Persistent fetal vasculature (PFV) is a rare ocular developmental disorder resulting from incomplete apoptosis of the embryonic hyaloid vasculature during the in-utero period. Variability in the development and regression of hyaloid vasculature is responsible for the wide range of clinical presentation of the disorder. PFV may manifest as anterior segment abnormalities (cataract, glaucoma, microphthalmia, elongated ciliary process with central traction, retrolental membrane, and shallow anterior chamber), posterior segment abnormalities (vitreous stalk, preretinal membranes, optic hypoplasia, and retinal folds), or with a combined anteroposterior disease. The most common associated clinical feature is leukocoria with microphthalmia and usually unilateral presentation. Most of the cases have poor visual prognosis and present early in childhood. Association with myopia is a very rare and atypical presentation, especially unilateral cases which may present later in life and have a good visual prognosis. Hereby, we present a case of a 27-year-old young adult male with unilateral atypical myopic posterior PFV with anisometropic amblyopia and good functional vision in the right eye.

OBJECTIVE: To evaluate and contrast the contrast sensitivity defects present in strabismic and anisometropic amblyopes. And to find out the association of contrast deterioration with the visual acuity of the amblyopic eye, the magnitude of strabismus, and the amount of anisometropia in both groups.
METHODS: This cross-sectional study was carried out in the orthoptics unit of a tertiary eye care facility between October 2021 and December 2021. There were 45 patients altogether. In the first phase, the patient\'s history and ocular examination data were recorded after informed consent. The Pelli-Robson chart was used to measure contrast sensitivity. In the second phase, results were interpreted using the SPSS (Statistical Package for the Social Sciences) version 26.0.
RESULTS: Strabismic amblyopes were 24 and anisometropic amblyopes were 21. A significant positive association existed between both groups\' contrast sensitivity and visual acuity (P = 0.000). A moderately negative correlation between contrast and anisometropia was statistically significant (P = 0.025) in anisometropic amblyopes. However, no association (P > 0.050) existed between the contrast and magnitude of strabismus in any group.
CONCLUSIONS: The study concluded that contrast sensitivity decreases in both groups, whereas anisometropic amblyopes have poorer contrast than strabismic amblyopes. Excessively decreased contrast sensitivity among anisometropic amblyopes was solely because of the worst amblyopia in this group, whereas the magnitude of strabismus does not affect contrast sensitivity.

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.

UNASSIGNED: To be successful, amblyopia therapeutic techniques must respond when ingenious (shrewd) amblyopic children sabotage treatment effect by discovering ways(1) to alter those therapy aspects they find frustrating.
UNASSIGNED: Her guardian consented to IRB-approved study outside typical FDA enrollment guidelines for CureSight dichoptic therapy. Acuity (EVA) and stereopsis was by PEDIG protocols.
UNASSIGNED: A 6-year-old rural Alaska native girl in foster care had previously been diagnosed with anisometropic amblyopia and treated with spectacles and patching but had poor compliance with BCVA 0.9-1.0 logMAR. She demonstrated exceptional creativity and hyperactivity but had no other medical issues. Atropine was prescribed in addition to her spectacles +5.50+1.00x90 and +0.50+1.00x90, but the patient discovered the rare \"Spectacle Flip\" method that sabotaged therapeutic impact. She had EVA enrollment acuities of logMAR 0.9 right and -0.1 left with stereo 400 seconds of arc. After just one month dichoptic therapy 1.5 hours 6 days per week, acuity improved to logMAR 0.7 and -0.1 with stereo up to 140 second of arc. Four months later acuity was 0.6 right and -0.2 left. Stereoacuity improved from 400 to 200 arc seconds.
UNASSIGNED: Even when conventional compliance methods fail, dichoptic therapy with eye-tracking has the novel and unique potential to improve amblyopia treatment compliance with real-time monitored fixation compliance and confirmation of correct spectacle wear.
UNASSIGNED: NCT06165705.
Dichoptic therapy with eye-tracking improved compliance and achieved de novo acuity and stereo gains in a girl with severe refractory anisometropic amblyopia compounded by the rare complication of topical atropine therapy called “spectacle-flip sabotage”.

OBJECTIVE: To observe the clinical efficacy of Tiaoqi Tongjing Mingmu acupuncture (acupuncture for regulating qi, unblocking meridians and brightening eyes) combined with conventional treatment for anisometropic amblyopia children.
METHODS: A total of 76 children with monocular anisometropic amblyopia were randomized into an observation group (38 cases, 2 cases dropped out) and a control group (38 cases). The lens covering therapy was adopted in both groups. The conventional treatment i.e. red flash, grating and visual stimulation was given in the control group, 5 min for one item each time; on the basis of the treatment in the control group, acupuncture was applied at bilateral Jingming (BL 1), Cuanzhu (BL 2), Fengchi (GB 20) and Guangming (GB 37) in the observation group. Both groups were treated once every other day, 3 times a week for 4 weeks. Before and after treatment, the best corrected visual acuity, the latency and amplitude of P100 wave of pattern visual evoked potential (P-VEP), the diopter (spherical equivalent [SE]) were observed, the stereoacuity was measured by Titmus stereoscopic examination, and the clinical efficacy was evaluated in both groups.
RESULTS: Compared with those before treatment, the best corrected visual acuity improved (P<0.05), the latency of P-VEP P100 wave was shortened and the amplitude of P-VEP P100 wave was increased (P<0.05), and the SE and Titmus values were decreased (P<0.05) after treatment in both groups. After treatment, in the observation group, the best corrected visual acuity was higher (P<0.05), the latency of P-VEP P100 wave was shorter and the amplitude of P-VEP P100 wave was higher (P<0.05), SE and Titmus values were lower (P<0.05) than those in the control group. The total effective rate was 86.1% (31/36) in the observation group, which was superior to 65.8% (25/38) in the control group (P<0.05).
CONCLUSIONS: During the visual plasticity period, Tiaoqi Tongjing Mingmu acupuncture combined with conventional treatment can effectively improve the best corrected vision, diopter and stereoacuity in children with anisometropic amblyopia, and enhance the nerve conduction function from retina to visual cortex. Its effect is superior to that of simple conventional treatment.
目的: 观察“调气通经明目”针刺联合常规疗法治疗儿童屈光参差性弱视的临床疗效。方法: 将76例屈光参差性单眼弱视患儿随机分为观察组（38例，脱落2例）和对照组（38例）。两组均予配镜遮盖治疗，对照组予常规治疗（红闪、光栅、视刺激），每次每项5 min；观察组在对照组治疗基础上，针刺双侧睛明、攒竹、风池、光明。两组均隔日1次，每周3次，共治疗4周。分别于治疗前后观察两组患儿最佳矫正视力、图形视觉诱发电位（P-VEP）P100波潜伏期及振幅、屈光度［等效球镜度数（SE）值］，采用Titmus立体视图检查近立体视锐度，并评定两组临床疗效。结果: 与治疗前比较，治疗后两组患儿最佳矫正视力提高（P<0.05），P-VEP P100波潜伏期缩短、振幅升高（P<0.05），SE值、Titmus值降低（P<0.05）；治疗后，观察组最佳矫正视力高于对照组（P<0.05），P-VEP P100波潜伏期短于对照组、振幅高于对照组（P<0.05），SE值、Titmus值低于对照组（P<0.05）。观察组总有效率为86.1%（31/36），高于对照组的65.8%（25/38，P<0.05）。结论: 在视觉可塑期内，“调气通经明目”针刺联合常规治疗可有效改善屈光参差性弱视患儿最佳矫正视力、屈光度和立体视锐度，增强视网膜至视皮层神经传导功能，疗效优于单纯常规治疗。.

OBJECTIVE: To explore the brain mechanism of acupuncture for children with anisometropic amblyopia using the voxel-mirror homotopic connectivity (VMHC) analysis method of resting functional magnetic resonance imaging (rs-fMRI) technology based on clinical effectiveness.
METHODS: Eighty children with anisometropic monocular amblyopia were randomly divided into two groups: control (40 cases, 1 case of shedding) and acupuncture (40 cases, 1 case of shedding) groups. The control group was treated with glasses, red flash, grating, and visual stimulations, with each procedure conducted for 5min per time. Based on routine treatment, the acupuncture group underwent acupuncture of \"regulating qi and unblocking meridians to bright eyes\", Jingming (BL1), Cuanzhu (BL2), Guangming (GB37), Fengchi (GB20) acupoints were taken on both sides, with the needle kept for 30min each time. Both groups were treated once every other day, three times per week, for a total of 4wk. After the treatment, the overall curative effect of the two groups and the latency and amplitude changes of P100 wave of pattern visual-evoked potential were counted. At the same time, nine children with left eye amblyopia were randomly selected from the two groups and were scanned with rs-fMRI before and after treatment. The differences in the brain regions between the two groups were compared and analyzed with VMHC.
RESULTS: Chi-square test showed a notable difference in the total efficiency rate between the acupuncture (94.87%) and control groups (79.49%). Regarding the P100 wave latency and amplitude, the acupuncture group had significantly shorter latency and higher amplitude of P100 wave than the control group. Moreover, the VMHC values of the bilateral temporal lobe, superior temporal gyrus, and middle temporal gyrus were notably increased in the acupuncture group after treatment.
CONCLUSIONS: Acupuncture combined with conventional treatment can significantly improve the corrected visual acuity and optic nerve conduction in children with anisometropic amblyopia. Compared with the conventional treatment, the regulation of acupuncture on the functional activities of the relevant brain areas in the anterior cerebellum may be an effective acupuncture mechanism for anisometropic amblyopia.

UNASSIGNED: Recent investigations observed substantial enhancements in binocular balance, visual acuity, and stereovision among older children and adults with amblyopia by patching the amblyopic eye (i.e., inverse patching) for 2 h daily over 2 months. Despite these promising findings, the precise neural mechanisms underlying inverse patching remain elusive. This study endeavors to delve deeper into the neural alterations induced by inverse patching, focusing on steady-state visual evoked potentials (SSVEPs). We specifically investigate the changes in SSVEPs following monocular deprivation of either the fellow eye or the amblyopic eye in older amblyopic children and adults.
UNASSIGNED: Ten participants (17.60 ± 2.03 years old; mean ± SEM), clinically diagnosed with anisometropic amblyopia, were recruited for this study. Each participant underwent a 120 min patching session on their fellow eye on the first day, followed by a similar session on their amblyopic eye on the second day. Baseline steady-state visual evoked potentials (SSVEPs) measurements were collected each day prior to patching, with post-patching SSVEPs measurements obtained immediately after the patching session. The experimental design incorporated a binocular rivalry paradigm, utilizing SSVEPs measurements.
UNASSIGNED: The results revealed that inverse patching induced a heightened influence on neural plasticity, manifesting in a reduction of interocular suppression from the fellow eye to the amblyopic eye. In contrast, patching the fellow eye demonstrated negligible effects on the visual cortex. Furthermore, alterations in interocular suppression subsequent to inverse patching exhibited a correlation with the visual acuity of the amblyopic eye.
UNASSIGNED: Inverse patching emerges as a promising therapeutic avenue for adolescents and adults grappling with severe anisometropic amblyopia that proves refractory to conventional interventions. This innovative approach exhibits the potential to induce more robust neural plasticity within the visual cortex, thereby modulating neural interactions more effectively than traditional amblyopia treatments.

BACKGROUND: Amblyopia treatment by occluding the healthy eye is known to be effective during a sensitive critical period. This study aims to clarify the factors for the total occlusion time (TOT) required for the amblyopic eye to achieve a normal visual acuity (VA) level of 1.0 (0.0 logMAR equivalent). This could contribute to an efficient treatment plan for eyes with hyperopic anisometropic amblyopia.
METHODS: Subjects were 58 patients (26 boys and 32 girls; age range, 3.6-9.2, average, 5.8 ± 1.3 years) with hyperopic anisometropic amblyopia. All the subjects had initially visited and completed occlusion therapy with improved VA of 1.0 or better in the amblyopic eye at Kindai University Hospital between January 2007 and March 2017. Using the subjects\' medical records, we retrospectively investigated five factors for the TOT: the age at treatment, the initial VA of the amblyopic eye, refraction of the amblyopic eye, anisometropic disparity, and the presence of microstrabismus. Patient\'s VA improvement at one month after treatment was also evaluated to confirm the effect of the occlusion therapy.
RESULTS: The initial VA of the amblyopic eye ranged from 0.1 to 0.9 (median, 0.4). The TOT ranged from 140 to 1795 (median, 598) hours with an average daily occlusion time of 7 hours. The initial VA of the amblyopic eye and presence of microstrabismus were the significant factors for the TOT (p < 0.01). To achieve VA of 1.0 or better, patients with an initial VA of ≤ 0.3 in the amblyopic eye required a longer TOT. Moreover, patients with concomitant microstrabismus required a 1.7-fold longer TOT compared to those without microstrabismus.
CONCLUSIONS: Longer daily occlusion hours and early start of the treatment will be necessary for patients with poor initial VA or microstrabismus to complete occlusion therapy within the sensitive critical period.

Amblyopia affects development of children\'s monocular vision and binocular function and becomes a largely intractable problem with increasing aging. This study is to investigate the binocular function and evaluate efficacy of digital therapy in children 8-13 years of age with anisometropic amblyopia. The patients in the digital therapy group performed the training with the digital amblyopia therapeutic software. The visual acuity and binocular function (perceptual eye position [PEP], suppression, and stereopsis) were examined at the first visit and 3-month post-treatment. Twenty-three cases in the control group and 25 cases in the digital therapy group were enrolled. The results revealed that 3-month digital therapy can effectively improve corrected distance visual acuity (CDVA) and improve the binocular function, including PEP, suppression, and second-order stereopsis in children with anisometropic amblyopia, 8-13 years of age. Digital therapy for amblyopia can effectively improve monocular CDVA of amblyopic eyes and binocular function in older children with anisometropic amblyopia.

The most common causes of vision loss in neurofibromatosis 1 (NF1) patients are sequelae from tumors such as optic pathway glioma, plexiform neurofibroma, or secondary glaucoma. Here we report the case of a six-year-old female with anisometropic amblyopia resulting from an isolated unilateral macro-ophthalmia with a known history of NF1. Our patient progressed to light perception vision in the left eye due to a non-neoplastic cause associated with NF1 with at least two years of documented unilateral macro-ophthalmia without any ophthalmology referral or evaluation. This case aims to highlight the importance of early and deliberate ophthalmologic examination in all patients with neurofibromatosis 1 to assess for appropriate visual development and early intervention.