This study investigates whether the myopia control efficacy of Peripheral Defocus spectacle lenses (PDL), as established in controlled trials, holds true in a real-world clinical environment. This single centre, retrospective study analysed clinical records from the University Eye Hospital Basel (2019 - 2024). Patients included had myopia diagnosis, had undergone at least three axial eye length measurements (approximately at 6, 12 and 18 months after starting therapy), and were treated with either PDL or Single Vision (SV) spectacle lenses exclusively, with no concurrent myopia treatments (e.g., atropine or contact lenses). Axial elongation and spherical equivalent (SE) were compared using independent t-tests. Statistical significance was set at p < .05. Of 177 patients, 30 were treated with PDL and 37 with SV lenses. Compared to SV lenses, PDL lenses significantly reduced axial elongation over 6, 12, and 18 months. At 6 months, average axial elongation in the left eye was 0.024 mm (CI: 0.007 - 0.041) in the PDL group compared to 0.101 mm (CI: 0.082 - 0.140) in the SV group (p = 0.005); in the right eye, - 0.003 mm (CI: - 0.040 - 0.034) vs. 0.112 mm (CI: 0.081 - 0.143) (p < 0.001). At 12 months, average axial elongation in the left eye was 0.088 mm (CI: 0.036 - 0.140) with PDL vs. 0.167 mm (CI: 0.119 - 0.215) with SV (p < 0.05); in the right eye 0.080 mm (CI: 0.029 - 0.131) vs. 0.191 mm (CI: 0.146 - 0.236) (p < 0.005).At 18 months, left eye elongation was 0.110 mm (CI: 0.028 - 0.192) with PDL vs. 0.229 mm (CI: 0.182 - 0.276) with SV; right eye 0.078 mm (CI: 0.008 - 0.148) vs. 0.254 mm (CI: 0.208 - 0.300) (p < 0.001 for both).No significant differences in SE were observed at 6 or 12 months. A significant difference in right eye SE was noted at 18 months (p = 0.044); however, no consistent trend emerged. This study confirms that PDL lenses significantly reduce myopic axial elongation compared to SV lenses in a real-world clinical setting. These results reinforce prior controlled trial findings and support the clinical adoption of PDL for effective myopia management.

Background Physical examinations are critical for early detection of spinal abnormalities and visual function issues in children. Spinal health has a significant impact on both physical and psychological well-being, while untreated abnormalities may lead to postural deformities. Despite evidence linking spinal posture and balance control to visual function, the relationship between these factors remains underexplored. This study investigates the association between spinal health and visual function. Methods Data were collected from 875 children undergoing health examinations. Spinal parameters, including the thoracic kyphosis angle and the angle of trunk rotation, were measured alongside visual and perceptual examinations and refractive status. Statistical analyses were performed to assess their relationships. Results Significant differences were observed in the distribution of spinal parameters across three orders of stereopsis and spherical equivalent (SE). Specifically, the median angle of trunk rotation (ATR) was 2° (IQR: 1°–3°) in participants with level 4 zero-order stereopsis, which was significantly lower than that in level 0 participants (median: 4°, IQR: 3°–5°, p &amp;lt; 0.05). The median kyphosis angle (KA) was 27° (IQR: 25°–29°) in those with pass-grade first-order stereopsis, significantly lower than the 35° (IQR: 32°–38°) in non-passers ( p &amp;lt; 0.001). Spearman’s rank correlation analysis revealed a significant negative correlation between SE and both KA (rs = −0.18, p &amp;lt; 0.001) and ATR (rs = −0.32, p &amp;lt; 0.001). Additionally, gender differences were found in KA distribution, with females having a higher median KA (29°, IQR: 26°–31°) than males (27°, IQR: 25°–30°, p &amp;lt; 0.05). Conclusion These findings suggest a potential link between spinal health and visual development. In this cross-sectional sample, poorer stereopsis and more myopic refractive error were associated with modestly higher kyphosis and trunk-rotation angles. These findings provide preliminary evidence for the link between visual function and spinal alignment in school-aged children. Incorporating spinal health assessments into pediatric visual screening programs could facilitate early intervention for both spinal and visual abnormalities, improving overall child health outcomes.

Objective: We aimed to study acquired esotropia in adults and its risk factors, compile treatments performed and describe surgical technique used, with a novel indication. Methods: We conducted a retrospective study of patients with insidious distant esotropia along with distant horizontal diplopia (angles 2–30 PD with wide fusion amplitude): Refractively emmetropic, moderately myopic and mildly hyperopic. No systemic alterations. Results: 30 cases were included, average age: 38.13 ± 14.95. Mean time elapsed from the onset of symptoms to surgical treatment was 22.52. Mean spherical equivalent is −3.19 ± 2.83. Mean preoperative horizontal deviation was 18.58 ± 5.45 PD in distant vision and 5.48 ± 8.35 PD in close vision (p &lt; 0.001). 100% of cases reported diplopia in distance vision. 20% required prismatic treatment (&lt;10 PD) and 80% surgical (&gt;10 PD) by lateral rectus resection, with an average of 4.82 ± 1.23 mm. Sensory result was successful in 100% of the cases and motor in 75%. Conclusions: We are facing a new type of acquired esotropia in adults that can be individualized by its clinical and therapeutic characteristics. Our prismatic and surgical treatment has been successful.

To evaluate the effects and safety of auricular acupressure combined with periocular thumbtack needle (AATN) therapy for premyopia children. This multi-center, randomized, controlled trial was conducted in 8 Chinese hospitals, and 298 premyopic children aged 6 to 10 years were recruited between October 2020 and February 2022. Eligible participants were randomly assigned to the treatment group or the control group via a simple randomization method. All the participants in both groups were provided with standard intensive eye health instruction through phone calls, WeChat or hospital visits once a week, and the children in the treatment group received AATN therapy additionally. Following 12-week treatment, participants were followed up at 3-month intervals, with the entire study extending over a 9-month duration from baseline to the final assessment. The primary outcome was the mean change in spherical equivalent (SE) from baseline to 36 weeks. The secondary outcomes included the rate of children with stable myopia (MSR), uncorrected visual acuity (UCVA), axial length (AL), corneal curvature (CC), accommodative amplitude (AMP) and intraocular pressure (IOP) at baseline, 6,12, 24 and 36 weeks. Safety assessment included analysis of treatment-related adverse events (AEs), such as allergic reactions and skin damage. Totally, 298 children with premyopia were included, 151 in the treatment group and 147 in the control group. At the 36th week, the SE was -0.81±0.55 D in the control group and -0.65±0.44 D in the treatment group (P=0.002). The treatment group demonstrated superior SE control efficacy compared with the control group, with differences of -0.29±0.37 D and -0.49±0.44 D, respectively (P<0.01). The children in the treatment group achieved a MSR of 57.78% with more favorable outcome than 37.10% in the control group (P<0.01). The adjusted mean change in AMP from baseline to 9th month was 8.85±4.02 in the control group and 9.85±3.41 in the treatment group (P=0.018). AL increased by a mean of 0.35±0.28 mm in the control group and 0.20±0.42 mm in the treatment group (P=0.004). No significant differences in UCVA or CC were found between the two groups (P>0.05) and no AEs were reported. AATN therapy was effective for controlling the onset of myopia and SE, enhancing ocular accommodation, and mitigating AL. (Registration No. ChiCTR2000039299).

Myopia is a major global health concern. To enable precision myopia management, we developed a Transformer-based artificial intelligence (AI) model, the Myopia Progression Predictive Model (MPPM), comprising two modules: the Natural Progression Module (NPM) for predicting untreated myopia progression and the Intervention Progression Module (IPM) for forecasting progression under specific interventions. NPM was trained on 1,109,827 refractive records from 304,353 children and adolescents, achieving high predictive accuracy for future spherical equivalent (SE) and axial length (AL) over a 10-year period. In the internal test set, SE prediction reached R² = 0.94, MAE = 0.35D; for AL, R² = 0.91, MAE = 0.16 mm. Comparable performance was observed in external validation. IPM was trained on four intervention cohorts (0.01% atropine, orthokeratology, peripheral defocus spectacles, and repeated low-level red light [RLRL] therapy) using a Transformer-based causal machine learning framework, enabling individualized estimation of treatment effects. It accurately predicted myopia changes under each intervention (SE: R² > 0.88, MAE < 0.45D; AL: R² > 0.80, MAE < 0.31 mm). Among the interventions, RLRL slightly reversed myopia progression, whereas the others slowed myopia progression. MPPM demonstrates strong promise as an AI-driven platform for personalized prediction and optimization of pediatric myopia management.

To investigate the correlation between anterior chamber depth (ACD), anterior chamber angle (ACA), anterior chamber volume (ACV), and IOP with white-to-white (WTW) corneal diameter in myopic eyes. This prospective study conducted at Qassim University, included 163 myopic eyes. Refraction was measured using an autorefractometer, axial length (AL) using IOL Master, and anterior chamber parameters, WTW corneal diameter, and central corneal thickness (CCT) using Pentacam. IOP was assessed with a non-contact tonometer. Correlation analysis was used to assess associations between measured parameters and WTW corneal diameter. For myopic eyes (spherical equivalent: -3.90 ± 1.75 D), mean ocular parameters were: ACD 3.18 ± 0.23mm, ACA 40.02 ± 3.75°, ACV 194.19 ± 18.75mm³, IOP 18.9 ± 2.90 mmHg, and WTW 12.06 ± 0.38mm. Bivariate analysis showed WTW corneal diameter positively correlated with ACD, ACV, ACA, AL, CCT, and IOP (P < 0.001). Multiple regression revealed age, myopia severity, AL, and CCT explained 43.6% of WTW variance, 32.7% in ACD, 26.7% in ACA, 23.0% in ACV, and 47.1% in IOP. Age was positively associated with WTW, ACA, and ACV (P < 0.001). Myopia severity was negatively associated with ACA and positively with ACV (P < 0.05). AL correlated positively with WTW, ACD, ACA, and IOP (P < 0.05), while CCT was significantly associated with most parameters (P < 0.05). Larger WTW corneal diameter predicts deeper anterior chamber and higher IOP in myopic eyes. High myopia shows posterior eye segment expansion with limited anterior growth, and an age-related changes indicate structural remodeling during ongoing myopia progression differs from classical physiological patterns. These findings underscore the importance of WTW corneal diameter as a significant predictor of ocular biometry and refractive development, particularly in young populations with progressing myopia.

The prevalence of myopia among adolescents in China has continued to rise in recent years, with an evident trend toward earlier onset and higher degrees of refractive error. This poses significant challenges to learning, daily life, and long-term visual health. Therefore, exploring effective non-pharmacological interventions for adolescent myopia is of practical importance. This study aims to evaluate the effectiveness of 3D visual training combined with physical exercise on visual function and myopia control in adolescents. A total of 188 adolescents with myopia who visited the Optometry Center of our hospital between November 2021 and November 2023 were enrolled and randomly assigned to an observation group (n = 94) or a control group (n = 94). The control group received standard interventions consisting of spectacle correction and eye exercises. The observation group underwent 3D visual training in combination with structured physical exercise. Outcomes assessed before and after intervention included mean uncorrected visual acuity (UCVA) of each eye, overall UCVA, refractive error, axial length, and spherical equivalent. Visual improvement after 6 months and the temporal progression of UCVA within the observation group were also analyzed. Baseline visual and refractive parameters showed no significant differences between the 2 groups (P > .05). After the intervention, both groups demonstrated improvements; however, the observation group exhibited significantly greater enhancement in UCVA, accompanied by lower refractive error, shorter axial length, and reduced spherical equivalent compared with the control group (P < .05). After 6 months, visual acuity improved in 64 participants (68.09%) in the observation group versus 39 participants (41.49%) in the control group, representing a statistically significant difference (P < .05). 3D visual training combined with physical exercise effectively improves uncorrected visual acuity, reduces refractive error, alleviates myopia progression, and promotes visual recovery in adolescents. This combined approach shows promise as a practical, noninvasive strategy for myopia prevention and management.

Purpose To quantitatively evaluate fundus tessellation density (FTD) in children with early-onset high myopia (eo-HM) using artificial intelligence (AI)–assisted image analysis and to explore its association with axial length (AL). Methods This cross-sectional study included children aged ≤6 years with eo-HM, defined as spherical equivalent (SE) ≤ −6.00 D and/or AL &amp;gt; 26.00 mm. Cycloplegic refraction, AL measurement, and ultra-widefield fundus photography were performed. A deep learning–based algorithm quantified FTD across concentric macular zones (1 mm, 3 mm, 6 mm) and anatomical sectors. Correlation and multivariate regression analyses were used to assess associations between FTD and AL. Results A total of 47 eyes from 31 children were analyzed. Mean SE was −9.35 ± 3.74 D and AL was 25.70 ± 1.50 mm. FTD declined from center to periphery ( p &amp;lt; 0.001), with greater values in nasal and inferior sectors at 6 mm. Overall FTD correlated with AL ( r = 0.46, p = 1.47 × 10 −3 ). In univariate regression, FTD significantly predicted AL ( β = 18.16, p = 1.76 × 10 −5 , R 2 = 0.352). Multivariable analysis showed that FTD in the 6 mm nasal and superonasal sectors remained independently associated with AL after adjusting for age and sex. Conclusion AI-assisted quantification of FTD provides a sensitive and objective measure of early retinal changes in eo-HM. Regional FTD, especially in nasal and perifoveal regions, is strongly associated with axial elongation and may serve as a useful biomarker for early diagnosis and monitoring of pediatric high myopia.

This study aimed to explore ocular and systemic factors associated with pathologic myopia in patients with high myopia and develop predictive models for differentiating between simple high myopia and pathologic myopia, particularly in its early stage. This cross-sectional study was conducted on 2767 patients with bilateral high myopia at baseline follow-up. Demographic, ocular biometric and clinical data were collected, including age, corrected distance visual acuity, axial length (AL), spherical equivalent (SE), myopic atrophy maculopathy (MAM) grading based on the International Meta-Analysis for Pathologic Myopia criteria and ocular and systemic comorbidities. Multimodal imaging techniques were employed to assess plus lesions and posterior staphyloma. Logistic regression was used to identify associated factors and develop predictive models. Among all patients, 1697 (61.33%) were classified as having pathologic myopia. Its prevalence increased with longer AL and more severe SE. Significant ocular comorbid associated factors included cataract, epiretinal membrane, foveoschisis, full-thickness macular hole, retinal detachment and strabismus, and hypertension was the only systemic associated factor identified. Predictive models for differentiating simple high myopia and pathologic myopia, MAM categories 1 and 2, achieved area under the curve values up to 0.978 and 0.964, respectively. This study underscores the high prevalence of pathologic myopia in a highly myopic population and identifies ocular and systemic associated factors for pathologic myopia. The developed predictive models provide valuable tools for distinguishing between simple high myopia and pathologic myopia, facilitating early diagnosis and management.

The Impact of BMI on Myopia Incidence in Chinese Children.

To assess anatomical and functional outcomes of encircling or segmental buckle in premature infants with stage 4 retinopathy of prematurity (ROP). This retrospective, single-center, interventional study included preterm infants with stage 4A or 4B ROP who underwent encircling (Group A) or segmental (Group B) scleral buckle. Surgical outcomes, long-term sequelae, and comorbidities were evaluated. A total of 105 eyes (90 infants) were analyzed-85 in Group A and 20 in Group B. Stage 4A was present in 75 eyes. The mean gestational age was 30.05 ± 2.73 weeks; mean birth weight, 1383 ± 411.01 gram. Primary surgical success was 90.5% in Group A (4A: 93.9%; 4B: 78.9%) and 90% in Group B (4A: 88.8%;4B: 90.9%). Preoperative treatment and combined intraoperative interventions significantly improved anatomical success (P < 0.05). Mean spherical equivalent was -6.00 D in Group A and -3.12 D in Group B. Functional vision (central, steady, maintained) was achieved in 32% of Group A and 55% of Group B. Common sequelae included disc drag and macular ectopia; comorbidities included myopia, strabismus, and nystagmus. Scleral buckling is an effective and less invasive treatment for selected cases of stage 4 ROP with peripheral traction.

Postoperative data leakage in AI-based IOL power prediction formulas: a hidden source of bias.

Cellular-Level Assessment of Macular Development in Patients With Familial Exudative Vitreoretinopathy Using Multimodal Imaging: A Prospective Cohort Study.

Anterior Segment Changes after Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) in Pseudophakic Patients with Open-angle Glaucoma.

Effect of Ocular Magnification Correction on Measurements of Macula Ganglion Cell Complex in Myopic Children.

Efficacy and Safety of Low-Concentration Atropine in Slowing Myopia Progression in Children in Japan: The Randomized, Double-Blind Phase II/III ORANGE Study.

Analysis of flap morphology and visual outcomes using a new femtosecond-laser platform: An observational study.

Purpose: To compare the Corneal and Anterior Chamber Parameters between Myopic Eyes and the LASIK-treated eyes Using Pentacam Study Design: Cross sectional observational study Place and duration of study: Department of Optometry, College of Applied Medical Sciences, Qassim University from January 2024 to May 2024. Methods: The study included 173 patients, 83 individuals with low to moderate myopia and 90 post-LASIK patients. Corneal and anterior chamber measurements were taken using Pentacam, including central corneal thickness, anterior and posterior corneal surface power, anterior chamber depth, angle, and volume. Results: The mean spherical equivalent was -2.01 ± 1.02 D in myopic eyes and -0.51 ± 0.41 D in post-LASIK eyes (P = 0.000). Central and thinnest corneal thicknesses were significantly reduced in the post-LASIK group (P = 0.000). Uncorrected visual acuity in post-LASIK eyes (mean 1.03 ± 0.15) was comparable to the best-corrected visual acuity in myopic eyes (P = 0.098). A significant decrease in anterior corneal surface power was noted post-LASIK, while posterior corneal power remained stable. Anterior chamber depth and volume showed modest but significant reductions, with no significant difference in anterior chamber angle between the groups. Conclusion: LASIK leads to significant thinning of the cornea and reduction in anterior corneal power, while posterior corneal curvature remains stable. Minor decreases in anterior chamber depth and volume occur without affecting the chamber angle or visual outcomes.

PurposeThis study aimed to compare the visual outcomes, safety and efficacy of myopic keratorefractive lenticule extraction treatments using the newer Zeiss VisuMax 800 system over its precursor, the VisuMax 500 system.Patients and MethodsA retrospective review conducted at a private clinic in Western Australia of myopic keratorefractive lenticule extraction treatments with the VisuMax 500 and the VisuMax 800 systems between July 2021 and February 2023. Pre-operative and 1-month post-operative data were compared between the two cohorts. Demographics, best corrected visual acuity, uncorrected distance visual acuity, mean refractive spherical equivalent, total suction time and complications were recorded.ResultsFifty procedures for each system were identified. Eight eyes in the VisuMax 500 cohort (group 1) and five eyes in the VisuMax 800 cohort (group 2) were excluded due to non-attendance at the 1-month post-operative review. The average total suction time was 34 seconds vs 13 seconds respectively. A single case of suction loss occurred in group 1. The mean pre-operative mean refractive spherical equivalent of groups 1 and 2 were −6.02D (−3.63 to −9.00) and −5.56D (−2.75 to −8.88) (P = 0.20). The mean post-operative mean refractive spherical equivalent of the two groups were 0.08D (−1.00 to 1.25) and −0.03D (−2.25 to 1.00) (P = 0.31).ConclusionThe VisuMax 500 and 800 systems have similar visual outcomes and no significant difference in safety profiles. The main advantage of the newer VisuMax 800 femtosecond laser is its speed and potential for less cases of suction loss. Larger studies over longer terms are required.

This study aimed to investigate the features of autonomic regulation in children with habitual excessive accommodation (HEA). A total of 104 children aged 6-17 years were examined: the main group comprised 54 patients with HEA and the control group included 50 children without this disorder. Mean manifest spherical equivalent was -1.75±0.60 D in the main group and -0.85±0.50 D in the control group (p<0.001); cycloplegic spherical equivalent was -0.72±0.52 D and -0.45±0.46 D, respectively (p<0.01). Ophthalmological examination included assessment of accommodative functions, pupil diameter, and cardiointervalography (CIG). Children with HEA had lower accommodative amplitude (8.6±1.9 vs. 11.2±2.1 D), reserve (1.4±0.6 vs. 2.6±0.7 D), and facility (5.3±1.8 vs. 9.1±2.0 cycles/min; p<0.01), as well as lower (p<0.001) parasympathetic heart rate variability (HRV) indices - standard deviation of NN intervals (SDNN), root mean square of successive differences (RMSSD), percentage of NN intervals >50 ms (pNN50), and high-frequency power (HF), while sympathetic markers - low-frequency power (LF), sympathovagal index (LF/HF), and stress index (SI) - were higher (p<0.001). Pupil diameter was smaller (3.96±0.75 vs. 5.04±0.49 mm; p<0.001). The amplitude of accommodative miosis (Δ_accom) correlated positively with LF/HF (r=0.34) and negatively with SDNN and HF (r≈-0.34; p<0.05). Autonomic imbalance was most pronounced at ages 14-17 and in grade 3 HEA (LF/HF=2.67±0.3; SI=200±35). HEA is associated with reduced parasympathetic and increased sympathetic activity. Cardiointervalography and pupillometry are informative for early detection of autonomic maladaptation.