Adult Eye Research Articles

Choroidal thickness in macular, nasal midperiphery, and temporal midperiphery regions and its relationship with axial length and refractive error.

This study aimed to investigate the choroidal thickness (ChT) distribution in adult myopic eyes, focusing on the macular, nasal midperiphery, and temporal midperiphery regions, and to explore its relationship with axial length (AL) and refractive error. A cross-sectional, observational study. Twenty-nine eyes of 29 adult volunteers were examined. ChT was measured using high-speed swept-source optical coherence tomography covering an area of 50 degrees in three different regions: centered at macular, nasal side at 33 degrees, and temporal side at 33 degrees. Statistical analyses were performed to assess differences in ChT between regions and correlations with AL and spherical equivalent (SE). ChT was found to be thickest in the macular region, followed by the nasal and temporal midperiphery regions. Significant correlations were observed between AL/SE and ChT in the macular and temporal regions, but not in the nasal region. The temporal midperiphery showed the strongest correlation with AL and SE. This study revealed a nasal-temporal asymmetry in ChT distribution in myopic eyes, with the temporal midperiphery showing the thinnest ChT. The strong correlations between ChT in the temporal midperiphery and AL/SE suggest a role for the temporal choroid in axial elongation and myopia progression. These findings highlight the importance of considering peripheral ChT in understanding ocular growth and myopia management.

Punctate hyperreflective vitreous opacities: a ubiquitous finding in healthy children beyond infancy.

The vitreous evolves from birth over lifetime. Little is known about the appearance of the healthy vitreous during childhood. We aimed to characterise posterior vitreous features in healthy children using spectral domain optical coherence tomography (SD-OCT). Retrospective cohort study including healthy eyes of 78 children aged 2-12 years and 39 healthy adults. Patients diagnosed with intraocular inflammation or vitreoretinal pathology were excluded. Proportion of eyes with presence of punctate hyperreflective vitreous opacities (PHVO). Percentage of B-scans demonstrating PHVO within an OCT volume scan, correlation between presence of PHVO and patients' age group, retinal measurements, and presence of premacular bursa were analysed. 154 paediatric eyes (median age 9.08 (IQR 5.17-9.75) years) and 76 adult eyes (30.75 (IQR 26.42-38.08) years) were included; 12244 OCT images were reviewed. All eyes (100%) in the paediatric group and 73% in the adult group presented PHVO. The median percentage of OCT images showing PHVO was 77.05% (IQR 51.23-88.52) in children and 8.0% (IQR 0-16.03) in adults (p < 0.001). Separate analysis of right and left eyes confirmed the results (p < 0001). Premacular bursa appeared in 20.5% of paediatric and 31.6% of adult eyes (p = 0.103). Mean central subfield thickness was significantly lower in children (257 ± 21 µm vs. 276 ± 18 µm, p < 0.001), while median total macular volume was similar (8.59 (IQR 8.25-8.86) mm3 vs. 8.62 (IQR 8.39-8.96) mm3, p = 0.145). This study demonstrates that PHVO are ubiquitous physiologic vitreous findings in healthy children beyond infancy. These findings enhance the understanding of the development of the posterior segment of the eye and might improve paediatric OCT interpretation, potentially avoiding misdiagnoses and unnecessary interventions in children.

The Endogenous Expression of BMI1 in Adult Human Eyes.

BMI1, also known as B lymphoma Mo-MLV insertion region 1, is a protein in the Polycomb group that is implicated in various cellular processes, including stem cell self-renewal and the regulation of cellular senescence. BMI1 plays a role in the regulation of retinal progenitor cells and the renewal of adult neuronal cells. However, the presence, location, and quantification of BMI1 in the adult human eye have never previously been reported. In this study, we collected 45 frozen globes from eye banks, and ocular tissues were dissected. Protein was quantified by utilizing a custom electrochemiluminescence (ECL) assay developed to quantify the BMI1 protein. BMI1 was found in all ocular tissues at the following levels: the retina (1483.6 ± 191.7 pg/mL) and the RPE (296.4 ± 78.1 pg/mL). BMI1 expression was noted ubiquitously in the GCL (ganglion cell layer), the INL (inner nuclear layer), the ONL (outer nuclear layer), and the RPE (retinal pigment epithelium) via immunofluorescence, with higher levels in the inner than in the outer retinal layers and the RPE. These data confirm that BMI1 is expressed in the human retina. Further studies will illuminate the role that BMI1 plays in ocular cells. BMI1 levels are lower in aged retinas, possibly reflecting changes in retinal somatic and stem cell maintenance and disease susceptibility.

Vitreoretinal Surgery in Pediatric Patients with the Disease of Vitreoretinal Interface

Comparing the ocular anatomy of children and adults, there are certain dimensions and structural differences. A safer surgical method is made possible by an understanding of the major distinctions between the eyes of children and adults,and specific evaluations are required. The primary distinctions are in the locations of sclerotomies, the requirement for posterior hyaloid separation and total vitrectomy, endo-tamponade, and the surgical technique according to the vitreoretinal disease. We tried to summarize the main differences in pediatric patients with the disease of the vitreoretinal interface compared to adult vitreoretinal surgery and some critical points for this surgery.

Oculomotor Behaviour in Individuals with Long COVID-19

Objective To determine, the impact of long COVID-19 on oculomotor behaviour. Design A case–control study. Setting Spanish Association of Persistent COVID. Participant Participants were 75 cases (64 women, 11 men, mean age 46.4 years ±8.9) and 42 controls (22 women, 20 men, mean age 53.5 years ±13.13). Intervention An eye-tracking test based on visual search paradigm and the Adult Developmental Eye Movement Test were used to evaluate the participants. Main measures The primary outcomes in the Adult Developmental Eye Movement Test were horizontal reading time, vertical reading time, and their ratio. And for the eye-tracking test the time to find the target, the duration, and the number of eye fixations. Results In cases and controls, eye movement test results were horizontal(Hadj) reading time 74.2 ± 22.7 s vs 52.0 ± 6.1 s (p < .0001); vertical(Vadj) reading time 67.6 ± 17.8 s vs 50.4 ± 6.9 s (p < .0001); Hadj/Vadj ratio 0.9 ± 0.1 vs 1.0 ± 0 (p = .0032), respectively; and eye-tracking test results were fixation number 11.3 ± 3.07 vs 3.51 ± 2.57 (p < .0001); fixation duration 2.01 ± 0.79 s vs 1.5 ± 0.4 s (p = .0013), and time to find target 24.5 ± 8.0 vs 18 ± 9.4 (p = .0034), respectively. Conclusions Data showed a lower performance in oculomotor behaviour in people with long COVID-19, compared to healthy individuals. It cannot be affirmed an ocular musculature dysfunction; the differentiated behaviour could be associated to cognitive alterations affected in these people. Both tests used could be an useful tool for the clinical assessment of these participants. Further studies are needed to explore the utility of these procedures.

The Microphthalmia-Associated Transcription Factor (MITF) and Its Role in the Structure and Function of the Eye.

The microphthalmia-associated transcription factor (Mitf) has been found to play an important role in eye development, structure, and function. The Mitf gene is responsible for controlling cellular processes in a range of cell types, contributing to multiple eye development processes. In this review, we survey what is now known about the impact of Mitf on eye structure and function in retinal disorders. Several mutations in the human and mouse Mitf gene are now known, and the effects of these on eye phenotype are addressed. We discuss the importance of Mitf in regulating ion transport across the retinal pigment epithelium (RPE) and the vasculature of the eye. The literature was searched using the PubMed, Scopus, and Google Scholar databases. Fundus and Optical Coherence Tomography (OCT) images from mice were obtained with a Micron IV rodent imaging system. Defects in neural-crest-derived melanocytes resulting from any Mitf mutations lead to hypopigmentation in the eye, coat, and inner functioning of the animals. While many Mitf mutations target RPE cells in the eye, fewer impact osteoclasts at the same time. Some of the mutations in mice lead to microphthalmia, and ultimately vision loss, while other mice show a normal eye size; however, the latter, in some cases, show hypopigmentation in the fundus and the choroid is depigmented and thickened, and in rare cases Mitf mutations lead to progressive retinal degeneration. The Mitf gene has an impact on the structure and function of the retina and its vasculature, the RPE, and the choroid in the adult eye.

The Analysis Study of Prevalence, Diagnosis, and Management of Cataract in Adult Eye: A Comprehensive Systematic Review

Background: Cataract remains a major cause of visual impairment worldwide. However, in many countries cataract surgery is easily available. Cataract surgery is a kind of effective way to deal with cataract, but it is acompanied with many surgical complications and expensive costs that present enormous social and economic problems to a society, especially in the remote and poor areas of developing countries. The aim: The aim of this study to show about prevalence, diagnosis, and management of cataract in adult eye. Methods: By the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. Result: Eight publications were found to be directly related to our ongoing systematic examination after a rigorous three-level screening approach. Subsequently, a comprehensive analysis of the complete text was conducted, and additional scrutiny was given to these articles. Conclusion: Cataracts to increase in the near future due to an increase in the aging population and pre-senile cataracts. The current study also provides clinical determinants for cataract and cataract surgery. Since cataract has emerged as a public concern and the cost burden for cataract surgery has increased with an aging population, it is expected that the present study will form a cornerstone for further investigations and the establishment of a public health plan.

Axial length reduction and choroidal thickening with short-term exposure to cyan light in human subjects.

Given the potential role of light and its wavelength on ocular growth, this study investigated the effect of short-term exposure to red, cyan and blue light on ocular biometry in humans. Forty-four young adults and 20 children, comprising emmetropes and myopes, underwent 2-h sessions of cyan (507 nm), red (638 nm) and broadband white light on three separate days via light-emitting glasses. Additionally, young adults were exposed to blue light (454 nm) on an additional day. Axial length (AL) and choroidal thickness (CT) were measured in the right eye before the light exposure (0 min), after 60 and 120 min of exposure and 30 min after light offset using an optical biometer and optical coherence tomographer, respectively. Compared to broadband light, exposure to red light resulted in a significant increase in AL (mean difference between white and red light at 120 min, +0.007 mm [0.002]), but no significant change in CT, while cyan light caused a significant AL reduction (-0.010 mm [0.003]) and choroidal thickening (+0.008 mm [0.002]) in young adults (p < 0.05). Blue light caused a significant decrease of -0.007 mm (0.002) in young adult eyes at 60 min (p < 0.05). In children, cyan light led to a significant reduction in AL (-0.016 mm [0.004]) and strong sustained choroidal thickening (+0.014 mm [0.004]) compared to broadband light at 120 min (p < 0.05). The effects of cyan light on AL and CT were found to be stronger in myopic young adults and emmetropic children. The opposing effects of red and cyan light on ocular biometry were similar between the two age groups (p > 0.05). Exposure to cyan light resulted in AL reduction and choroidal thickening in both young adults and children. Further research is needed to determine the application of these results in developing interventions for myopia control.

Inner retinal layer thickness alterations in adult and pediatric patients with neurofibromatosis 1

This study compared the thickness of each intraretinal layer in patients with neurofibromatosis 1 (NF1) and controls to analyze the association between intraretinal layer thickness and visual function. The macular spectral-domain optical coherence tomography volumetric dataset obtained from 68 eyes (25 adult eyes, 43 pediatric eyes) with NF1 without optic glioma and 143 control eyes (100 adult eyes, 43 pediatric eyes) was used for image auto-segmentation. The intraretinal layers segmented from the volumetric data included the macular retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer (GCIPL), inner nuclear layer, outer plexiform layer, outer nuclear layer, and photoreceptor layer. Cases and controls were compared after adjusting for age, sex, refractive error, and binocular use. The association between retinal layer thickness and visual acuity was also analyzed. The GCIPL was significantly thinner in both adult and pediatric patients with NF1 compared with healthy controls. Average RNFL and GCIPL thicknesses were associated with visual acuity in adult patients with NF1. In pediatric patients, average GCIPL thickness was associated with visual acuity. These results suggest that changes in the inner retinal layer could be a biomarker of the structural and functional status of patients with NF1.

Late Bedtime and Altered Diurnal Axial Length Rhythms of the Eye

Purpose Affecting one-third of the population worldwide and increasing, the sight-threatening condition myopia is causing a significant socio-economic burden. To better understand its etiology, recent studies investigated the role of ocular and systemic rhythms, yet results are conflicting. Here we profiled 24-h variations of axial length of the eye and salivary melatonin concentration in young adults with and without myopia and explored the potential impacts of bedtime on these rhythms. Methods A total of 25 healthy young adults (age 25.0 ± 4.8 years, 13 females) completed this study, including 13 myopes (mean spherical equivalent refractive error −2.93 ± 1.46 diopters) and 12 non-myopes (0.14 ± 0.42 diopters). Saliva sample collection and axial length measurements were repeated for seven times over 24 h starting from 8 am. Information on sleep and chronotype was collected at first visit with the Pittsburgh Sleep Quality Index and the Morningness-Eveningness Questionnaire. Results Significant diurnal rhythms of axial length and salivary melatonin concentration were identified in both refractive groups (both p < 0.001), with no myopia-related rhythm difference (interaction of measurement time-point × myopia, p = 0.9). Late bedtime was associated with altered rhythms (p = 0.009) and smaller diurnal change (p = 0.01) in axial length. Elevated melatonin levels were observed in myopes (p = 0.006) and in late sleepers (p = 0.017). Conclusions These findings suggest that sleep/wake cycles may be involved in the regulation of axial length rhythms. Further research is needed to determine if there exists a causal relationship between the two.

An accessible digital imaging workflow for multiplexed quantitative analysis of adult eye phenotypes in Drosophila melanogaster.

The compound eye of Drosophila melanogaster has long been a model for studying genetics, development, neurodegeneration, and heterochromatin. Imaging and morphometry of adult Drosophila and other insects is hampered by the low throughput, narrow focal plane, and small image sensors typical of stereomicroscope cameras. When data collection is distributed among many individuals or extended time periods, these limitations are compounded by inter-operator variability in lighting, sample positioning, focus, and post-acquisition processing. To address these limitations we developed a method for multiplexed quantitative analysis of adult Drosophila melanogaster phenotypes. Efficient data collection and analysis of up to 60 adult flies in a single image with standardized conditions eliminates inter-operator variability and enables precise quantitative comparison of morphology. Semi-automated data analysis using ImageJ and R reduces image manipulations, facilitates reproducibility, and supports emerging automated segmentation methods, as well as a wide range of graphical and statistical tools. These methods also serve as a low-cost hands-on introduction to imaging, data visualization, and statistical analysis for students and trainees.

Temporal Transcriptomic Profiling of the Developing Xenopus laevis Eye.

Retinal progenitor cells (RPCs) are a multipotent and highly proliferative population that give rise to all retinal cell types during organogenesis. Defining their molecular signature is a key step towards identifying suitable approaches to treat visual impairments. Here, we performed RNA sequencing of whole eyes from Xenopus at three embryonic stages and used differential expression analysis to define the transcriptomic profiles of optic tissues containing proliferating and differentiating RPCs during retinogenesis. Gene Ontology and KEGG pathway analyses showed that genes associated with developmental pathways (including Wnt and Hedgehog signaling) were upregulated during the period of active RPC proliferation in early retinal development (Nieuwkoop Faber st. 24 and 27). Developing eyes had dynamic expression profiles and shifted to enrichment for metabolic processes and phototransduction during RPC progeny specification and differentiation (st. 35). Furthermore, conserved adult eye regeneration genes were also expressed during early retinal development, including sox2, pax6, nrl, and Notch signaling components. The eye transcriptomic profiles presented here span RPC proliferation to retinogenesis and include regrowth-competent stages. Thus, our dataset provides a rich resource to uncover molecular regulators of RPC activity and will allow future studies to address regulators of RPC proliferation during eye repair and regrowth.

Spatial arrangement, polarity, and posttranslational modifications of the microtubule system in the Drosophila eye

We have analyzed the organization of the microtubule system in photoreceptor cells and pigment cells within the adult Drosophila compound eye. Immunofluorescence localization of tubulin and of Short stop, a spectraplakin that has been reported to be involved in the anchorage of microtubule minus ends at the membrane, suggests the presence of non-centrosomal microtubule-organizing centers at the distal tip of the visual cells. Ultrastructural analyses confirm that microtubules emanate from membrane-associated plaques at the site of contact with cone cells and that all microtubules are aligned in distal–proximal direction within the photoreceptor cells. Determination of microtubule polarities demonstrated that about 95% of the microtubules in photoreceptor cells are oriented with their plus end in the direction of the synapse. Pigment cells in the eye contain only microtubules aligned in distal–proximal direction, with their plus end pointing towards the retinal floor. There, two populations of microtubules can be distinguished, single microtubules and bundled microtubules, the latter associated with actin filaments. Whereas microtubules in both photoreceptor cells and pigment cells are acetylated and mono/bi-glutamylated on α-tubulin, bundled microtubules in pigment cells are apparently also mono/bi-glutamylated on β-tubulin, providing the possibility of binding different microtubule-associated proteins.

Generalised models of the vertebrate eye.

To present a set of closed-form analytical equations to create a consistent eye model balance based on clinically measured input parameters in a single step. These models complement the existing iterative approaches in the literature. Two different approaches are presented, both considering the cornea and lens as equivalent thin lenses. The first, called the Gaussian model, starts by defining the refractive error as the difference between the axial power (or dioptric distance) and the whole eye power, which can be expanded by filling in the formulas for each power. The resulting equation can be solved for either the refractive error, axial length, corneal power, lens power or the distance between the cornea and the lens as a function of the other four parameters. The second approach uses vergence calculations to provide alternative expressions, assuming that the refractive error is located at the corneal plane. Both models are explored for a biometric range typically found in adult human eyes. The Gaussian and vergence models each instantly balance the input data into a working eye model over the human physiological range and far beyond as demonstrated in various examples. The equations of the Gaussian model are more complicated, while the vergence model experiences more singularities, albeit in trivial or highly unlikely parameter combinations. The proposed equations form a flexible and robust platform to create eye models from clinical data. Possible applications lie in creating animal eye models or providing a generic reference for real biometric data and the relationships between the ocular dimensions.

A nuclear jamming transition in vertebrate organogenesis.

Jamming of cell collectives and associated rigidity transitions have been shown to play a key role in tissue dynamics, structure and morphogenesis. Cellular jamming is controlled by cellular density and the mechanics of cell-cell contacts. However, the contribution of subcellular organelles to the physical state of the emergent tissue is unclear. Here we report a nuclear jamming transition in zebrafish retina and brain tissues, where physical interactions between highly packed nuclei restrict cellular movements and control tissue mechanics and architecture. Computational modelling suggests that the nuclear volume fraction and anisotropy of cells control the emerging tissue physical state. Analysis of tissue architecture, mechanics and nuclear movements during eye development show that retina tissues undergo a nuclear jamming transition as they form, with increasing nuclear packing leading to more ordered cellular arrangements, reminiscent of the crystalline cellular packings in the functional adult eye. Our results reveal an important role of the cell nucleus in tissue mechanics and architecture.

A cross-over, randomised feasibility study of digitally-printed versus hand-painted artificial eyes in adults: PERSONAL-EYE-S.

Over 60,000 patients in the United Kingdom are estimated to have artificial eyes. Manufacturing and hand-painting of artificial eyes have not changed significantly since 1948. Delays and colour-matching issues may severely impact a patient's rehabilitation pathway. Technology advances mean alternatives are now possible. This cross-over, randomised feasibility trial aimed to determine the feasibility of conducting a full-scale trial of the effectiveness and cost-effectiveness of digitally-printed artificial eyes compared to hand-painted. Patients aged ≥18 years who were longstanding artificial eye users requiring a replacement were randomised to receive either a hand-painted or digitally-printed eye first followed by the other type of eye. Participants were asked to approach a close contact (CC) willing to participate alongside them. A subset of participants, their CCs, and staff were interviewed about their opinions on trial procedures, artificial eyes, delivery times and satisfaction. Thirty-five participants were randomised and 10 CCs consented. Participant retention at final follow-up was 85.7%. Outcome data completion rates ranged from 91-100%. EQ-5D-5L completion ranged from 83-97%. Resource-use completion ranged from 0-94% with total costs at £347 for hand-painted and £404 for digitally-printed eye. There were two adverse events. Twelve participants, five CCs, and five staff were interviewed. There were positive and negative features of both types of eyes. We identified that social and psychological wellbeing is affected, often for many years after eye removal. Participation in the feasibility study was well accepted. The feasibility study outcomes indicate that a full trial is achievable. ISRCTN85921622.

Temporal Transcriptomic Profiling of the Developing Xenopus laevis Eye.

Retinal progenitor cells (RPCs) are a multipotent and highly proliferative population that give rise to all retinal cell types during organogenesis. Defining their molecular signature is a key step towards identifying suitable approaches to treat visual impairments. Here, we performed RNA-sequencing of whole eyes from Xenopus at three embryonic stages and used differential expression analysis to define the transcriptomic profiles of optic tissues containing proliferating and differentiating RPCs during retinogenesis. Gene Ontology and KEGG pathway analyses showed that genes associated with developmental pathways (including Wnt and Hedgehog signaling) were upregulated during the period of active RPC proliferation in early retinal development (Nieuwkoop Faber st. 24 and 27). Developing eyes had dynamic expression profiles and shifted to enrichment for metabolic processes and phototransduction during RPC progeny specification and differentiation (st. 35). Furthermore, conserved adult eye regeneration genes were also expressed during early retinal development including sox2, pax6, nrl, and Notch signaling components. The eye transcriptomic profiles presented here span RPC proliferation to retinogenesis and included regrowth-competent stages. Thus, our dataset provides a rich resource to uncover molecular regulators of RPC activity and will allow future studies to address regulators of RPC proliferation during eye repair and regrowth.

Examining the concordance between dominant eye and hand preference in healthy adults

Examining the concordance between dominant eye and hand preference in healthy adults

Effects of Different Scleral Photo-Crosslinking Modalities on Scleral Stiffness and Hydration.

The purpose of this study was to evaluate the biomechanical and hydration differences in scleral tissue after two modalities of collagen cross-linking. Scleral tissue from 40 adult white rabbit eyes was crosslinked by application of 0.1% Rose Bengal solution followed by 80 J/cm2 green light irradiation (RGX) or by application of 0.1% riboflavin solution followed by 5.4 J/cm2 ultraviolet A irradiation (UVX). Posterior scleral strips were excised from treated and untreated sclera for tensile and hydration-tensile tests. For tensile tests, the strips were subjected to uniaxial extension after excision. For hydration-tensile tests, the strips were dehydrated, rehydrated, and then tested. Young's modulus at 8% strain and swelling rate were estimated. ANOVAs were used to test treated-induced differences in scleral biomechanical and hydration properties. Photo-crosslinked sclera tissue was stiffer (Young's modulus at 8% strain: 10.7 ± 4.5 MPa, on average across treatments) than untreated scleral tissue (7.1 ± 4.0 MPa). Scleral stiffness increased 132% after RGX and 90% after UVX compared to untreated sclera. Scleral swelling rate was reduced by 11% after RGX and by 13% after UVX. The stiffness of the treated sclera was also associated with the tissue hydration level. The lower the swelling, the higher the Young's modulus of RGX (-3.8% swelling/MPa) and UVX (-3.5% swelling/MPa) treated sclera. Cross-linking with RGX and UVX impacted the stiffness and hydration of rabbit posterior sclera. The Rose Bengal with green light irradiation may be an alternative method to determine the efficacy and suitability of inducing scleral tissue stiffening in the treatment of myopia.

Deficits of the "Good" Eye in Amblyopia: Processing Geometric Properties.

Although fellow eyes of amblyopia are typically considered normal, recent studies have revealed impairments in certain aspects of vision. However, it remains unclear at which level of object processing these impairments occur. This study aims to investigate the functional level of visual perception impairment in the fellow eye of children and adults with amblyopia using the geometric functional hierarchy discrimination task based on Klein Mathematics methodology. Seventy-six patients with amblyopia (40 children and 36 adults) and 77 age-matched healthy controls (40 children and 37 adults) were recruited for this study. The participants completed four sets of geometric hierarchies (in ascending order of stability: Euclidean, affine, projective, and topology) and one set of color discrimination tasks. They were instructed to rapidly and accurately select a distinct shape from the four quadrants. The participants' performance was evaluated using the inverse efficiency (IE) score (IE = response time (RT)/accuracy). The results of IEs show that the fellow eye of children with amblyopia exhibits normal topological processing, yet displays higher IEs in other geometric properties and color processing, suggesting impairments in these specific discrimination abilities. However, adults with amblyopia did not show deficits on any discrimination types compared with adult controls. The lack of compromised topological processing suggests that amblyopia may not have inflicted any damage to the subcortical visual pathways. Furthermore, these deficits observed in the fellow eye tend to diminish significantly during adulthood, implying that amblyopia may potentially hinder the maturation process of the fellow eye.