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Purpose: To assess the associations between the prevalence of congenital color vision deficiency (CVD) and genetics and environment, represented by place of origin (ethnic background) and place of birth, respectively., Methods: This is a retrospective study of the computerized database of the northern recruitment center of Israel of 53,895 consecutive male Jewish conscripts 16-19 years old, who completed the medical profiling process between 1988 and 2011. CVD was diagnosed using the 24-pseudo-isochromatic plate Ishihara test. Associations of CVD prevalence with sociodemographic variables, anthropometric indices, refractive errors, and mainly place of origin and place of birth were tested by both univariate analysis and multivariate regression models., Results: Elevated BMI (obesity) and blood pressure (hypertension), as well as myopia, were all positively associated with congenital CVD. The composition of the study population provides a unique opportunity to investigate the relationship between ethnicity and environment. The prevalence of CVD significantly differs among subpopulations of different ethnic background as well as among those who were born in different geographical locations. Additionally, differences in the prevalence of CVD (1.2-1.6%) were observed among conscripts from the same origin, who were born in Israel, compared to those who were born elsewhere. Both place of origin (p < 0.01) and place of birth (p < 0.05) were associated with the prevalence of CVD in a multivariable regression model., Conclusion: This study affirms previously established associations of CVD with certain variables and reveals a possible novel association of CVD with environmental factors., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background and Objective: To evaluate the relationship between spherical equivalent (SE) refractive error and myopia-related peripheral retinal changes (MPRCs) and to find the optimal cutoff for screening myopic teenagers., Patients and Methods: The study included 2,286 myopic subjects who had a dilated fundus examination between 1998 and 2011 and SE of -4.0 diopters (D) or higher in both eyes., Results: Ninety-five subjects (4.16%) had MPRCs. Two subjects (0.09%) had moderate-to-severe MPRCs. A significant correlation (P < .0001) between SE and MPRC was found. The highest sum of sensitivity (72.63%) and specificity (73.44%) was achieved when a SE of -6.25 D in the more myopic eye was utilized as the cutoff., Conclusions: SE and MPRCs are highly associated. The optimal cutoff to detect MPRC in teenagers is -6.25 D. However, using a SE of -4.0 D as the cutoff may be the practical choice for screening due to the noninvasiveness nature and low cost of the examination. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:e311-e319.]., (Copyright 2019, SLACK Incorporated.)

Purpose: To investigate visual function and ocular features in children with attention deficit hyperactivity disorder (ADHD)., Methods: Fifty-one children underwent a detailed ophthalmologic evaluation. Thirty-two were diagnosed with ADHD, and 19 children with attention deficit disorder (ADD). The mean age was 9.9±3.1 years., Results: The average best-corrected visual acuity of the better-seeing eye was 1 (range 0.9-1.25) and 0.96 (range 0.5-1.25) for the fellow eye. Eighteen percent (10) had amblyopia in one or both eyes (3 had strabismic and 7 had ametropic amblyopia). Heterotropia was found in 5 (10%), and absent stereo acuity was found in 3 (6%). Subnormal convergence amplitude was noted in 2 patients (4%). The mean spherical equivalent (SE) of the eyes in this study was 0.17±1.73 (range -5.5 to +7). Twenty-two subjects (43%) had a myopia of -0.50 D or higher. Hyperopia higher than 3.5 D was seen in 10 cases(20%), and astigmatism larger or equal to 1.0 D was observed in 10 patients (20%). With-the-rule a stigmatism was by far most common type in the 29 eyes with an astigmatic refractive error (59%).Significant ametropia was detected in 42 (83%) of the patients. In contrast to other studies, we did not find a higher rate of convergence insufficiency or heterotropia., Conclusions: Children diagnosed with either ADHD or ADD can present with significant ametropia but infrequent heterotropia.

Pattern reversal visual stimuli are used to evoke potentials (VEPs) for assessment of visual acuity and for localizing defects along the visual pathways. Our goal was to assess the importance of attention and defocusing to the recordings of pattern VEP. Forty-one volunteers with normal (6/6) corrected visual acuity participated in this study. Twenty-one were asked to defocus intentionally the visual stimulus (located 200 cm away) by fixating at a target 25 or 50 cm from the eye. Twenty other subjects performed auditory tasks to distract their attention from the visual stimulus. Pattern VEPs were elicited by different check sizes. The amplitude and time-to-peak of the P100 wave were measured. Intentional defocusing caused amplitude reduction and prolongation of the time-to-peak in young subjects (20-34 years old). With the smallest checks used (7.5') we could not record a reliable response from 43% of the young subjects (6 out of 14). In older patients (35-61 years old), intentional defocusing induced negligible effects on pattern VEPs regardless of check size. There were no effects of auditory distraction upon the pattern VEPs. Our data suggest that intentional defocusing can produce false positive results (reduced VEP with prolonged time-to-peak) only when small checks are used in young subjects. Divided attention has negligible effect on the recordings of pattern VEPs. With proper controls, the pattern VEP test can be used for objective assessment of visual function.

Purpose: To assess the associations between the prevalence of congenital color vision deficiency (CVD) and genetics and environment, represented by place of origin (ethnic background) and place of birth, respectively. Methods: This is a retrospective study of the computerized database of the northern recruitment center of Israel of 53,895 consecutive male Jewish conscripts 16–19 years old, who completed the medical profiling process between 1988 and 2011. CVD was diagnosed using the 24-pseudo-isochromatic plate Ishihara test. Associations of CVD prevalence with sociodemographic variables, anthropometric indices, refractive errors, and mainly place of origin and place of birth were tested by both univariate analysis and multivariate regression models. Results: Elevated BMI (obesity) and blood pressure (hypertension), as well as myopia, were all positively associated with congenital CVD. The composition of the study population provides a unique opportunity to investigate the relationship between ethnicity and environment. The prevalence of CVD significantly differs among subpopulations of different ethnic background as well as among those who were born in different geographical locations. Additionally, differences in the prevalence of CVD (1.2–1.6%) were observed among conscripts from the same origin, who were born in Israel, compared to those who were born elsewhere. Both place of origin (p < 0.01) and place of birth (p < 0.05) were associated with the prevalence of CVD in a multivariable regression model. Conclusion: This study affirms previously established associations of CVD with certain variables and reveals a possible novel association of CVD with environmental factors. [ABSTRACT FROM AUTHOR]

Purpose: To assess the long-term results of a reduced amount of medial rectus recession in children with esotropia and developmental delay. Methods: A retrospective chart analysis of 42 children with developmental delay who had undergone surgery for esotropia during a 20-year period in a large referral center was performed. The pre- and postoperative angle of deviation was calculated for each subject as the mean of distant and near angles measured by a cover test or the Krimsky measurement. Surgical success was categorized as esotropia or exotropia of ≤10 prism diopters (PD). The main outcome measure was a stable surgical result after several years of follow-up. Results: The chart review identified 42 children who met inclusion criteria, with a mean age of 2.9 years (range, 0.8-10 years). The mean angle of esotropia prior to surgery was 44.29 ± 13.9 PD (range 20-80 PD). All patients had bilateral medial rectus muscle recessions, with a mean surgical dosage of 5.04 ± 0.62 mm per muscle, on average 0.66 mm less than the standard amount. The average postoperative follow-up was 4.6 years (median 3.67 years, range 8 months-15 years). Twenty-four children (57%) achieved surgical success, 13 (31%) were undercorrected, and 5 (12%) were overcorrected. Ten of the 18 with an unsuccessful surgical outcome underwent a second procedure. The overall surgical success rate for all patients after all procedures was 71%. Conclusions: The main reason for surgical failure after bilateral medial rectus muscle recession (BMR) in developmentally delayed children remains residual esotropia. However, with time, more patients demonstrated consecutive exotropia. Although it is difficult to achieve a stable long-term ocular alignment in children with developmental delay, satisfactory results may be achieved with additional surgical procedures. The optimal amount of primary recession and whether to perform the surgical schedules according to the Parks tables or to reduce the amount of the recession when operating on children with developmental delay is still debatable. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the long-term outcome of high hypermetropic refractive errors in childhood. Methods: We retrospectively reviewed data from the clinical records of 164 children with spherical equivalent (SE) hypermetropic refractive errors in three medical centers collected over 29 years. Refractive errors between +1.00 and +3.00 diopter (D) on initial examination were classified as mild hypermetropia and those +5.00D or greater were classified as high hypermetropia. The four variables studied were, age, refractive error, strabismus, and gender. The rate of reduction in hypermetropic refractive error was calculated over time in years. We identified subgroups according to age, gender, and initial refractive error. Results: Seventy-eight children with high hypermetropia and 86 children with mild hypermetropia were studied. High hypermetropia was detected at a mean age of 3.3 years, while mild hypermetropia was detected at a mean 4 years of age. The mean follow-up was 6.6 years for high hypermetropia and 6.4 years for mild hypermetropia. Over the follow-up period, children in all subgroups tended to reduce their refractive errors. The reduction in refraction power was small for both mild and high hypermetropic refractive errors. Amblyopia in the high hypermetropia group was more common and more refractory to treatment. Conclusions: Most children with hypermetropia of less than +3.00D experience a reduction in hyperopic refractive error over time and will outgrow any need for corrective lenses. Children with hyperopia greater than +5.00D will not experience a significant reduction in the power of the refractive error. [ABSTRACT FROM AUTHOR]