UNASSIGNED: To investigate characteristics and risk factors of poor stereoacuity of Convergence insufficiency-type Intermittent Exotropia (CI-type X(T)).
UNASSIGNED: Observational, cross-sectional study.
UNASSIGNED: The medical records of 615 CI-type X(T) and 222 basic-type intermittent exotropia (X(T)) were enrolled from January 2018 to January 2022. The characteristics were compared between the two types, and the associations between clinical factors and poor stereoacuity were examined using logistic regression.
UNASSIGNED: Compared with basic-type X(T), earlier surgery age, shorter misalignment duration, and the smaller distance exodeviation were observed in CI-type X(T). The CI-type X(T) demonstrated better sensory status and lower incidence of ocular muscle dysfunction than did the basic-type X(T). The surgery age between 6 and 12 years (odds ratio [OR], 0.595; compared with ≤6 years) was inversely associated with poor near stereoacuity, whereas duration more than 4 years (OR, 2.474), amblyopia (OR, 4.057), large distance exodeviation (>60PD: OR, 2.462) and anisometropia (>2.00D: OR, 3.874) were positively associated with poor near stereoacuity. The onset age older than 6 years (6-9 years: OR, 0.397; >9 years: OR, 0.317) was associated with better distance stereoacuity, whereas large distance exodeviation (>60PD: OR, 23.513), and dominant eye best corrected visual acuity (BCVA) worsen than 0.20 (OR, 2.987) were positively associated with poor distance stereoacuity.
UNASSIGNED: CI-type X(T) declined surgery early, with small distance exodeviation, better sensory status, and low incidence of ocular muscle dysfunction. A strong dose-dependent link between early onset age, long misalignment duration, worse dominant eye BCVA, distance exodeviation, amblyopia, anisometropia, and poor stereoacuity was confirmed.

UNASSIGNED: To assess visual acuity (VA) and stereoacuity (SA) improvements in children with amblyopia treated with either binocular dichoptic treatment or patching treatment.
UNASSIGNED: In this pilot prospective coherent study, 34 participants between 4 and 9 years of age with unilateral anisometropic amblyopia and without history of prior amblyopia treatment were enrolled into three groups. Full treatment group (FTG; n = 12): participants were prescribed the binocular dichoptic treatment to watch for 90 minutes per day, 5 days a week. Part-time treatment group (PTTG; n = 8): participants were prescribed the same binocular treatment as FTG, 90 minutes per day, 3 days per week. Patching treatment group (PTG; n = 14): participants wore an adhesive patch over the dominant eye for 2 hours per day, 7 days per week. Amblyopic-eye distance visual acuity (DVA), near visual acuity (NVA) and SA were evaluated at baseline, 4, 8, and 12 weeks.
UNASSIGNED: At 12 weeks, mean amblyopic-eye DVA improved 1.8 lines (95% CI, 1.1-2.5) in FTG, 1.5 lines (95% CI, 0.4-2.7) in PTTG and 3.0 lines (95% CI, 2.0-4.0) in PTG. The amblyopic-eye NVA improved 2.9 lines (95% CI, 2.4-3.5) in FTG, 1.7 lines (95% CI, 0.5-3.0) in PTTG and 2.8 lines (95% CI, 1.8-3.9) in PTG. The SA improved 0.38 log-arcseconds (95% CI, 0.24-0.53) in FTG, 0.59 log-arcseconds (95% CI, 0.36-0.82) in PTTG and 0.40 log-arcseconds (95% CI, 0.13-0.67) in PTG. No significant differences were found in DVA, NVA or SA improvement between FTG and PTG at 12 weeks.
UNASSIGNED: VA and SA after binocular dichoptic treatment produced a similar therapeutic outcome to patching, suggesting a potential value for binocular therapy when treating anisometropic moderate degree of Children\'s amblyopia.

OBJECTIVE: To assess the effectiveness of combined use of stereoscopic 3D video movies and part-time patching in treating older amblyopic children with poor response or compliance to traditional patching treatments and comparing this combined treatment with patching alone.
METHODS: Thirty-two children aged 5-12 years with amblyopia associated with anisometropia, strabismus, or both were recruited in a randomized clinical trial. Eligible participants were assigned randomly to the combined and patching groups. Here, binocular treatment refers to using the Bangerter filter to blur the fellow eye and subsequently watching a close-up 3D movie with large parallax. The primary outcome was amblyopic eye (AE) best-corrected visual acuity (BCVA) improvement at six weeks. In addition, secondary outcomes included BCVA of AE improvement at three weeks and change of stereoacuity.
RESULTS: Of 32 participants, mean (SD) age was 6.63 (1.46) years, and 19 (59%) were female. At 6 weeks, mean (SD) amblyopic eye VA improved by 0.17 ± 0.08 logMAR (2-sided 95% CI, 0.13 to 0.22; F = 57.2, p < 0.01) and 0.05 ± 0.04 logMAR (2-sided 95% CI, 0.05 to 0.09; F = 8.73, p = 0.01) in the combined and patching groups, respectively. The difference was statistically significant (mean difference, 0.13 logMAR [1.3 line]; 95% CI, 0.08-0.17 logMAR [0.8-1.7 lines]; t25 = 5.65, p < 0 .01). After treatment, only the combined group had significantly improved stereoacuity, such as binocular function score (median [interquartile range], 2.30 [2.23 to 2.68] vs. 1.69 [1.60 to 2.30] log arcsec; paired, z = -3.53, p < 0.01), and mean stereoacuity gain was 0.47 log arcsec (± 0.22). Changes in other types of stereoacuity were similar.
CONCLUSIONS: Our laboratory-based binocular treatment strategy engaged a high level of compliance that led to a substantial gain in visual function after a short period of treatment for older amblyopic children having poor response or compliance to traditional patching treatments. Notably, the improving stereoacuity showed a greater advantage.

UNASSIGNED: The impact of aniseikonia on stereopsis has been studied for decades, however, inconsistency which may be partly attributed to the method of inducing aniseikonia exists among these findings. This study aimed to induce overall and meridional aniseikonia using a three-dimensional (3D) computer and then evaluate the effect of induced aniseikonia on distance stereopsis using contour-based and random-dot-based patterns.
UNASSIGNED: A 3D laptop was used to produce all of the test symbols. Unlike the usual method of creating aniseikonia with size lenses, which would change not only the size but also the relative position of the test symbols in the two images as seen by the two eyes, a new test system was designed to evaluate the aniseikonia, which only modified the size while maintaining the relative position of the test symbols. This new method reduced the disparities induced by location changing of the paired test targets when inducing aniseikonia. Aniseikonia was induced overall or in one of the meridians. The induced meridional aniseikonia included 180°, 30°, 45°, 60°, and 90°, respectively. The range of induced aniseikonia was 0-30% with an increment of 5%.
UNASSIGNED: Overall magnification affected stereopsis more than magnification in any one of the meridians. The stereoacuity differences between oblique meridians (30°, 45°, and 60°) were not significant until the aniseikonia increased up to 20%. The difference between 180°, 45°, and 90° was significant when the aniseikonia increased up to 10% in the contour-based test and over 20% in the random-dot-based test. The stereoacuity trend was improved gradually, coupled with the angle changing from 180º to 90º in the contour-based pattern, and deteriorated gradually in the random-dot-based pattern.
UNASSIGNED: Overall aniseikonia affected stereopsis more than meridional aniseikonia. The stereoacuity of the contour-based pattern was superior to that of the random-dot-based pattern in the 90° meridian, while the opposite result was obtained in the 180° meridian.

BACKGROUND: The aim of this observational study was to identify ocular and visual perceptive risk factors related to treatment results following refractive correction and patching in children with anisometropic amblyopia, who were between the ages of 4 to 14 years old.
METHODS: One-hundred and two children with newly diagnosed anisometropic amblyopia were recruited. Successful treatment of amblyopia was defined as the final best corrected visual acuity (BCVA) better than or equal to 0.1 logMAR and amblyopic eye BCVA within 1 line of the sound eye BCVA by the end of the treatment period. BCVA, cycloplegic refraction, stereoacuity, perceptual eye position (PEP) and interocular suppression were measured.
RESULTS: Of these patients, 45.10% achieved successful treatment of amblyopia after refractive correction and patching for 10.5 months. The mean age was not significantly different between patients who were successfully and unsuccessfully treated (5.50 ± 1.59 years vs 6.14 ± 2.19 years, respectively). Patients who failed treatment had significantly larger interocular difference of BCVA at the time of initial treatment (successful group: 0.33 ± 0.29 logMAR, unsuccessful group: 0.65 ± 0.35 logMAR) and after refractive adaptation (successful group: 0.15 ± 0.13 logMAR, unsuccessful group: 0.42 ± 0.35 logMAR). They also had higher spherical equivalent (SE) of amblyopic eyes (successful group: 3.08 ± 3.61 D, unsuccessful group: 5.27 ± 3.38 D), bigger interocular difference of SE (successful group: 0.94 ± 2.71 D, unsuccessful group: 3.09 ± 3.05 D), worse stereoacuity (successful group: 2.32 ± 0.37 log seconds of arc, unsuccessful group: 2.75 ± 0.32 log seconds of arc), larger vertical PEP deviation (successful group: 6.41 ± 6.08 pixel, unsuccessful group: 19.07 ± 24.96 pixel) and deeper interocular suppression (successful group: 21.7 ± 19.7%, unsuccessful group: 37.8 ± 27.1%) than those of successfully treated patients. The most influential treatment failure risk factors were larger vertical PEP deviation [adjusted odds ratio (OR) (95% confidence interval) 1.12 (1.02-1.22)] and worse stereoacuity [adjusted odds ratio (OR) (95% confidence interval) 7.72 (1.50-39.85)] in multiple logistic regression analysis.
CONCLUSIONS: Larger vertical PEP deviation and worse stereoacuity were the most influential treatment failure risk factors in children with anisometropic amblyopia. The vertical PEP deviation and stereoacuity, which can reflect interocular interaction, may be useful in predicting the response to therapy.

Objectives: This research aimed to present a novel glasses-free distance random-dot stereotest system (GFDRDSS) using an eye-tracking method. Methods: A single-view autostereoscopic display applying a backlight control system combined with an eye-tracking method and the corresponding random-dot stereotest software were developed to create a GFDRDSS with a viewing distance of 5 m. The stereoacuity of 12 subjects with normal eye position was evaluated using the Randot Stereotest, Stereoscopic Test Charts vol. 3 (Yan\'s Charts), Distance Randot® Stereotest, and GFDRDSS. Results: The GFDRDSS could provide distinct and stable glasses-free stereoscopic perception even while the subject was moving their head. It could evaluate binocular disparities of 40-2,400 arcsec. Eleven subjects with normal near visual acuity had fine near stereovision (20-60 arcsec) using the Randot stereotest and Yan\'s Charts. Under refractive correction, 10 subjects had fine stereovision (≤60 arcsec) using the GFDRDSS at a distance of 5 m, and 9 had fine stereovision using the Distance Randot® Stereotest at 3 m. Other subjects described the 100 arcsec-level stereograms correctly. The results exhibited a concordance of stereoacuity within one degrade between the two distance stereotests. Conclusion: The proposed GFDRDSS can alternately project a couple of random-dot stereograms to the subjects\' eyes and provide a glasses-free distance stereotest, which showed good concordance with the Distance Randot® Stereotest. More data are needed for statistical studies.

OBJECTIVE: To compare the effectiveness of network-based perception learning (NBPL) and traditional training in the treatment of amblyopia children.
METHODS: This randomized controlled clinical trial recruited 56 participants aged 4-12y with anisometropic and/or strabismic amblyopia. Participants were randomly divided into two groups: the NBPL group (n=28) who received patching and NBPL for 3mo, and the control group (n=28) who got 3mo of patching and traditional training. Best-corrected visual acuity (BCVA) in the amblyopic eye and stereoacuity were measured and compared at baseline, 1, 2, and 3mo post-randomization.
RESULTS: There were no significant differences in age, gender ratio, and BCVA between the two groups at baseline. At 3mo, most patients gained lines (2 logMAR lines on average) of BCVA in both groups except one 11-year-old girl in the control group (P<0.05). But no significant difference in BCVA improvement of the amblyopic eye between the two groups was found (P=0.725), and amblyopia resolved (BCVA of 0.1 logMAR or better or within 1 logMAR line of the fellow eye) for 13 (46.4%) participants in both groups. The number of patients with improvement of stereoacuity was 25 and 13 in the NBPL group and control group (P=0.041), respectively, and a significant difference exists in the distribution of stereopsis at 3mo between the two groups (P=0.015). Besides, in patients with measurable stereopsis improvement degree and space for improvement in the two groups, the NBPL group also achieved better stereoscopic improvement than the control group (10/11 vs 4/11, P<0.05).
CONCLUSIONS: The NBPL system has a significant effect on the improvement of BCVA and stereoacuity of amblyopia children and is better than traditional training in terms of stereoacuity improvement. Perceptual learning visual training may play a more important role in the treatment of amblyopia in the future.

OBJECTIVE: To evaluate binocular visual function after unilateral and bilateral implantation of segmented refractive multifocal intraocular lenses (MIOLs).
METHODS: This prospective comparative pilot study included patients who underwent SBL-3 (Lenstec; + 3.00 D) implantation at Peking University Third Hospital. Patients were divided into two groups (monocular or binocular surgery). Thirty-two patients with emmetropic presbyopic contralateral eyes and 49 patients with bilateral SBL-3 implantation within a week between eyes were included in the unilateral SBL-3 and bilateral groups, respectively. At 3-month follow-up, the main outcomes were binocular uncorrected distant, intermediate, and near visual acuity (UDVA, UIVA, and UNVA). Secondary outcomes included binocular best-corrected visual acuity at all distances, defocus curve, contrast sensitivity, photic phenomena, spectacle independence, patient satisfaction, and National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) score. The essential perceptual phenomena constituting binocular vision, simultaneous perception, fusion, and stereopsis were also evaluated.
RESULTS: Both groups showed similar binocular UDVA and UIVA, but UNVA was significantly better in the bilateral group (0.07 ± 0.07 versus 0.12 ± 0.07, P = 0.008). Better binocular defocus curve at intermediate to near focal points, higher percentage of spectacle independence at near distance, and NEI-VFQ-25 near activity scores were observed in the bilateral group. No significant differences in contrast sensitivity, photic phenomena, overall satisfaction, other NEI-VFQ-25 subscales, fusional amplitude, and stereoacuity were found between groups.
CONCLUSIONS: Unilateral implantation of segmented refractive MIOL provided desirable distant visual acuity and high patient satisfaction, but inferior intermediate and near visual outcomes compared with bilateral implantation.

OBJECTIVE: To explore the distribution of stereoacuity and to examine its determinants in school-age children in Tibetan plateau, Southwest China.
METHODS: This is the cross-sectional part of a school-based cohort study of 7-year-old children in Lhasa, Tibet Autonomous Region, Southwest China. Children in first year of primary school were invited to undergo a comprehensive examination, including height, weight, visual acuity, cycloplegic autorefraction (1% cyclopentolate), anterior segment, cover and uncover test, and stereoacuity (Titmus Stereo Test).
RESULTS: A total of 1833 eligible subjects were included, with a mean age of 6.82 ± 0.46 years. Mean stereoacuity was 1.78 ± 0.21 in log units (median: 60 arcsec). Children with stereoacuity equal to 40 arcsec and stereoacuity worse than 100 arcsec accounted for 29.24% and 8.18% of the cohort, respectively. Tibetan ethnicity (OR = 1.98; 95%CI, 1.30-3.03), astigmatism (OR = 1.65; 95%CI, 1.26-2.17), strabismus (OR = 2.92; 95%CI, 1.38-6.18), and amblyopia (OR = 3.77; 95%CI, 1.14-12.49) were risk factors for normal stereoacuity (= 40 arcsec). Shorter height, younger age, strabismus, and worse BCVA (P < 0.05 for all) were both related to lower stereoacuity in Spearman correlation analysis and associated with lower stereoacuity in multivariate regression analysis.
CONCLUSIONS: Stereoacuity maturation does not appear fully completed in 7-year-old children, while few children present stereoacuity worse than 100 arcsec (8.18%). Lower stereoacuity was associated with younger age, shorter height, strabismus, and lower best-corrected visual acuity.

BACKGROUND: Amblyopia always presents with monocular and binocular dysfunction. In this study, we aim to investigate the efficacy of alternative occlusion using liquid crystal glasses versus continuous occlusion therapy using traditional patches for treating amblyopia.
METHODS: Eligible subjects with anisometropic amblyopia were randomized into 2 groups: alternative flicker glass (AFG) or patching group. In the AFG group, subjects were instructed to wear the flicker glasses for 1 h a day. The AFG is a lightweight spectacle frame with liquid crystal lenses that provide direct square-wave alternating occlusion, which were preprogrammed at a temporal frequency of 7 Hz. In the patching group, the patients were prescribed to wear traditional patches for 2 h a day. The best-corrected visual acuity (BCVA), contrast sensitivity function (CSF), and stereoacuity were measured at the baseline and 3 and 12 weeks.
RESULTS: In this pilot study, a total of 40 children were recruited, with 20 in the AFG group. Mean BCVA improved by 0.17 ± 0.14 logMAR (95% CI = 0.10-0.23) in the AFG group and 0.18 ± 0.18 logMAR (95% CI = 0.09-0.26) in the patching group from baseline to 12 weeks. The improvement in BCVA in both groups was significant (both p < 0.01), while there was no significant difference between the groups (p = 0.82). The CSF of both low and high spatial frequencies exhibited significant improvement at 12 weeks in the AFG group (p < 0.01, respectively) and just had a significant improvement at low spatial frequency in the patching group (p < 0.01). The stereoacuity significantly improved by 504.00 ± 848.00 (95% CI = 107.12 to 900.88) arc seconds in the AFG group (p < 0.05), while it was 263.50 ± 639.55 (95% CI = -35.82 to 562.82) arc seconds in the patching group (p > 0.05).
CONCLUSIONS: Alternative flicker glass was effective in improving both monocular and binocular function, which was most likely achieved by reducing suppression and promoting binocular fusion. This therapy exhibited promise as an alternative method for amblyopia treatment.