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PURPOSE: To observe the effects of visual neuroplasticity training on visual perception, visual quality, and macular blood flow in patients with concomitant strabismus postoperatively. METHODS: In total, 108 patients underwent binocular strabismus correction operation, and some patients underwent neuroplasticity training. All patients underwent clinical ophthalmic examination, including measurement of best-corrected visual acuity, spherical equivalent, axis length, optical coherence tomography angiography, optical quality analysis system, and visual perception examinations. RESULTS: A total of 78 patients received neuroplasticity training for 1 month postoperatively, and 30 patients did not receive training. All patients underwent a visual perception examination preoperatively and at 1 day, 1 week, and 1 month postoperatively. Macular blood flow and visual quality were examined preoperatively and at 1 month postoperatively. Postoperative visual perception was better than preoperative visual perception (P < 0.05). After neuroplasticity training, the visual perception of the trained subjects was better than that of the untrained subjects (P < 0.05), and the blood flow in the macular area of the trained patients was lower than that of the untrained subjects (P < 0.05). The visual quality of the untrained subjects was lower than that of the trained patients (P < 0.05). CONCLUSIONS: Visual inspection system could accurately evaluate binocular visual perception in patients with concomitant strabismus. After surgical alignment of the strabismus patient, training can stimulate and integrate the formation of stereovision in a short period of time, maintain the visual quality of patients after surgery, and provide conditions for the formation of binocular visual signals and binocular stereovision, but in the short term, it will lead to the decrease of macular blood vessel density and perfusion density. However, the long-term effects of training have not been proven.
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Rhegmatogenous retinal detachment (RRD) is a type of ophthalmologic emergency, if left untreated, the blindness rate approaches 100 %. The RRD patient postoperative recovery of visual function is unsatisfactory, most notably due to photoreceptor death. We conducted to identify the key genes for oxidative stress (OS) in RRD through bioinformatics analysis and clinical validation, thus providing new ideas for the recovery of visual function in RRD patients after surgery. A gene database for RRD was obtained from the Gene Expression Omnibus (GEO) database (GSE28133). Then we screened differentially expressed OS genes (DEOSGs) from the database and assessed the critical pathways in RRD with Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway. Protein-protein interaction (PPI) networks and hub genes among the common DEOSGs were identified. In addition, we collected general information and vitreous fluid from 42 patients with RRD and 22 controls [11 each of epiretinal membrane (EM) and macular hole (MH)], examined the expression levels of proteins encoded by hub genes in vitreous fluid by enzyme-linked immunosorbent assay (ELISA) to further assess the relationship between the ELISA data and the clinical characteristics of patients with RRD. Ten hub genes (CCL2, ICAM1, STAT3, CD4, ITGAM, PTPRC, CCL5, IL18, TLR2, VCAM1) were finally screened out from the dataset. The ELISA results showed that, compared with the control group, patients with RRD: TLR2 and ICAM-1 were significantly elevated, and CCL2 had a tendency to be elevated, but no statistically significant; RRD patients and MH patients compared with EM patients: STAT3 and VCAM-1 were significantly elevated. We found affected eyes of RRD patients compared with healthy eyes: temporal and nasal retinal nerve fiber layer (RNFL) were significantly thickened. By correlation analysis, we found that: STAT3 was negatively correlated with ocular perfusion pressure (OPP); temporal RNFL was not only significantly positively correlated with CCL2, but also negatively correlated with Scotopic b-wave amplitude. These findings help us to further explore the mechanism of RRD development and provide new ideas for finding postoperative visual function recovery.
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Membrana Epirretinal , Desprendimiento de Retina , Perforaciones de la Retina , Humanos , Desprendimiento de Retina/genética , Desprendimiento de Retina/cirugía , Desprendimiento de Retina/metabolismo , Receptor Toll-Like 2/metabolismo , Cuerpo Vítreo/metabolismo , Retina/metabolismo , Membrana Epirretinal/metabolismo , Perforaciones de la Retina/cirugía , Estrés OxidativoRESUMEN
OBJECTIVE: This study aims to reveal the factors influencing the selection of the dominant eye in refractive surgery patients, and enhance the accuracy of clinical evaluation and surgical treatment. METHODS: A retrospective study method was employed. The ocular biometric parameters were analyzed in 4,114 patients who underwent refractive surgery at the affiliated hospital of Southwest Medical University from 2019 to 2023. RESULTS: The study found that 79.07% of the patients had the right eye as the dominant eye, while 20.93% had the left eye. Although there was no significant difference between the dominant and non-dominant eyes in terms of uncorrected visual acuity and Kappa angle, the dominant eye performed better in aspects such as spherical lens, eye axis, and corneal flat curvature. Furthermore, univariate and multivariate logistic regression results showed that best-corrected visual acuity, pupil diameter, horizontal displacement x-value of the Kappa angle, and astigmatism vector J45 were significant influencing factors for the selection of the dominant eye. CONCLUSION: There are numerous factors affecting the dominant eye, and the most important core factor is J45. This study comprehensively evaluated the possible factors affecting the dominant eye in patients undergoing refractive surgery, which provides a foundation for the designation of refractive surgical modalities and assurance of surgical outcomes, and opens up new perspectives on understanding the mechanisms of the formation and development of the dominant eye.
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Astigmatismo , Procedimientos Quirúrgicos Refractivos , Humanos , Refracción Ocular , Estudios Retrospectivos , Agudeza Visual , Astigmatismo/cirugíaRESUMEN
PURPOSE: The aim of this study was to evaluate the effectiveness and safety of repeated low-level red light (RLRL) therapy in controlling myopia progression in children through a meta-analysis. METHODS: We searched several databases including PubMed, Embase, The Cochrane Library, Web of Science, CNKI, WANFANG, CBM, and VIP with languages restricted to both Chinese and English. The search was conducted from the establishment of the databases to March 23, 2023. We collected randomized controlled trials and controlled experiments to evaluate changes in axial length (AL) and spherical equivalent (SE) before and after RLRL intervention. Two researchers performed literature screening and data extraction, and RevMan software (Ver 5.3) and StataMP 17.0 were used for meta-analysis. RESULTS: A total of 141 articles were retrieved, and finally, six randomized controlled trials met the inclusion and exclusion criteria, including 820 eyes (RLRL group: 411 eyes, control group: 409 eyes). The meta-analysis results showed that the RLRL group was significantly better than the control group in controlling AL, and the difference between the two groups was statistically significant (mean difference [MD] = -0.22, 95% confidence interval [CI] [ - 0.28, -0.16]; P < 0.001). The RLRL group was also better than the control group in terms of SE, and the difference between the two groups was statistically significant (MD = 0.46, 95% CI [0.32, 0.6]; P < 0.001). Five studies reported adverse reactions in the RLRL group, and two cases stopped treatment due to the feeling of too bright light, while the others had no significant side effects in the short term. CONCLUSION: RLRL therapy is a safe and effective method for controlling myopia, which can inhibit the growth of AL and slow down the progression of myopia. However, further research and validation are needed to determine its treatment efficacy and course.