Aspectos a considerar para el diagnóstico del queratocono infantil / Aspects to consider for the diagnosis of infant keratoconus

Introducción: Globalmente, existe un aumento de la prevalencia del queratocono y su diagnóstico en edades tempranas. Se notifican un gran número de casos subclínicos y otros con una rápida progresión, condicionada por el inicio precoz de la enfermedad y la asociación a factores de riesgo. Objetivo: Describir los aspectos epidemiológicos, clínicos y el resultado de los medios de diagnóstico implicados en la detección precoz del queratocono infantil. Desarrollo: En niños con ametropía hay elementos que alertan la presencia de un queratocono como causa del defecto refractivo. Desde el punto de vista epidemiológico se encuentran: distribución geográfica, rol de la herencia y factores ambientales. Clínicamente se señalan los antecedentes de enfermedades, tales como las alergias, la presencia de miopía o astigmatismo miópico con inestabilidad refractiva y los signos clínicos relacionados con la progresión del cono. En los pacientes de riesgo es preciso realizar exámenes mediante diferentes medios de diagnóstico según su disponibilidad, siendo primordial el análisis refractivo, queratométrico y topográfico. Conclusiones: En la evaluación de los niños con ametropía se deben tener en cuenta elementos epidemiológicos y clínicos que permiten sospechar y diagnosticar precozmente el queratocono. En la interpretación de los resultados de los medios de diagnóstico involucrados en su detección, se deben considerar los hallazgos más frecuentes en la población infantil según el grado de progresión de la ectasia.

Introduction: Globally, there is an increase of the keratoconus prevalence and its diagnosis in early ages. A great number of subclinical cases and others with a quick progression are notified, conditioned by the early onset of the disease and the association with risk factors. Objective: To describe the epidemiological, clinical aspects and the result of diagnostic means involved in the early detection of infant keratoconus. Development: There are elements that alert the presence of a keratoconus as a cause of the refractive defect in children with ametropia. From the epidemiologic point of view they are: geographical distribution, heredity role and environmental factors. History of previous diseases are clinically pointed out, such as allergies, myopia or myopic astigmatism with refractive instability and the clinical signs related to cone progression. In risk patients it is necessary to carry out exams by means of different diagnostic means according to their availability, being essential the refractive, keratometric and topographic analysis. Conclusions: In the evaluation of children with ametropia, epidemiological and clinical elements should be taken into account that allow to suspect and early diagnose the keratoconus. In the interpretation of results of the diagnostic means involved in their detection the most frequent findings in the infant population, should be considered according to the ectasia degree of progression.

Bibliometric analysis of scleral lens research trends based on Web of Science / 中华实验眼科杂志

Objective:To analyze the research status of scleral lenses by bibliometric method based on the relevant collection of scleral lenses in the Web of Science database.Methods:Using the scleral lens-related literature collected in the Web of Science Core Collection database in the past 10 years (January 2013 to December 2022) as the object of analysis, bibliometric method and CiteSpace tools were used to conduct visual analysis of the literature.A comprehensive analysis of the volume of literature published, the distribution of countries and institutions, the information of core authors, the distribution of journals, and keyword clustering was performed.Results:A total of 340 articles were retrieved, which were published in 54 journals, with an average of 6.3 articles per journal, involving 301 authors.Research in this area covered 35 countries or regions, and 256 research institutions were involved.Discipline development was mainly in the United States, India, Spain and Australia.The main focus was on scleral lens (scleral contact lens), ocular surface disease, corneal edema, miniature scleral lens, etc.In the past 10 years, the trend of research hot topics in scleral lenses had shifted from the initial study of combining scleral contact lenses with ocular surface diseases to the subsequent study of prosthetic replacement of the ocular surface ecosystem, and the exploration of corneal clearance and shape.From 2013 to 2021, the main focuses were ocular surface diseases, scleral contact lenses, and corneal edema.After 2021, research on ocular surface diseases and keratoplasty declined.From January 2013 to December 2022, emergent keywords related to scleral lens mainly included scleral contact lens, transplantation, anti-host disease, prosthetic device in the first stage, artificial replacement of ocular surface ecosystem and irregular cornea in the second stage, and the research on corneal gap and characteristic shape in the third stage.Optical coherence tomography and corneal topography were commonly used examinations for scleral lens research and fitting.Conclusions:At present, the scleral lens is mainly used for dry eye, corneal diseases, corneal ectasia, keratitis, and corneal transplantation, especially after penetrating keratoplasty and refractive errors.Prosthetic replacement of the ocular surface ecosystem, and the exploration of corneal clearance and shape are the research hotspots in scleral lenses.

Efficacy and safety of refractive surgery combined with prophylactic collagen cross-linking for ametropia / 中华实验眼科杂志

Corneal refractive surgery is a safe and effective way to correct ametropia.Although the biomechanical stability of the cornea is reduced due to the change in corneal tissue integrity after surgery, the vast majority of postoperative corneal structures are safe.Patients with preoperative risk factors, such as high diopters, thin cornea, irregular corneal topography, high astigmatism, binocular asymmetry, allergic constitution, eye rubbing, etc., may experience postoperative refractive regression and corneal ectasia.Corneal collagen cross-linking can enhance the biomechanical properties of cornea and effectively prevent the occurrence and progression of corneal ectasia, keratoconus or other ectatic diseases.In recent years, many researchers at home and abroad have tried a new design of refractive surgery, that is, corneal refractive surgery with prophylactic corneal collagen cross-linking to improve the biomechanical stability of the cornea after refractive surgery, and then potentially prevent corneal ectasia and refractive regression.A number of studies have found that combined surgery has a good visual acuity and refractive prognosis, especially in patients at high risk for postoperative ectasia.This article reviews the efficacy, safety, predictability, stability, and complications of combined surgery.

An interpretation of the new version of Refractive Errors Preferred Practice Pattern? / 中华实验眼科杂志

In September 2022, the American Academy of Ophthalmology released the latest version of Refractive Errors Preferred Practice Pattern? (PPP). It provides authoritative guidance for the diagnosis and treatment of refractive errors based on the best evidence-based medical updates.The new version of Refractive Errors PPP continues the rigorous, comprehensive and detailed features of the 2017 version.Updates have been made to the definition, epidemiology, classification, and diagnosis and correction of refractive errors.For example, the new version of Refractive Errors PPP defines high refractive errors as myopia≥-6.0 D, hyperopia≥+ 3.0 D, astigmatism≥-3.0 D, adds content on myopia prevention and control, recommends outdoor activities for at least 2 hours per day, selects appropriate optical prevention and control methods, and considers the use of low-concentration atropine eye drops to delay the onset and development of myopia.It enriched the evidence-based medical evidence that myopia is an interactive influence of genetic and environmental factors, and emphasized the future pandemic trend of high myopia, and the global public health significance of delaying the progression of myopia.In addition, the new version of Refractive Errors PPP emphasizes for the first time that myopia can cause irreversible visual impairment, suggesting that it is necessary to delay the onset time of myopia in children and slow the speed of myopia progression.This article introduces and interprets the main contents and updates of the new edition of the Refractive Errors PPP.

Features of dominant eye and the significance of ocular dominance switching in the treatment of ocular diseases / 中华实验眼科杂志

The dominant eye is the eye that plays a significant role in visual perception.It plays an essential role in binocular vision and fusion functions with a complex formation mechanism.According to the principle of the dominant eye examination method, ocular dominance can be classified into sighting, motor, and sensory dominance.Changes in visual acuity or visual function due to the unbalanced progression of binocular disease may lead to the switch in the dominant eye, affecting the balance of binocular vision and the therapeutic effect.Therefore, misjudging or neglecting of the dominant eye will change the long-term visual balance between the eyes, which may affect people's visual quality and quality of life.These aspects are mainly represented in the process of refractive error correction, refractive surgery, strabismus correction surgery, amblyopia training methods and cataract intraocular lens measurement.The formulation of medical plans based on the strategy of the dominant eye can remarkably improve the reconstruction good binocular vision and the quality of life of patients.However, the role of the dominant eye in binocular vision is not fully understood, and clinicians are not sufficiently aware of its importance.Therefore, this study will review the latest research progress on the mechanism of dominant eye formation, examination methods, and clinical significance of dominant eye switching.

Biometric error analysis after cataract surgery performed by residents, in patients with high myopia with SRK/T formula and Wang-Koch formula adjustment / Análise de erros biométricos após cirurgia de catarata realizada por residentes em pacientes com alta miopia com a fórmula SRK/T com ajuste pela fórmula Wang-Koch

ABSTRACT Objective To evaluate intraocular lens power calculation and postoperative refractive errors in patients with high myopia undergoing cataract surgery, comparing predicted target refraction and actual postoperative refraction measured 30 days after surgery with SRK/T formula. Methods This retrospective analysis comprised 39 eyes of 31 patients undergoing cataract surgery through phacoemulsification with in-the-bag IOL implantation. Axial length was measured by partial coherence interferometry or immersion ultrasound biometry, with measurements greater than 26 mm and preoperative myopia greater than -6.0 D Manifest refraction was performed at the 1-month postoperative visit, and the spherical equivalent was analyzed. Results After analysis of 39 eyes of 31 patients undergoing cataract surgery with a mean axial length of 30.4 (standard deviation of 2.2) mm, the mean preoperative refractive spherical equivalent was -15.6 (standard deviation of 7.6) D, ranging from -24.0 to -13.4 D. At 30 days postoperatively, the mean spherical equivalent was -0.35 (standard deviation of 1.1) D, ranging from -2.4 to 2.50 D. Conclusion We encountered a correlation between the absolute refractive error and the dioptric power of the intraocular lens. Against expectations, in our study, ultrasound biometry yielded better results than the optical biometer device, probably due to the small number of patients undergoing optical biometry, suggesting that well-performed immersion biometry can still produce satisfactory results.

RESUMO Objetivo Avaliar os cálculos de potência da lente intraocular e os erros refrativos pós-operatórios em pacientes com alta miopia submetidos à cirurgia de catarata, comparando a refração-alvo prevista e a refração pós-operatória real medida 30 dias após a cirurgia com a fórmula SRK/T. Métodos Esta análise retrospectiva incluiu 39 olhos de 31 pacientes com cirurgia de catarata de facoemulsificação não complicada com implantação de lente intraocular na bolsa. Os comprimentos axiais foram medidos por biometria de coerência óptica ou ultrassônica (imersão), com medidas de axial length (AL) maiores que 26 mm em pacientes com miopia maior que -6.0 D. A refração manifesta foi realizada na consulta pós-operatória de 1 mês, e o equivalente esférico foi analisado. Resultados Após análise de 39 olhos de 31 pacientes submetidos à cirurgia de catarata com AL médio de 30,4 (desvio-padrão de 2,2) mm, o equivalente esférico refrativo médio pré-operatório foi de -15,6 (desvio-padrão de 7,6) D, variando de -24,0 a -13,4 D. Aos 30 dias de pós-operatório, o equivalente esférico médio foi de -0,35 (desvio-padrão de 1,1) D, variando de -2,4 a 2,50 D. Conclusão Encontramos uma correlação entre o erro refrativo absoluto e o poder dióptrico da lente intraocular. Contrariando as expectativas, em nosso estudo, a biometria ultrassônica apresentou melhores resultados que o biômetro óptico, provavelmente devido ao pequeno número de pacientes submetidos à biometria óptica, sugerindo que a biometria de imersão bem executada ainda pode produzir resultados satisfatórios.

Comparison of refractometric measurements obtained with a portable autorefractor and conventional methods of refraction in schoolchildren / Comparação de medidas refratométricas obtidas com autorrefrator portátil e métodos convencionais de refração em escolares

ABSTRACT Objective: To assess the performance of a portable autorefractor as refractor and screening tool for refractive errors in schoolchildren. Methods: Cross-sectional observational study. Refractometric measurements of children between 5 and 10 years old were obtained through four methods: 2WIN under non-cycloplegic conditions, and 2WIN, conventional autorefractor, and retinoscopy, under cycloplegic conditions. Correlations and agreement between the methods and accuracy of the portable autorefractor to define whether to prescribe glasses were assessed. Results: The mean age ± standard deviation was 6.87 ± 1.42 years. The portable autorefractor without cycloplegia showed a high correlation with retinoscopy (0.77) but tended to underestimate hyperopia and overestimate high astigmatism. Regarding screening for prescription of glasses in comparison with the reference method "retinoscopy," the sensitivity of the portable autorefractor without cycloplegia was calculated to be 100,00% and the specificity, 34.3%. Conclusion: The portable autorefractor should be used as a screening tool and, when prescribing glasses, the tendency of underestimating hyperopia and overestimating high astigmatism should be kept in mind.

RESUMO Objetivo: Avaliar o desempenho de um autorrefrator portátil como refrator e ferramenta de triagem para erros de refração em crianças em idade escolar. Métodos: Estudo observacional transversal. As medidas refratométricas de crianças de 5 a 10 anos foram obtidas por meio de quatro métodos: 2WIN em condições não cicloplégicas e 2WIN, autorrefrator convencional e retinoscopia, em condições cicloplégicas. Foram avaliadas as correlações e a concordância entre os métodos e a acurácia do autorrefrator portátil para definir a prescrição de óculos. Resultados: A média de idade ± desvio-padrão foi de 6,87 ± 1,42 anos. O autorrefrator portátil sem cicloplegia apresentou alta correlação com a retinoscopia (0,77), mas tendeu a subestimar a hipermetropia e a superestimar o alto astigmatismo. Em relação à triagem para prescrição de óculos em comparação com o método de referência retinoscópio, a sensibilidade do autorrefrator portátil sem cicloplegia foi calculada em 100,00% e a especificidade, em 34,3%. Conclusão: O autorrefrator portátil deve ser usado como ferramenta de triagem e, ao se prescreverem óculos, deve-se ter em mente a tendência de subestimar a hipermetropia e superestimar o alto astigmatismo.

Vertex distance variability of the Vision-S™ 700 refractors in normal population / Variabilidade da distância vértice do refrator Vision-S™ 700 em uma população normal

ABSTRACT Objective: To study vertex-optical distance variation and estimate its impact on manifest refraction. Methods: Prospective study in a private clinic using the Vision-S™ 700 with five forehead positions. Forehead on the third position showed the closest vertex-optical distance of 12mm. Results: Analysis of 52 eyes from 26 patients revealed mean differences in vertex-optical distance of 12.25mm (right eye) and 11.75mm (left eye). A 2mm change in vertex-optical distance resulted in a 0.05D change for a 5D spherical equivalent and 0.20D for a 10D equivalent. Conclusion: Vertex-optical distance varies among patients and is influenced by forehead adjustment. These variations impact refraction accuracy and treatment evaluation. Adjusting the forehead to the third position on the Vision-S™ 700 is recommended.

RESUMO Objetivo: Estudar a variação da distância vértice-óptico, de acordo com o ajuste da testa, e estimar seu impacto na refração manifesta. Métodos: Estudo prospectivo realizado em clínica privada. A refração foi realizada utilizando cinco posições preestabelecidas com o Vision-Sa 700. A testa disposta na terceira posição apresentou distância vértice do refrator mais próxima de 12mm. Resultados: Foram analisados 52 olhos de 26 pacientes. A diferença média da distância vértice do refrator no olho direito foi de 12,25mm (variação de 11,50mm) e, no olho esquerdo, 11,75mm (variação de 12,00mm). O impacto foi de 2mm na distância vértice do refrator, fomentando em uma mudança de 0,05D para um equivalente esférico de 5D e 0,20D para um equivalente de 10D. Conclusão: A distância vértice do refrator varia entre pacientes, estando relacionada ao ajuste da testa. As variações afetam a precisão da refração, impactando no ajuste dos óculos, das lentes de contato e na avaliação pós-operatória de cirurgia refrativa. Sugerimos ajustar a posição da testa para terceira posição no Vision-S™ 700, se a distância vértice do refrator não for medida em todos os pacientes.

Refractive profile of children treated with intravitreal bevacizumab for retinopathy of prematurity

Purpose: To study the refractive profile of children after they received intravitreal injection of bevacizumab for retinopathy of prematurity (ROP). Methods: The study was conducted at a tertiary eye care hospital in South India. ROP patients of more than 1 year of age, presenting to the Pediatric Ophthalmology Clinic and Retina Clinic and having history of treatment for type ? ROP with intravitreal bevacizumab (IVB) or intravitreal bevacizumab and laser photocoagulation were included in the study. Cycloplegic refraction was done, and the refractive status was evaluated. The refractive status of age?matched, full?term children with uneventful perinatal and neonatal history was also recorded and compared to the study group. Results: Among 134 eyes of 67 study subjects, the major refractive error was myopia in 93 eyes (69.4%; spherical equivalent [SE] = ?2.89 ± 3.1, range = ?11.5 to ?0.5 D). There were 75 eyes (56%) with low?to?moderate myopia; high myopia was seen in 13.4%, emmetropia in 18.7%, and hypermetropia in 11.9% of eyes. The majority of them (87%) had with?the?rule (WTR) astigmatism. In 134 eyes, the SE was ?1.78 ± 3.2 (range = ?11.5 to 4 D); the SE of the 75 eyes with low?to?moderate myopia was ?1.53 ± 1.2 (range = ?0.50 to ?5 D). In the control group, the majority had emmetropia (91.8%). There was no significant association between the age at which IVB had been injected and the development of refractive errors (P = 0.078). The prevalence of low?to?moderate myopia was more than high myopia in patients with zone ? and zone ? ROP before treatment (60.0% and 54.5%, respectively). Conclusion: Myopia was the major refractive error seen in post?IVB pediatric patients. WTR astigmatism was more commonly seen. The age at which IVB injection had been given had no effect on the development of refractive errors

Clinical correlation between automated vision screening under cycloplegia and retinoscopy in young children / Correlação clínica entre triagem visual automatizada sob cicloplegia e retinoscopia em crianças pequenas

ABSTRACT Purpose: To evaluate the clinical performance of the Spot Vision Screener and establish clinical correlations between automated screening and retinoscopy following induction of cycloplegia in preverbal children. Methods: In this prospective, cross-sectional study, children aged 6-36 months were evaluated using the Spot Vision Screener. A complete ophthalmologic examination, including cycloplegic refraction assessment, was performed, followed by repeat spot vision screening and retinoscopy in all cases to establish correlations regarding hypermetropia, myopia, and astigmatism following induction of induction cycloplegia. Results: The study included 185 children. The sensitivity of the automated screener after cycloplegia was 100% (95%CI: 85.18-100%), and specificity was 87.04% (95%CI: 80.87-91.79%). Positive and negative predictive values were 52.27% (42.36-62.01%) and 100%, respectively. Compared to retinoscopy, the Spot Vision Screener overestimated spherical values by 0.62 D (95%CI: 0.56-0.69) in the right eye and by 0.60 (95%CI: 0.54-0.66) in the left eye and cylindrical values by -0.38 D in the right eye (95%CI: -0.42--0.33) and by -0.39 D in the left eye (95%CI: -0.43--0.34). For overall spherical and cylindrical values, the difference was 0.61 D (95%CI: 0.57-0.65) and -0.38 D (95%CI: -0.41--0.35) in the left and right eyes, respectively. Conclusion: A substantial correlation was found between retinoscopy and objective data captured by the device. This shows that technology can be used in conjunction, reaching a more accurate diagnosis and identifying amblyopia risk factors as early as possible. Photoscreening may make a difference at the population level for early screening and intervention.

RESUMO Objetivo: Avaliar o desempenho clínico do Spot Vision Screener e estabelecer correlações clínicas entre a triagem automatizada e a retinoscopia após indução de cicloplegia em crianças pré-verbais. Métodos: Neste estudo transversal prospectivo, crianças de 6 a 36 meses foram avaliadas usando o Spot Vision Screener. O exame oftalmológico completo, incluindo refração cicloplégica, foi então realizado, seguido de repetição da triagem automatizada e retinoscopia em todos os casos, a fim de estabelecer correlações quanto à hipermetropia, miopia e astigmatismo após a indução de cicloplegia. Resultados: O estudo incluiu 185 crianças. A sensibilidade do dispositivo de triagem automática após cicloplegia foi de 100% (IC 95%: 85,18-100%) e a especificidade foi de 87,04% (IC 95%: 80,87-91,79%). Os valores preditivos positivos e negativos foram de 52,27% (42,36 - 62,01%) e 100%, respectivamente. Em comparação com a retinoscopia, o Spot Vision Screener superestimou os valores esféricos em 0,62 D (IC 95%: 0,56 - 0,69) no olho direito e em 0,60 (IC 95%: 0,54 - 0,66) no olho esquerdo e os valores cilíndricos em -0,38 D (IC 95%: -0,42 a -0,33) no olho direito e por -0,39 D (IC 95%: -0,43 a -0,34) no olho esquerdo. A diferença para os valores esféricos e cilíndricos de forma geral foi de 0,61 D (IC 95%: 0,57 - 0,65) e -0,38 D (IC 95%: -0,41 a -0,35), respectivamente. Conclusão: Foi encontrada correlação substancial entre a retinoscopia e os dados objetivos captados pelo dispositivo. Isso mostra que a tecnologia pode ser usada em conjunto, contribuindo para um diagnóstico mais preciso e identificando os fatores de risco de ambliopia o mais precocemente possível. A técnica automatizada pode fazer a diferença em nível populacional para triagem e intervenção precoce.

CLINICAL EVALUATION OF INTRAOCULAR PRESSURE MEASUREMENTS USING DIFFERENT TONOMETERS IN PATIENTS OF VARIOUS REFRACTIVE ERRORS

Background: Intraocular pressure (IOP)is an important ?rst indicator of probability and suspicion of Glaucoma. The virtual IOP status is grossly in?uenced by multiple factors including Refractive errors ,corneal biomechanics ,central corneal thickness(CCT) and Scleral rigidity. To compare relative IOP measurements and Aim: its variability in Emmetropes, myopic and hypermetropic patients using Schiotz, Goldmann Applanation(GAT)and I-Care Rebound tonometer to establish an equation between virtual and real time IOP. This observational Materials and Methods: prospective study comprised of 100 subjects above the age of 18 years inclusive37 Emmetropes , 31 Hypermetropes and remaining 32 belonged to myopia . Descriptive statistics were performed using SPSS for Windows Statistical Analysis : version 17.0 to calculate the demographic characteristics of the study cohort. The data were expressed as mean values including the standard deviation (SD) and the 95% con?dence interval (CI). Mean IOP measurements between Schiotz, I-Care and GAT were compared by One way ANOVA along with Individual pair wise comparison by applying Post Hoc Tukey Test for comparison of IOP measurements using a particular method of Tonometry in individuals of myopia, hypermetropia and emmetropia. The highest mean value of CCT 536.667 mum was in Hypermetropes whereas the lowest CCT value of Results: 507.031mum was in myopic eyes with statistically signi?cant (P<0.05). The mean value for IOP in Emmetropes was16.665 mm Hg for Schiotz , 15.027 Hg for GAT and 15.081 mm Hg for I –Care .Whereas Hypermetropes revealed mean value of 15.055 mm Hg for Schiotz , 14.323 mm Hg for GAT and 14.065 mm Hg for I –Care . The mean value for IOP in Myopic eyes was 16.875 mm Hg for Schiotz , 14.375 mm Hg for GAT and 14.688 mm Hg for I –Care . The study had revealed higher mean Conclusion : value of IOP in Myopic eyes as compare to Emetropic and Hypermetropic subjects.IOP measurements by the Schiotz tonometer were signi?cantly higher as compare to GAT and I-Care tonometer. Whereas recordings by GAT and I Care tonometers were almost in agreement .De?nitive correlation could not be established between pachymetry readings and adjusted IOP following GAT and I –Care tonometry .

A cross-sectional study analyzing the correlation between the mean retinal nerve fiber layer and ganglion cell layer thickness with axial length and refractive errors among children aged 5–15 years

Purpose: To analyze the correlation between the mean retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness with axial length and refractive errors among children aged 5–15 years. Methods: This cross?sectional, observational study was done on 130 eyes of 65 consecutive subjects with refractive errors. The patients were evaluated for RNFL thickness and macular GCL thickness using spectral domain? optical coherence tomography. Results: One hundred and thirty eyes of 65 subjects aged between 5 and 15 years were divided into three groups based on their spherical equivalent in diopters (D). The children with a spherical equivalent of ??0.50 D were considered myopic, ??0.5 to ?+0.5 D were considered emmetropic, and ?+0.50 D were considered hypermetropic. RNFL thickness and GCL thickness were correlated with age, gender, spherical equivalent, and axial length. The mean global RNFL thickness was 104.58 ?m ± 7.567. Conclusion: There exists a negative correlation between RNFL thickness and macular GCL thickness with increasing severity of myopia and increase in axial length, and the possible reason could be stretching of the sclera, which further leads to stretching of the retina, resulting in thinner RNFL and macular GCL thickness

Analysis of refractive parameters and theirs correlation with spherical equivalent in preschool children aged 3 to 6 years / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the distribution of refractive parameters and theirs correlation with spherical equivalent(SE)in preschool children aged 3 to 6 years, and evaluate the accuracy of each screening index in diagnosing refractive errors.METHODS: Cross-sectional study. A total of 791 preschool children, ranging from 3 to 6 years old, who consented to undergo mydriatic refraction were selected. Axial length(AL), corneal refractive power(K), and SE were measured after microcoria optometry and mydriatic optometry. Additionally, the corneal radius of curvature(CR)and the axial length/corneal radius of curvature(AL/CR)ratio were calculated.RESULTS: A total of 791 students participated in the study, out of which 400(50.6%)were male and 391(49.4%)were female. The mean values for AL, CR, AL/CR, and SE were 22.62±0.94mm, 7.81±0.29mm, 2.90±0.09, and +1.95±1.31D, respectively. AL, CR, and AL/CR increased with age. AL and CR were significantly higher in males than in females(all P&#x003C;0.001), while there was no statistically significant difference between AL/CR and SE in males and females(P=0.82, 0.19). The correlation coefficients of SE and AL/CR, AL and CR were -0.86, -0.50 and 0.16, respectively. The results of multiple linear regression analysis indicate that for each unit increase in AL/CR, there was a corresponding shift of 10.91 towards myopia in SE. The sensitivity of AL/CR in screening for myopia was 94.44%, with a specificity of 90.46% and a Youden index of 0.84. For screening myopia under microcoria optometry, the sensitivity was 100%, with a specificity of 66.09% and a Youden index of 0.66. The area under the curve was 0.967 and 0.809 when the ROC curves were plotted using AL/CR and AL as indicators for screening myopia, respectively.CONCLUSION: For large group screening activities where mydriatic optometry is not feasible, AL/CR is better for evaluating refractive status and identifying children with myopia and hyperopia reserve that are lower than normal for their age, compared to AL and microcoria optometry.

An interpretation of AAPOS uniform guidelines for instrument-based pediatric vision screen validation 2021 / 中华实验眼科杂志

In January 2022, after an eight-year hiatus, the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) published the latest version of AAPOS uniform guidelines for instrument-based pediatric vision screen validation.Based on recent studies, the new guidelines have been updated and supplemented in many aspects, such as screening population, key points, methods and diagnosis criteria, including clinically significant refractive errors and myopia, simplified age subgroups, and adopted meridional refractive power.The updated guidelines will improve pediatric eye care, early detection of amblyopia and refractive screening, reduce excessive referral and ultimately improve the effectiveness of vision screening.In this article, the background and specific content of the updated guidelines were interpreted to guide clinical practice.

Accuracy of different intraocular lens power calculation formulas in cataract patients with shallow anterior chamber: a meta-analysis / 中华实验眼科杂志

Objective:To systematically compare the accuracy of intraocular lens (IOL) power calculation formulas in cataract patients with shallow anterior chamber.Methods:A comprehensive literature search was conducted in MEDLINE, EMBASE, Cochrane Library, and the Chinese databases including CNKI, Wanfang, and VIP databases.The peer-reviewed literature on the accuracy of IOL power calculation formulas in cataract patients with shallow anterior chamber was searched from the establishment of the database until August 2020.Literature screening, data extraction and quality assessment were performed according to inclusion and exclusion criteria.The mean difference ( MD) of mean absolute error (MAE) among different formulas was analyzed.Meta-analysis was performed using Revman 5.3 software. Results:Seven studies involving 499 eyes were included.The accuracy of six formulas, Barrett Universal Ⅱ, Haigis, SRK/T, Hoffer Q, Holladay 1 and Holladay 2, was evaluated.The MAE of Barrett Universal Ⅱ was significantly lower than that of Hoffer Q ( MD=0.11 D; 95% CI: 0.05-0.17 D; P<0.001), Haigis ( MD=0.08 D; 95% CI: 0.03-0.13 D; P=0.002), and Holladay 2 ( MD=-0.06 D; 95% CI: -0.11--0.01 D; P=0.020). No significant difference was found in the remaining pairwise comparisons (all at P>0.05). Conclusions:The Barrett Universal Ⅱ formula is more accurate than Hoffer Q, Haigis, and Holladay 2 formulas in predicting IOL power in cataract patients with shallow anterior chamber.

Clinical observation of acupuncture treatment for children with accommodative myopia / 针灸推拿医学（英文版）

Objective:To observe the effect of acupuncture in the treatment of accommodative myopia in children.Methods:A total of 76 children with accommodative myopia who met the inclusion criteria were divided into a control group or a test group according to the random number table method,with 38 cases in each group.The control group was given education on eye hygiene,and the test group was treated with acupuncture twice a week for 2 months in addition to the intervention used in the control group.The patient's uncorrected visual acuity(UCVA),refraction,and axial length(AL)were measured before treatment and 1 month and 2 months after treatment.Results:After 1 month of treatment,there was no significant difference in the UCVA between the two groups(P＞0.05);after 2 months of treatment,the UCVA of the test group was better than that of the control group(P＜0.05).After 1 and 2 months of treatment,the refraction of the two groups was significantly different from that before treatment(P＜0.01),but there was no significant difference between the two groups(P＞0.05).After 1 and 2 months of treatment,the AL in the control group was increased compared with that before treatment(P＜0.05),while there was no significant change in the test group(P＞0.05),and there was no significant difference between the two groups(P＞0.05).Conclusion:Acupuncture treatment can improve UCVA in children with accommodative myopia.

Comparative application of three methods for testing distance visual acuity among children / 中国学校卫生

Objective@#To understand the differences in the application of three distant vision examination methods in children, so as to provide a reference for developing a unified distant vision examination for this population.@*Methods@#The study involved 98 children aged 4 to 16 years who visited the ophthalmology department of a children s hospital in Anhui Province between August 15 and 25, 2022. Vision was measured using the distant vision test method specified in the 2014 National Student Physical Fitness and Health Survey (V1), the 2019 National Student Physical Fitness and Health Survey (V2), and Specification for Screening of Refractive Error in Primary and Secondary School Students (WS/T 663-2020) (V3). The paired samples McNemar s test and Wilcoxon test were performed to compare the detection rate of poor vision and the difference between the visual acuity test results of the three methods.@*Results@#The results of the 98 children examined according to V1, V2, and V3 showed that the M (P25, P 75 ) of the right eye were 4.8（4.6，5.0），4.8（4.7，5.0），and 4.8（4.7，5.0）while the left eye visual acuity M ( P 25 , P 75 ) were 4.8 （4.6，5.0），4.9（ 4.7 ，5.0），and 4.9（4.7，5.0），respectively. The rates of poor visual acuity detection for the right eye were 63.3%, 58.2% and 58.2 % for V1, V2, and V3, respectively, while for the left eye, they were 58.2%, 54.1% and 53.1%, respectively. McNemar test results showed that there were no statistically significant differences in the rates of poor visual acuity detection between the right and left eyes for V1 vs. V2, V1 vs. V3, and V2 vs. V3 (left eyes： χ 2=2.25，2.29，0.00，right eyes： χ 2=3.20，3.20，0.00， P >0.05).Wilcoxon test results indicated that there were statistically significant differences between the right and left eye visual acuity groups for V1 vs. V2 and V1 vs. V3 (left eyes： Z =-4.15，-4.60, right eyes： Z = -4.70，-4.99, P <0.01).@*Conclusion@#Irrespective of whether the starting visual standard starts at row 4.0 or 5.0, different standards of visual standard passage have an impact on the visual acuity results. It is recommended that existing methods of screening for distance vision are standardized.

Aumento das aberrações de alta ordem pós-ceratectomia fotorrefrativa guiada por frente de onda: relato de caso / Increased high-order aberrations after wavefront-guided photorefractive keratectomy: case report

RESUMO Ao remodelar a córnea usando um perfil de ablação individualizado para cada olho obtido por meio de aberrometria de frente de onda, o tratamento guiado por frente de onda tenta reduzir aberrações preexistentes e induzidas cirurgicamente, minimizando as aberrações de alta ordem (HOAs) visualmente significativas. No entanto, o aumento de HOA ainda é uma preocupação, mesmo com ablações personalizadas. Na cirurgia refrativa a laser miópica, como o feixe de laser entra na periferia, algumas partes são refletidas, e o feixe circular se torna elíptico, resultando em diminuição na eficácia da energia do laser. A subablação da córnea periférica pode ser induzida por esses fatores que aumentam a HOA, especialmente a aberração esférica. Este relato tem por finalidade mostrar uma paciente alto míope submetida à PRK guiada por frente de onda que evoluiu com aumento das HOAs.

ABSTRACT By reshaping the cornea using an individualized ablation profile for each eye obtained through wavefront aberrometry, wavefront guided treatment attempts to reduce preexisting and surgically induced aberrations while minimizing visually significant higher-order aberrations (HOAs). However, HOA enhancement is still a concern, even with custom ablations. In the myopic laser refractive surgery, as the laser beam enters the periphery, some parts are reflected, and the circular beam becomes elliptical, resulting in a decrease in the effectiveness of the laser energy. Peripheral corneal subablation can be induced by these factors that increase HOA, especially spherical aberration. This report aims to show a high myopic patient undergoing wavefront-guided PRK, who evolved with an increase in HOAs.

Alterações oculares em escolares e adolescentes após início da pandemia por COVID-19 / Acute eye symptoms in schoolchildren and adolescents after the onset of COVID-19 pandemic

RESUMO Objetivo Identificar as alterações oculares em crianças e adolescentes secundárias ao fator do isolamento social e ao consequente aumento do uso de telas. Métodos Estudo observacional, descritivo e analítico, do tipo transversal realizado no período de julho a agosto de 2021, por meio da aplicação de questionários. Resultados Apresentaram cefaleia associada ao uso excessivo de tela 26,51% dos estudantes e 38,8% relataram suspeita de insuficiência de convergência. Em relação ao questionário de olho seco, 18,8% foram sintomáticos e 7,5% sintomáticos de difícil manejo. O computador foi o dispositivo mais utilizado em atividades escolares (71,5%), e, em segundo lugar, esteve o celular (66,3%). Casos sintomáticos de olho seco foram mais relatados em participantes que não faziam uso de computador (36,4%). Não foi possível identificar relação entre insuficiência de convergência e tempo de uso de dispositivos. Em relação ao olho seco, aqueles que passaram mais tempo em frente a tela relataram maior porcentagem de sintomas de difícil manejo (42,9%). Conclusão Foram mais prevalentes olho seco e sintomas de insuficiência de convergência na população estudada.

ABSTRACT Objective To identify eye conditions associated to social distancing and related increase in screen time exposure on children and teenagers. Methods Observational, descriptive and analytical study, with a cross-section design, carried out between July and August 2021, by questionnaire survey. Results Headaches related to excessive screen time exposure were reported by 26.51% of the students surveyed, while 38.8% reported suspect convergence insufficiency. Regarding the questionnaire about dry eye, 18.8% were symptomatic and 7.5% reported hard-to-manage symptoms. Computers were the devices most used for schoolwork (71.5%), followed by cellphones on second place (66.3%). Symptomatic cases of dry eye were mostly reported by participants that did not make use of computers (36.4%). It was not possible to establish a connection between convergence insufficiency and device usage time. Those participants that reported more screen time exposure also reported an increased percentage of hard-to-manage symptoms (42.9%), regarding dry eye. Conclusion Dry eye and convergence insufficiency symptoms were more prevalent in the surveyed population.

Pattern of Refractive Errors in a Tertiary Hospital in South East, Nigeria

Background: Uncorrected refractive errors (RE) are a major cause of visual impairment. They affect a large proportion of the population globally and have psychological and socio-economic effects on the individual, family and society. They could lead to poor quality of life.Aim: To determine the pattern and predisposing factors of refractive errors among patients seen in the outpatient clinic.Methodology: A cross-sectional, descriptive study involving patients with refractive error that presented to the eye clinic in the year 2017. Data were obtained from patients’ records, entered into and analysed using IBM SPSS version 25.Results: A total of 300 patients with refractive errors were seen in the period of study. This comprised of 93 males and 207 females with mean age of 40.13±17.6 years. The commonest presenting complaint was blurring of both far & near vision (24%), other presenting complaints in decreasing order of frequency were blurring of distant vision, itching, blurring of near vision, eye pain, headache and red eyes in 18%,15%, 9.6%, 5.6%, and 3.2% respectively. Presbyopia was noted in 55.3% while myopia, anisometropia, astigmatism and hypermetropia were noted in 20.7%, 19.3%, 7.0% and 1.3% respectively. Nuclear sclerosis was the commonest co-existing ocular pathology or morbidity.Statistically significant association was found between age of the patients and presence of ocular disease existing with RE (p=0.016).Conclusion: Fifty-one percent of the study population had refractive errors. The commonest refractive error was myopia while hypermetropia was the least common refractive error in this environment.