OBJECTIVE: To investigate the characteristics of eye movement in children with anisometropic amblyopia, and to compare those characteristics with eye movement in a control group.
METHODS: 31 children in the anisometropic amblyopia group (31 amblyopic eyes in group A, 31 contralateral eyes in group B) and 24 children in the control group (48 eyes in group C). Group A was subdivided into groups Aa (severe amblyopia) and Ab (mild-moderate amblyopia). The overall age range was 6-12 years (mean, 7.83 ± 1.79 years). All children underwent ophthalmic examinations; eye movement parameters including saccade latency and amplitude were evaluated using an Eyelink1000 eye tracker. Data Viewer and MATLAB software were used for data analysis.
RESULTS: Mean and maximum saccade latencies, as well as mean and maximum saccade amplitudes, were significantly greater in group A than in groups B and C before and after treatment (P < 0.05). Mean and maximum saccade latencies were significantly different among groups Aa, Ab, and C (P < 0.05). Pupil trajectories in two detection modes suggested that binocular fixation was better than monocular fixation.
CONCLUSIONS: Eye movement parameters significantly differed between contralateral normal eyes and control eyes. Clinical evaluation of children with anisometropic amblyopia should not focus only on static visual acuity, but also on the assessment of eye movement.

BACKGROUND: This study aims to investigate relative peripheral refractive (RPR) characteristics in children with non-amblyopic myopic anisometropia and explore potential associations between relative peripheral refractive errors (RPRE) and myopia.
METHODS: Relative peripheral refractive errors were assessed in 64 children diagnosed with non-amblyopic myopic anisometropia utilizing multispectral refraction topography (MRT). Two eyes of each patient were divided into into the more myopia eyes group (ME) and the fellow eyes group (FE). Evaluated parameters encompassed total defocus values (TRDV), defocus values at eccentricities spanning 0 to 15 degrees (RDV-15), 0 to 30 degrees (RDV-30), 0 to 45 degrees (RDV-45), as well as superior (RDV-S), inferior (RDV-I), temporal (RDV-T), and nasal (RDV-N) positions.
RESULTS: The study revealed a noteworthy contrast in TRDV values between Group ME (0.52 ± 0.36) and Group FE (0.17 ± 0.41), with a substantial significance (P < 0.0001). While no significant RDV-15 difference emerged between Group ME (0.01 ± 0.05) and Group FE (-0.01 ± 0.07) (P > 0.05), a meaningful RDV-30 difference existed between Group ME (0.11 ± 0.14) and Group FE (0.03 ± 0.19) (P = 0.0017). A significant discrepancy in RDV-45 was also observed between Group ME (0.39 ± 0.29) and Group FE (0.13 ± 0.34) (P < 0.001). Notably, RDV-I and RDV-T positions demonstrated marked differences between Group ME and Group FE (P < 0.0001), whereas no significant disparity was noted in RDV-S and RDV-N positions (P > 0.05).
CONCLUSIONS: Eyes exhibiting greater myopia manifested more hyperopic peripheral defocus in the context of anisometropia. MRT as a novel ophthalmic evaluation technique, holds promising potential for broader clinical applications in the future.

UNASSIGNED: This study aims to investigate the differences in binocular corneal parameters and their interrelation with binocular biometric parameters asymmetry in patients with simple myopic anisometropia, thereby elucidating the influence of myopia process on various corneal parameters.
UNASSIGNED: In this cross-sectional study, 65 patients with anisometropia in monocular myopia were included. They were divided into low anisometropia group: 3.00D<Δ spherical equivalent (SE)≤-1.00D (Δ represents the difference between the two eyes, i.e., myopic data minus emmetropic data) and high anisometropia group: ΔSE ≤ -3.00D. Corneal and ocular biometric parameters were measured using Pentacam, Corvis ST, and IOL Master 700. Statistical analyses focused on the binocular corneal parameters asymmetry, using the contralateral emmetropia as a control.
UNASSIGNED: The mean age of participants was 18.5 ± 1.3 years, with the average SE for myopia and emmetropia being -2.93 ± 1.09D and -0.16 ± 0.41D, respectively. The central corneal thickness (CCT), flat keratometry (Kf), keratometry astigmatism (Ka), total corneal aberration (6 mm) (TOA), surface variance index (ISV), vertical asymmetry index (IVA), stress-strain index (SSI), and first applanation stiffness parameter (SPA1) and ambrosia relational thickness-horizontal (ARTh) showed significant differences between anisometropic fellow eyes (p < 0.05). There were significant differences in ΔIVA, Δ the difference between the mean refractive power of the inferior and superior corneas (I-S), Δ deviation value of Belin/Ambrósio enhanced ectasia display (BAD-D), Δ deformation amplitude ratio max (2 mm) (DAR)and Δ tomographic biomechanical index (TBI) (p < 0.05) in two groups. Asymmetry of corneal parameters was correlated with asymmetry of ocular biometric parameters. Anisometropia (ΔSE) was positively correlated with ΔIVA (r = 0.255, p = 0.040), ΔBAD-D (r = 0.360, p = 0.006), and ΔSSI (r = 0.276, p = 0.039) and negatively correlated with ΔDAR (r = -0.329, p = 0.013) in multiple regression analysis. Δ mean keratometry (Km), Δ anterior chamber depth (ACD), and Δ biomechanically corrected intraocular pressure (bIOP) were also associated with binocular corneal differences.
UNASSIGNED: Compared to contralateral emmetropia, myopic eyes have thinner corneas and smaller corneal astigmatism. Myopic corneas exhibit relatively more regular surface morphology but are more susceptible to deformation and possess marginally inferior biomechanical properties. In addition, there is a certain correlation between anisometropia and corneal parameter asymmetry, which would be instrumental in predicting the development of myopia.

OBJECTIVE: To investigate bilateral axial length (AL) growth patterns and interactions of myopic eyes in anisometropic children during unilateral orthokeratology (OK) treatment in their singularly myopic eyes (Eyes1), followed by bilateral treatment when their second eyes (Eyes2) developed myopia.
METHODS: This study enrolled 94 eyes from 47 anisometropes (20 males). All patients had undergone monocular OK treatment for > 1 year followed by binocular treatment for > 1 year. Axial growth of Eyes1 and Eyes2 during the first year of monocular treatment (Stage 1), average annual axial elongation during the monocular treatment period, and axial elongation during the first year of binocular treatment (Stage 2) were respectively termed: S1E1 and S1E2, Annual E1 and Annual E2, and S2E1 and S2E2. Associations between AL growth and age, sex, interval time, and ocular parameters were analysed using correlation and generalised estimating equation (GEE) analysis.
RESULTS: During the monocular period, Eyes1 showed less AL growth (S1E1: 0.05 ± 0.18 mm; Annual E1: 0.05 ± 0.21 mm) than Eyes2 (S1E2: 0.51 ± 0.24 mm; Annual E2: 0.52 ± 0.25 mm) (all p < 0.001). During the binocular period, there was no significant difference between S2E1 and S2E2(0.21 ± 0.14 mm v. 0.19 ± 0.17 mm, p = 0.951). Between monocular and binocular periods, Eyes1 had significantly higher S2E1 compared to S1E1 and Annual E1 (both p < 0.001), and Eyes2 had significantly lower S2E2 than S1E2 and Annual E2 (both p < 0.001). In the GEE model, spherical equivalent refraction (SER) and between periods interval time showed independently significant associations with AL growth after adjusting for age and sex.
CONCLUSIONS: Orthokeratology can significantly control AL growth in unilateral myopia. AL growth of the initial myopic OK-treated eyes accelerated relative to the monocular period when contralateral eyes developed myopia and assumed OK treatment. During the binocular treatment phase, OK lenses showed moderate and comparable effects on AL retardation across both eyes.

We herein report a case of a 4-year-old female patient who presented with anisometropic amblyopia with initial visual acuity recorded at 20/400 OD and 20/100 OS. The patient was recommended for patching. Eighteen months later, the patient presented with visual acuity of 20/60 OD and 20/80 and reverse amblyopia was noted. In settings of amblyopia, where alternate patching may be used, it is most likely that reverse amblyopia, if present, will affect the more myopic eye. However, unexpectedly, in this case, reverse amblyopia occurred in the less myopic eye. With discontinuation of occlusion therapy and continued use of optical correction, the patients reverse amblyopia resolved and the visual equity equalized. To our knowledge, this is the first case described in the literature demonstrating such an occurrence. Awareness of this rare presentation by clinicians is of great importance to aid in correctly diagnosing and treating such patients.

Objective: To explore the differences in clinical characteristics and interocular interactions between patients with anisometropic amblyopia and ametropic amblyopia. Methods: Cross-sectional study. The newly diagnosed anisometropic (the binocular difference in spherical equivalent≥1.00 D) amblyopia patients and ametropic amblyopia patients (aged 4 to 6 years) in Beijing Tongren Hospital from January 2020 to December 2022 were involved. Patients were further categorized by the refractive status after cycloplegia, including hyperopia, myopia, astigmatism, hyperopia with astigmatism, myopia with astigmatism, mild anisometropia and severe anisometropia. Quantitative measurements of best-corrected visual acuity (logMAR), stereoacuity (transformed to log units), perceptual eye position and interocular suppression were performed, and the differences between groups were analyzed. The rank sum test was used for statistical evaluation. Results: The average age of 45 ametropic amblyopia patients (21 males and 24 females) and 84 anisometropic amblyopia patients (48 males and 36 females) was 5.0 (4.0, 5.0) years and 5.0 (4.0, 6.0) years, respectively. The interocular differences in spherical equivalent [2.56 (1.50, 4.19) D vs. 0.25 (0.13, 0.56) D] and best-corrected visual acuity [0.40 (0.18, 0.70) logMAR vs. 0.07 (0.00, 0.12) logMAR] were larger in patients with anisometropic amblyopia than those with ametropic amblyopia. The anisometropic amblyopia patients had worse stereoacuity [2.60 (2.00, 2.90) log arcsec vs. 2.00 (2.00, 2.30) log arcsec] and deeper suppression [20.0% (13.3%, 40.0%) vs. 10.0% (0, 23.3%)], compared with the ametropic amblyopia patients. The differences were all statistically significant (P<0.05). The suppression and stereoacuity between patients with hyperopic anisometropic amblyopia [suppression, 30.0% (17.5%, 50.0%); stereoacuity, 2.90 (2.30, 2.90) log arcsec] and astigmatic anisometropic amblyopia [suppression, 10.0% (0, 20.0%); stereoacuity, 2.00 (2.00, 2.30) log arcsec] were significantly different (P<0.05). The differences of suppression and stereoacuity between patients with severe (binocular difference in spherical equivalent>2.50 D) [suppression, 30.0% (20.0%, 53.3%); stereoacuity, 2.90 (2.57, 2.90) log arcsec] and mild anisometropia [suppression, 20.0% (0, 30.0%); stereoacuity, 2.00 (2.00, 2.90) log arcsec] were also statistically significant (P<0.05). Conclusions: Patients with anisometropic amblyopia have deeper binocular suppression, worse stereoacuity and more severe binocular interaction abnormality than those with ametropic amblyopia. The severity of anisometropia affects the degree of the interaction abnormality.
目的： 探讨屈光参差性弱视与屈光不正性弱视的临床特征和双眼之间相互作用的差异。 方法： 横断面研究。收集2020年1月至2022年12月在首都医科大学附属北京同仁医院北京同仁眼科中心就诊的4~6岁初次诊断为屈光参差（双眼等效球镜度数差值≥1.00 D）性弱视和屈光不正性弱视患者，散瞳验光后，根据屈光状态因素进行分类，分为远视、近视、散光、远视合并散光、近视合并散光以及轻度和重度类型。采用定量方法检查每类患者的最佳矫正视力（最小分辨角对数视力）、立体视觉（对数记录）、知觉眼位、抑制度等，并进行比较。采用秩和检验进行统计学分析。 结果： 屈光不正性弱视45例患者，男性21例，女性24例；年龄为5.0（4.0，5.0）岁。屈光参差性弱视84例患者，男性48例，女性36例；年龄为5.0（4.0，6.0）岁。屈光参差性弱视的双眼等效球镜度数差值［2.56（1.50，4.19）D］和双眼最佳矫正视力差值［0.40（0.18，0.70）］更大，立体视觉［2.60（2.00，2.90）］更差，抑制度更重［20.0%（13.3%，40.0%）］，与屈光不正性弱视［0.25（0.13，0.56）D、0.07（0.00，0.12）、2.00（2.00，2.30）、10.0%（0，23.3%）］比较，差异均有统计学意义（均P<0.05）。远视屈光参差性弱视的抑制度［30.0%（17.5%，50.0%）］和立体视觉［2.90（2.30，2.90）］与散光屈光参差性弱视［10.0%（0，20.0%）和2.00（2.00，2.30）］比较，差异均有统计学意义（均P<0.05）。重度屈光参差（双眼等效球镜度数差值>2.50 D）性弱视的抑制度［30.0%（20.0%，53.3%）］和立体视觉［2.90（2.57，2.90）］与轻度屈光参差性弱视［20.0%（0，30.0%）和2.00（2.00，2.90）］比较，差异均有统计学意义（均P<0.05）。 结论： 与屈光不正性弱视比较，屈光参差性弱视的抑制度更重，立体视觉更差，双眼之间相互作用异常更严重。屈光参差度数影响双眼之间作用异常程度。.

OBJECTIVE: Pediatric refractive surgery has been growing at a steady pace since its introduction in the early 1980 s. This article will review common laser refractive surgeries performed on pediatric patients along with controversies regarding the practice.
RESULTS: Pediatric refractive surgery is reserved for a small population of children who fail amblyopic treatment due to high anisometropic refractive errors. Publications over the years have treated these children with various types of laser refractive surgery.
CONCLUSIONS: Laser pediatric refractive surgery appears to be well tolerated and effective for the population of children that need it. It provides an alternative for anisometropic amblyopia treatment for children who would have otherwise not been able to improve their vision.

UNASSIGNED: Individuals with amblyopia experience central vision deficits, including loss of visual acuity, binocular vision, and stereopsis. In this study, we examine the differences in peripheral binocular imbalance in children with anisometropic amblyopia, strabismic amblyopia, and typical binocular vision to determine if there are systematic patterns of deficits across the visual field.
UNASSIGNED: This prospective cohort study recruited 12 participants with anisometropic amblyopia, 10 with strabismic amblyopia, and 10 typically sighted controls (age range, 5-18 years). Binocular imbalance was tested at 0°, 4°, and 8° eccentricities (4 angular locations each) using band-pass filtered Auckland optotypes (5 cycles per optotype) dichoptically presented with differing contrast to each eye. The interocular contrast ratio was adjusted until the participant reported each optotype with equal frequency.
UNASSIGNED: Participants with anisometropic and strabismic amblyopia had a more balanced contrast ratio, or decreased binocular imbalance, at 4° and 8° eccentricities as compared with central vision. Participants with strabismic amblyopia had significantly more binocular imbalance in the periphery as compared with individuals with anisometropic amblyopia or controls. A linear mixed effects model showed a main effect for strabismic amblyopia and eccentricity on binocular imbalance across the visual field.
UNASSIGNED: There is evidence of decreased binocularity deficits, or interocular suppression, in the periphery in anisometropic and strabismic amblyopia as compared with controls. Notably, those with strabismic amblyopia exhibited more significant peripheral binocular imbalance. These variations in binocularity across the visual field among different amblyopia subtypes may necessitate tailored approaches for dichoptic treatment.

BACKGROUND: This study aimed to explore the functional connectivity of the primary visual cortex (V1) in children with anisometropic amblyopia by using the resting-state functional connectivity analysis method and determine whether anisometropic amblyopia is associated with changes in brain function.
METHODS: Functional magnetic resonance imaging (fMRI) data were obtained from 16 children with anisometropia amblyopia (CAA group) and 12 healthy children (HC group) during the resting state. The Brodmann area 17 (BA17) was used as the region of interest, and the functional connection (FC) of V1 was analyzed in both groups. A two-sample t test was used to analyze the FC value between the two groups. Pearson\'s correlation was used to analyze the correlation between the mean FC value in the brain function change area of the CAA group and the best corrected visual acuity (BCVA) of amblyopia. p < 0.05 was considered statistically significant.
RESULTS: There were no significant differences in age and sex between the CAA and HC groups (p > 0.05). Compared to the HC group, the CAA group showed lower FC values in BA17 and the left medial frontal gyrus, as well as BA17 and the left triangle inferior frontal gyrus. Conversely, the CAA group showed higher FC values in BA17 and the left central posterior gyrus. Notably, BCVA in amblyopia did not correlate with the area of change in mean FC in the brain function of the CAA group.
CONCLUSIONS: Resting-state fMRI-based functional connectivity analysis indicates a significant alteration in V1 of children with anisometropic amblyopia. These findings contribute additional insights into the neuropathological mechanisms underlying visual impairment in anisometropic amblyopia.

OBJECTIVE: This study aims to investigate the relationship between the type and severity of refractive error and anisometropia development in preschool children.
METHODS: Retrospective cohort study.
METHODS: Data from Maccabi Healthcare Services, Israel\'s second-largest Health Maintenance Organization (HMO), were analyzed. The study included all isometropic children aged 1 to 6 years, re-examined for refraction at least 2 years following their initial examination between 2012 and 2022. Anisometropia was defined as a ≥1 diopter interocular difference in spherical equivalent. Relationships were assessed using logistic regression models adjusted for key sociodemographic factors.
RESULTS: Among 33,496 isometropic children (51.2% male, mean age 3.2 ± 1.5 years), the prevalences of emmetropia, myopia, and hyperopia were 26.7% (n = 8944), 4.2% (n = 1397), and 69.1% (n = 23,155), respectively. Over a mean follow-up period of 5.1 ± 2.4 years, 2593 children (7.7%) were diagnosed with anisometropia. Adjusted odds ratios (ORs) for anisometropia gradually increased with baseline refractive error severity, reaching 13.90 (5.32-36.34) in severe myopia and 4.19 (3.42-5.15) in severe hyperopia. This pattern was also evident in cylindrical anisometropia, where ORs increased with greater baseline astigmatism, peaking at 12.10 (9.19-15.92) in children with high astigmatism (≥3 D). Associations remained consistent in sensitivity and subgroup analyses including across both sexes and when using a stricter anisometropia criterion.
CONCLUSIONS: Children aged 1 to 6 years, initially without anisometropia but showing increasing severity of myopia, hyperopia, or astigmatism, are more likely to develop anisometropia. This underscores the importance of follow-up refractive measurements within this population to promptly diagnose and treat anisometropia and prevent potential visual complications.