参与者完成三次测量他们的近点。结果经线性回归分析，app测量值与临床增加值具有较强的相关性（R²= 0.82）。Bland-Altman分析显示，平均过估计为-0.22±0.38 D，接近校正的一致性限制为±0.74 D。累积误差分析显示，61.7%的app测量值与临床值在0.25 D范围内，82.5%的app测量值在0.50 D范围内。结论基于智能手机的老花眼度数主观测量可用于评估检测完全老花眼患者度数不足或过度矫正所需的度数。

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引用次数: 0

A novel approach using a polarized nonius test to evaluate the near point of convergence 一种新的方法使用偏振nonius检验来评估近收敛点

IF 2.2 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-06-13 DOI: 10.1016/j.optom.2025.100563

Cristina Rovira-Gay , Marc Argilés , Luis Pérez-Maña , Bernat Sunyer-Grau

Purpose

This study aims to evaluate the efficacy of a new method for measuring the near point of convergence (NPC) using a Nonius polarized target stimulus, comparing its sensitivity in detecting convergence ability to that of traditional approaches.

Methods

In this prospective study, 65 participants underwent near point of convergence (NPC) measurements using three methods: an accommodative target (NPC1), a penlight with a red filter (NPC2), and a Nonius polarized target (NPC3). Participants also completed the Convergence Insufficiency Symptom Survey (CISS). Statistical analyses, including repeated-measures ANOVA and Spearman’s correlation, were conducted to assess differences among the methods.

Results

The Nonius method demonstrated a median break point of 8.37 cm, significantly higher than the other methods, NPC1: 6.63 cm, and NPC2: 7.17 cm. Sensitivity for detecting CI symptoms was 92.6 % for the NPC3, which outperformed NPC1 (77.8 %) and NPC2 (74.1 %). NPC3 exhibited low specificity (7.4 %). Correlations between NPC measurements and CISS scores were weak and nonsignificant, though the strongest correlation was observed for NPC3

Conclusion

The Nonius polarized target method shows benefits compared to traditional methods in measuring NPC. This study provides a more sensitive method to measure convergence ability, reducing variability across clinical settings, and enhancing the reliability of assessments in both research and practice.

目的评价一种利用Nonius极化目标刺激测量近收敛点（NPC）的新方法的有效性，比较其检测收敛能力的灵敏度与传统方法的灵敏度。方法在这项前瞻性研究中，65名参与者使用三种方法进行近收敛点（NPC）测量：调节靶（NPC1），带红色滤光片的笔灯（NPC2）和Nonius偏振靶（NPC3）。参与者还完成了收敛不足症状调查（CISS）。统计分析包括重复测量方差分析和Spearman相关，以评估方法之间的差异。结果Nonius法的中位断点为8.37 cm，显著高于NPC1法的6.63 cm和NPC2法的7.17 cm。NPC3检测CI症状的灵敏度为92.6%，优于NPC1（77.8%）和NPC2（74.1%）。NPC3表现出低特异性（7.4%）。鼻咽癌测量值与CISS评分之间的相关性较弱且不显著，但npc3的相关性最强。结论与传统的鼻咽癌测量方法相比，Nonius极化靶法具有优势。这项研究提供了一种更灵敏的方法来测量收敛能力，减少临床环境中的变异性，并提高研究和实践中评估的可靠性。

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引用次数: 0

Successful persistent strabismic amblyopia treatment using active therapy as an adjuvant to occlusion 成功的持续性斜视弱视治疗使用积极疗法作为辅助闭塞

IF 2.2 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-05-21 DOI: 10.1016/j.optom.2025.100557

Irene Sanchez , Santiago Martin-Gonzalez , Juan Antonio Portela-Camino

Purpose

A novel protocol to improve long-term results in the treatment of amblyopia was proposed. The protocol combines active home-based therapy through perceptual learning activities (Gabor patch, dichoptic stimulation, and random dot stereograms) with conventional visual therapy in the clinic as an adjunct to patching occlusion in subjects with patch-resistant amblyopia

Methods

Between 2018 and 2022, a group of patients received treatment for persistent strabismic and combined-mechanism amblyopia according to the novel treatment protocol, consisting of in-clinic orthoptics/visual therapy combined with the use of gamified PL software at home, as an adjunct to occlusion treatment.

Results

A retrospective analysis of treatment outcomes was subsequently carried out for 53 patients aged 7.75±5.88. Eccentric fixation was present in 17 of the 53 subjects.

The distribution of patients presenting with combined-mechanism and strabismic amblyopia was 37 and 16, respectively. Eighteen patients (34 %) demonstrated measurable stereoacuity prior to treatment. Following treatment using the combined treatment protocol, forty-six (87 %) participants achieved a of logMAR 0.1 or better, mean BCVA was significantly improved, from logMAR 0.30±0.23 to logMAR 0.07±0.12 (p < 0.01). Eleven subjects (65 %) of seventeen participants with eccentric fixation achieved central fixation. In addition, stereoacuity was measurable in 43 patients (81 %). Mean stereoacuity improved, from 1200.00±258.69 arc seconds to 539.62±518.69 arc seconds (p < 0.01). These results remained stable six months after completion of the therapy.

Conclusion

The outcomes of the proposed novel treatment protocol were reduced angle of deviation, and improved BCVA and stereoacuity in patients with persistent strabismic and combined-mechanism amblyopia.

目的提出一种改善弱视长期治疗效果的新方案。该方案结合了积极的家庭治疗，通过知觉学习活动（Gabor贴片，二分刺激和随机点立体图）与临床常规视觉治疗相结合，作为贴片抵抗性弱视患者贴片遮挡的辅助手段。在2018年至2022年期间，一组患者根据新的治疗方案接受了持续性斜视和联合机制弱视的治疗。包括临床矫视/视觉治疗结合在家中使用游戏化的PL软件，作为闭塞治疗的辅助手段。结果对53例患者（年龄7.75±5.88岁）的治疗结果进行回顾性分析。53例受试者中有17例出现偏心固定。合并机制弱视和斜视弱视分布分别为37例和16例。18名患者（34%）在治疗前表现出可测量的立体视力。采用联合治疗方案治疗后，46名（87%）参与者的logMAR达到0.1或更高，平均BCVA显著改善，从logMAR 0.30±0.23降至logMAR 0.07±0.12 (p <；0.01)。17名偏心固定的受试者中有11名（65%）实现了中心固定。此外，43例（81%）患者的立体视敏度可测量。平均立体视锐度从1200.00±258.69弧秒提高到539.62±518.69弧秒(p <；0.01)。这些结果在治疗结束6个月后保持稳定。结论提出的新治疗方案可降低持续性斜视和联合机制弱视患者的斜视角度，改善BCVA和立体视敏度。

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引用次数: 0

Assessment of binocular vision and accommodation in myopic children wearing defocus incorporated multiple segments (DIMS) spectacle lenses for 24 months 近视儿童配戴离焦合并多节段（DIMS）镜片24个月后双眼视力及调节的评估

IF 2.2 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-05-17 DOI: 10.1016/j.optom.2025.100558

Nur Adibah Yahaya , Bariah Mohd-Ali , Fatin Nur Najwa Norazman , Syarifah Faiza Syed Mohd Dardin , Mizhanim Mohamad Shahimin , Norliza Mohamad Fadzil

Purpose

This study aimed to determine the changes in binocular vision (BV) and accommodation in Malay myopic children following long-term wear of Defocus Incorporated Multiple Segments (DIMS) spectacle lenses for 24 months.

Methods

Twenty-three Malay myopic children aged 7–12 years were enrolled in this prospective, self-controlled study. DIMS spectacle lenses were prescribed, and analyses were conducted at baseline, 12, and 24 months. Assessments included stereopsis, near point of convergence (NPC), phoria, positive/negative fusional vergence (PFV/NFV), amplitude of accommodation (AA), accommodative lag, positive/negative relative accommodation (PRA/NRA), and accommodative convergence to accommodation (AC/A) ratio. Visual acuity (VA), cycloplegic refraction (SER) and axial length (AL) were monitored. Data were analyzed using repeated-measures analysis of variance (ANOVA) within-subject or the Friedman test, with Bonferroni correction applied. p < 0.05 was considered statistically significant.

Results

Statistically significant changes were observed after 24 months, including median changes in NPC (receded by 2 cm, p < 0.001), AA (reduced by 1.67D, p = 0.002), distance PFV break (increased by 8Δ, p = 0.026) and recovery (increased by 6Δ, p = 0.033), distance NFV break (no change, p = 0.043), stereopsis (improved by 10″, p < 0.001), accommodative lag (reduced by 0.25D, p = 0.002), and AC/A ratio (increased by 1Δ/D, p < 0.001). Additionally, distance and near VA improved (p < 0.001), while SER and AL increased (p < 0.001).

Conclusion

: Wearing DIMS spectacle lenses for 24 months resulted in changes in BV and accommodation while slowing myopia progression. Regular NPC monitoring is recommended to maintain optimal BV function and visual comfort in children wearing DIMS lenses.

目的观察马来族近视儿童长期配戴离焦多节段（DIMS）镜片24个月后双眼视力和适应能力的变化。方法选取23名7 ~ 12岁马来近视儿童进行前瞻性、自我对照研究。处方DIMS眼镜镜片，并在基线、12个月和24个月进行分析。评估包括立体视觉、近收敛点（NPC）、视野、正/负融合收敛（PFV/NFV）、调节幅度（AA）、调节滞后、正/负相对调节（PRA/NRA）和调节收敛与调节（AC/A）比。监测视力（VA）、睫状体麻痹屈光（SER）和眼轴长度（AL）。数据分析采用受试者内重复测量方差分析（ANOVA）或Friedman检验，并应用Bonferroni校正。p & lt;0.05认为有统计学意义。结果24个月后观察到有统计学意义的变化，包括鼻咽癌的中位变化(消退2cm， p <；0.001)， AA（减少1.67D, p = 0.002），距离PFV断裂（增加8Δ， p = 0.026）和恢复（增加6Δ， p = 0.033），距离NFV断裂（没有变化，p = 0.043），立体视觉(提高10″，p <；0.001)，调节滞后（减少0.25D, p = 0.002）和AC/A比(增加1Δ/D， p <；0.001)。此外，距离和近VA也得到了改善(p <；0.001)， SER和AL升高(p <；0.001)。结论：配戴DIMS眼镜24个月后，BV和调节功能发生改变，近视进展缓慢。建议对佩戴DIMS镜片的儿童进行定期鼻咽癌监测，以保持最佳的BV功能和视觉舒适度。

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引用次数: 0

Refractive error in preterm infants without retinopathy of prematurity aged 1–18 months: A propensity score matching analysis 1-18个月无视网膜病变早产儿屈光不正：倾向评分匹配分析

IF 2.2 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-05-17 DOI: 10.1016/j.optom.2025.100559

Lu Huo, Xinyu Jia, Chunmei Li

Background

Preterm birth is associated with an increased risk of abnormal refractive development, even without retinopathy of prematurity (ROP). This study aimed to evaluate the differences in refractive error between preterm infants without ROP and full-term infants, as well as to assess the relationship between physical parameters at birth and refractive status in preterm infants.

Methods

A total of 1205 infants aged 1–18 months participated in this cross-sectional study conducted at Tianjin Women’s and Children’s Health Center in China from March 2020 to September 2023. Following One-to-one propensity score matching (PSM), 230 pairs of infants were included. Refraction was examined by cycloplegic refraction, and the mean spherical equivalent (MSE) of both eyes was analyzed. A simple linear regression model was employed to determine the relationships between refractive state and gestational age (GA), birth weight (BW), and birth length (BL) in preterm infants.

Results

Among the 1205 infants, 230 were preterm infants without ROP, and 975 were full-term infants. After PSM, the MSE of preterm infants was lower than that of full-term infants during every period (t = −0.320, P = 0.749). Compared with full-term infants, preterm infants exhibited a significantly higher prevalence of refractive error (P = 0.014), particularly astigmatism (P = 0.040). Although the difference in myopia between the two groups was not significant (P = 0.500), preterm infants had more frequent emmetropia than full-term infants across all stages (P = 0.037). In addition, MSE was negatively correlated with both BW and BL (R² = 0.260, P < 0.001; R² = 0.035, P = 0.004); however, there was no correlation between MSE and GA (R² = 0.048, P = 0.051).

Conclusions

Compared to full-term infants, preterm infants without ROP exhibit lower MSE values and a higher prevalence of refractive errors, particularly astigmatism, and a trend towards developing myopia was observed during early life. BW can be utilized as a parameter to predict the early refractive status of these preterm infants.

背景：即使没有早产儿视网膜病变（ROP），早产也与异常屈光发育的风险增加有关。本研究旨在评估无ROP早产儿与足月婴儿屈光不正的差异，以及早产儿出生时身体参数与屈光状态的关系。方法本横断面研究于2020年3月至2023年9月在中国天津市妇女儿童健康中心进行，共有1205名1-18个月的婴儿参与。遵循一对一倾向评分匹配（PSM），纳入230对婴儿。用麻痹性屈光检查双眼屈光，分析双眼平均球等效（MSE）。采用简单线性回归模型确定早产儿屈光状态与胎龄（GA）、出生体重（BW）和出生长度（BL）之间的关系。结果1205例患儿中，无ROP早产儿230例，足月儿975例。经PSM后，各时期早产儿的MSE均低于足月儿（t = - 0.320, P = 0.749）。与足月婴儿相比，早产儿屈光不正的发生率明显高于足月婴儿（P = 0.014），尤其是散光（P = 0.040）。虽然两组之间的近视差异不显著（P = 0.500），但早产儿在所有阶段的近视发生率均高于足月婴儿（P = 0.037）。MSE与BW、BL均呈负相关(R2 = 0.260, P <；0.001;R2 = 0.035, p = 0.004)；而MSE与GA之间无相关性（R2 = 0.048, P = 0.051）。结论与足月儿相比，无ROP的早产儿MSE值较低，屈光不正（尤其是散光）发生率较高，并有早期发展为近视的趋势。体重可作为预测早产儿早期屈光状态的参数。

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引用次数: 0