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Purpose To evaluate the effectiveness and safety of pars plana vitrectomy (PPV) combined with phacoemulsification and intraocular lens implantation in proliferative diabetic retinopathy (PDR) patients over 45 years old with mild-moderate cataract, in comparison with PPV with subsequent cataract surgery. Methods This multi-center randomized controlled trial was conducted in three Chinese hospitals. From February 2021 to October 2021, 168 PDR patients were assessed for eligibility. After exclusion, a total of 129 patients were recruited and randomly assigned to PPV combined with cataract surgery concurrently (the combined group) or PPV with subsequent cataract surgery 6 months later (the subsequent group). A 12-month follow-up period was scheduled. Changes of best correct visual acuity (BCVA), rate of complications were compared between groups. Results 66 patients were assigned to the combined group and 63 to the subsequent group. The change of BCVA in the combined group with mean 36.90 (95% confidence interval, 95% CI: 30.35-43.45) letters was significantly better (adjusted difference of 16.43, 95% CI: 8.77-24.08, P<0.001) than the subsequent group with 22.40 (95% CI: 15.55-29.24) letters 6 months after the PPV, and no significant difference was found after the cataract surgery in the subsequent group. Compared with the combined group, the rates of neovascular glaucoma (17.65% vs. 3.77%, P=0.005) were significantly higher in the subsequent group. Conclusion Compared with PPV with subsequent cataract surgery, PPV combined with cataract surgery concurrently was relatively effective, convenient and safe, being a promising and reliable surgical option for PDR patients over 45 years old with mild-moderate cataract. Trial registration number NCT04729023.

AimsTo report the baseline intraocular pressure (IOP) characteristics and its diurnal fluctuation in the Laser in Glaucoma and Ocular Hypertension China cohort.Methods622 primary open-angle glaucoma (POAG) patients and 149 ocular hypertension (OHT) patients were recruited at Zhongshan Ophthalmic Center from 2015 to 2019. Standardised ocular examinations were performed including IOP measurement using the Goldmann applanation tonometer. Daytime phasing IOP was recorded at 8:00, 10:00, 11:30, 14:30, 17:00 hour.ResultsThe mean baseline IOP was 20.2 mm Hg for POAG patients and 24.4 mm Hg for OHT. Multiple regression analysis revealed that thicker central corneal thickness (CCT) was correlated with higher IOP in both POAG and OHT. Male gender and younger age were correlated with higher IOP only for POAG. As for diurnal IOP fluctuation, mean IOP fluctuation was 3.4 mm Hg in POAG eyes and 4.4 mm Hg in OHT. The peak and trough IOP occurred at 8:00 and 14:30 hour in both POAG and OHT eyes.ConclusionsYounger age, male gender and thicker CCT are correlated to higher IOP in POAG patients while only thicker CCT is related to higher IOP in OHT patients. Peak IOP appears mostly at early morning or late afternoon and trough value occurs mostly at early afternoon.

The ocular features of phacomatosis pigmentovascularis (PPV) have rarely been reported, and glaucoma is the leading cause of blindness in patients with this condition. To protect vision in these patients, it is important to identify glaucoma as early as possible.To systematically report the systemic and ocular manifestations of phacomatosis cesioflammea and phacomatosis cesioflammeo-marmorata, and to investigate a glaucoma risk scoring system.In this prospective study, patients with PPV from 2014 to 2021 were included. Clinical information was collected, and associations with glaucoma were evaluated. The suitability of the scoring system was assessed. A systematic literature review and analysis of reported cases of PPV was performed.A total of 28 participants with PPV were included. Their ocular findings were similar, ranging from episcleral hyperpigmentation (78.5%), glaucoma (75%), choroid haemangioma (38%), and retinal vascular abnormalities (48%), to hyperpigmentation of the cornea, iris, lens and fundus. Glaucoma was associated with multiple factors, especially a thick choroid (odds ratio: 2.61; p = 0.008) and a diffuse mass-type of episcleral hyperpigmentation (odds ratio: 41.3; p = 0.027). The risk scoring system was characterized by high sensitivity (84%) and specificity (80%; AUC = 0.91) in predicting glaucoma.In addition to involving the systemic system, phacomatosis cesioflammea and phacomatosis cesioflammeo-marmorata also represent a specific spectrum of ophthalmic vascular malformations and hyperpigmentation. Early and periodic detailed ocular examination are recommended. The novel scoring system will help to tailor follow-up for visual protection.

Pulverization and surface instability have been identified as the main impediments to the application of Si anodes in high-energy lithium-ion batteries (LIBs). In this study, a Si-graphitic carbon hybrid (SiG) is created via embedding Si nanoparticles in between expanding graphite interlayers, thus to be adopted as a model system to unravel structure-properties relations for LIBs applications. We explore the impact of artificial surface coating layers on the lithium cycling performance of SiG particles. In comparison with native SiG and carbon-coated SiG (CC-SiG), we find that the “sticky-carbon” coating, i.e., an epoxy-rich layer on top of the carbon coating, gave rise to superior cycle performance. In the “sticky carbon” coated SiG (SCC-SiG), the surface chemistry appears to have a pivotal role in both alleviating electrode disintegration and forming a favorable SEI rich in fluorine-polymers. These positive findings are examined in electrodes with mass loading ranging from 1.0 to 5.0 mg/cm2, achieving area capacities up to ∼5.0 mAh/cm2. A full cell adopting >6 mg/cm2 LiNi0.8Co0.1Mn0.1O2 (NCM811) cathode and SCC-SiG delivers stable cycling performances. It is hence unraveled that the carbon coating layer with reactive surface groups on the top is an unrecognized key for wide range of Si-based anodes.

Background/aimsWe aimed to explore the impact of glaucomatous macular damage, specifically retinal ganglion cell (RGC) loss, on macular pattern vision measured by the vanishing optotype (VO) recognition contrast threshold.MethodsSeventy-two patients (mean age, 33.51±7.05 years) with primary open-angle glaucoma and 36 healthy controls (mean age, 30.25±6.70 years) were enrolled. VO recognition contrast thresholds of each participant were measured at the 16 preset test locations covering the central 5° visual field (VF). Macular sensitivity (MS) was tested by macular threshold test of Humphrey Field Analyzer. Macular RGC plus inner plexiform layer (GCIPL) thickness was also measured by spectral domain optical coherence tomography.ResultsThe VO contrast threshold demonstrated weak-to-moderate correlations (rho=−0.275 to −0.653) with MS (pConclusionsGlaucomatous eyes have higher contrast thresholds for VO recognition in fovea-around VF. Stronger structure–function relationships indicate that VO contrast threshold is more vulnerable to RGC damage.

To assess the safety and tolerability of a new contact lens sensor (CLS) system for continuous 3- and 24-hr intraocular pressure (IOP) monitoring in human eyes.Twenty-five subjects were recruited for 3-hr IOP measurement by CLS. Corneal fluorescein staining (CFS) scores were evaluated before and after measurement. Then, 30 participants (10 normal subjects and 20 glaucoma patients) were recruited for 24-hr IOP monitoring. Ocular surface disease index (OSDI) was assessed before and one day after measurement. Contact lens dry eye questionnaire-8 was assessed immediately after measurement. Visual analog scale of discomfort was measured before, immediately after, and one day after measurement. Best-corrected visual acuity (BCVA), tear break-up time (TBUT), and CFS were assessed before, immediately after, and 1 day after measurement.All participants completed 3- or 24-hr IOP measurement by CLS. Corneal fluorescein staining increased from 0.6±0.7 to 2.4±1.5 after 3-hr IOP measurement ( P0.001). For participants undergoing 24-hr IOP monitoring, OSDI increased from 9.1±9.7 to 18.0±12.4 ( P =0.001). CLDEQ-8 score was 11.6±5.8. Visual analog scale increased from 11.1±14.2 to 35.2±21.8 after measurement ( P0.001) and decreased to 26.7±18.4 one day later ( P0.001 compared with baseline). BCVA decreased from 1.0±0.01 to 0.8±0.1 ( P0.001) and returned to 0.9±0.1 after one day ( P0.001 compared with baseline). TBUT decreased from 5.1±3.9 to 2.6±1.5 s ( P =0.001) and returned to 4.8±2.5 s ( P =0.465 compared with baseline). Corneal fluorescein staining increased from 0.7±0.9 to 4.3±0.8 ( P0.001) and dropped to 0.8±0.7 ( P =0.599 compared with baseline). No significant difference was found for all variations of indicators between normal subjects and glaucoma patients ( P0.1 for all comparisons).The CLS shows a great potential for a safe and tolerable 24-hr IOP monitoring in normal subjects and glaucoma patients. Clinical attention to the worsening signs and symptoms after measurement is required.

Sodium metal battery (SMB, NMB) anodes can become dendritic due to an electrochemically unstable native Na-based solid electrolyte interphase (SEI). Herein Li-ion activated tin sulfide graphene nanocomposite membrane (A-SnS–G) is employed as an artificial SEI layer, allowing cyclability of record-thin 100 μm Na metal foils. The thin Na metal is prepared by a self-designed metallurgical rolling protocol. A-SnS–G is initially placed onto the polypropylene (PP) separator but becomes in situ transferred onto the Na metal surface. Symmetric metal cells protected by A-SnS–G achieve low-overpotential extended high-rate cycling in a standard carbonate electrolyte (EC : DEC = 1 : 1, 5% FEC). Accumulated capacity of 1000 mA h cm−2 is obtained after 500 cycles at 4 mA cm−2, with accumulated capacity-to-foil capacity (A/F) ratio of 90.9. This is among the most favorable cycle life, accumulated capacity, and anode utilization combinations reported. Protection by non-activated SnS–G membrane yields significantly worse cycling, albeit still superior to the baseline unprotected sodium. Post-mortem and dedicated light optical analysis indicate that metal swelling, dendrite growth and dead metal formation is extensive for the unprotected sample, but is suppressed with A-SnS–G. Per XPS, post-100 cycles near-surface structure of A-SnS–G is rich in metallic Sn alloys and inorganic carbonate salts. Even after 300 cycles, Li-based SEI components ROCO2-Li, Li2CO3 and LiF are detected with A-SnS–G. As a proof of principle, an SMB with a high mass loading (6 mg cm−2) NVP cathode and a A-SnS–G protected anode delivered extended cyclability, achieving 74 mA h g−1 after 400 cycles at 0.4C.

To assess and compare the corneal biomechanics of normal-tension glaucoma (NTG), high-tension glaucoma (HTG), and normal controls based on stiffness and modulus. The correlations among central corneal thickness (CCT), visual field, retinal nerve fiber layer (RNFL) thickness, and corneal biomechanics in glaucoma eyes were also evaluated.A prospective, cross-sectional, comparative study.This study included 334 eyes of 108 NTG patients, 113 HTG patients, and 113 control subjects at Zhongshan Ophthalmic Center, Sun Yat-Sen University. Corneal biomechanics were evaluated using a corneal indentation device (CID) and corneal visualization Scheimpflug technology (Corvis ST). Visual field and RNFL thickness were obtained using standard automated perimetry and spectral-domain optical coherence tomography. One-way analyses of variance with Bonferroni post hoc tests and a multivariable linear regression analysis with adjustment were conducted. Correlations among corneal biomechanical parameters, CCT, visual field, and RNFL thickness were analyzed.The corneal stiffness of the NTG patients (71.0 ± 10.9 N/m) was significantly lower than that of the HTG patients (77.3 ± 15.6 N/m; P = .001) and the CCT- and IOP-matched normal controls (75.6 ± 11.0 N/m; P = .023). The patients in the NTG group had lower corneal stiffness than those in the control group (β = -4.88, 95% CI -9.002, -0.758; P = .020) after adjusting for confounders. Stiffness was positively correlated with CCT in the NTG group (P = .028) but not in the HTG group (P = .509). There was no significant correlation (P.05) between corneal biomechanics, visual field, or RNFL thickness.The corneas of NTG patients were softer than those of HTG patients and controls, as assessed by CID, which were associated with thinner CCT. These might suggest different ocular biomechanical properties in NTG and HTG.

We report a new approach for nanosilicon-graphene hybrids with uniquely stable solid electrolyte interphase. Expanded graphite is gently exfoliated creating "defect-free" graphene that is non-catalytic towards electrolyte decomposition, simultaneously introducing high mass loading (48 wt. %) Si nanoparticles. Silane surface treatment creates epoxy chemical tethers, mechanically binding nano-Si to CMC binder through epoxy ring-opening reaction while stabilizing the Si surface chemistry. Epoxy-tethered silicon pristine-graphene hybrid "E-Si-pG" exhibits state-of-the-art performance in full battery opposing commercial mass loading (12 mg cm-2 ) LiCoO2 (LCO) cathode. At 0.4 C, with areal capacity of 1.62 mAh cm-2 and energy of 437 Wh kg-1 , achieving 1.32 mAh cm-2 , 340.4 Wh kg-1 at 1 C. After 150 cycles, it retains 1.25 mAh cm-2 , 306.5 Wh kg-1 . Sputter-down XPS demonstrates survival of surface C-Si-O-Si groups in E-Si-pG after repeated cycling. The discovered synergy between support defects, chemical-mechanical stabilization of Si surfaces, and SEI-related failure may become key LIB anode design rule.

Purpose: Eye movement in intermittent exotropia (IXT) patients is characterized by viability and uncertainty, however, conventional strabismus inspection methods cannot reflect these important qualities. Here, we sought to study the ocular motor behavior of IXT under different viewing conditions by eye tracker.Methods: Sixty-one IXT patients (33 males and 28 females) and 15 age-matched control participants were recruited for this study. An eye tracker equipped with a high-speed camera and MATLAB software was employed to monitor and record eye movement as well as eye position in included subjects with 3D shutter glasses at a normal reading distance (57 cm).Results: By using an eye tracker, our data showed that 90% of the included IXT patients lost their control and showed exotropia in 1.5±2.1s. The average deviation degree measured by the eye tracker was 32.9±11.5△, ranging from 6 to 50△, and reached its maximum deviation degree at 36.9±12.4△, with a mean time of 2±1.5s. Although a significant difference exists in the strabismus quantification between the prism test and the eye tracker, the test results obtained from these two methods were positively correlated. Moreover, by using the eye tracker, the fixation instability of IXT patients could be easily recorded and analyzed. In addition, the included IXT patients were divided into three types according to their ocular motor behavior as monitored by an eye tracker.Conclusion: Eye trackers could not only provide continuous, precise and effective strabismus assessments but also analyze ocular motor behavior over a period of time in IXT patients.

Purpose The purpose of this study was to evaluate the features of and relationships among corneal diameter, central corneal thickness (CCT), endothelial cell density (ECD), and corneal refractive properties in cases of microcornea (MC) with normal axial length. Methods We included 22 patients (35 eyes) with MC and cataracts and 41 patients (48 eyes) with isolated cataracts as age-matched controls. They were divided into patients with MC younger than 18 years (MC-child), patients with MC 18 years or older (MC-adult), children with congenital cataracts (CCs), and adults with senile cataracts (SCs). Corneal diameter, axial and anterior chamber length, and keratometry were measured; central corneal endothelial cell imaging was performed. Results The mean horizontal corneal diameter was 7.71 ± 1.51 and 8.78 ± 0.52 mm in MC-child and MC-adult groups, respectively, and 11.89 ± 0.59 and 11.52 ± 2.42 mm in child and adult controls, respectively. The mean CCT was 641.26 ± 63.37 (MC-child) and 617.38 ± 45.40 mm (MC-adult), and 554.92 ± 34.64 (CC) and 551.58 ± 28.47 mm (SC). The mean ECD was 2898.47 ± 443.90 (MC-child) and 2825.81 ± 484.65 cells/mm2 (MC-adult), and 3155.13 ± 372.67 (CC) and 2749.33 ± 399.63 cells/mm2 (SC). The average keratometry was 44.22 ± 3.14 D (MC-child) and 43.86 ± 2.59 D (MC-adult), and 44.19 ± 1.44 D (CC) and 43.94 ± 1.34 D (SC). Conclusions Patients with MC and normal axial length possess specific parameters, including significantly smaller corneal diameter and thicker CCT than the patients in the control groups. There were no significant differences in ECD and average keratometry. These parameters should be taken into account in the follow-up and treatment.

Purpose The Logarithm of the Minimum Angle of Resolution (logMAR) chart is the most common clinical test for assessing central visual function in glaucoma. However, based on the use of these charts, visual acuity (VA) often remains normal even when severe macular damage exists. Here, we aim to investigate the potential advantages of high-pass VA in detecting glaucoma compared with conventional VA. Methods Monocular best-corrected VA measurements were compared for a novel high-pass electronic VA chart (e-chart) and a conventional e-chart in 113 primary open-angle glaucoma (POAG) patients with normal logMAR VA and 65 age-similar healthy controls. One hundred thirty-nine POAG patients underwent spectral-domain optical coherence tomography (SD-OCT) for measurement of macular ganglion cell layer plus inner plexiform layer (GCL+IPL) thickness. Structure-function relationships between OCT measurements and the two VAs were compared. The enrolled eyes were divided into two groups for further analyses according to macular visual field (MVF) defects, specifically two or more adjacent abnormal points within the 12 central sites of 30-2 VF. Results The mean deviation (MD) of 30-2 VF test was −12.77 ± 7.47 dB for glaucoma group and −1.70 ± 1.12 dB for control group. The mean difference of the two VAs was slightly larger in glaucoma group (0.29 logMAR) than in control group (0.22 logMAR). The area under the receiver operating characteristic curve of the high-pass e-chart was larger than that of conventional e-chart (0.917 vs. 0.757, P < 0.001). Significant correlations between high-pass VA and GCL+IPL thickness were found only in the MVF-damaged group. Compared with conventional VA, high-pass VA demonstrates stronger correlations with nasal-side macular GCL+IPL thickness (Fisher's Z-test, two-tailed, P2mm in diameter = 0.033 and P3mm in diameter = 0.005). Conclusions Compared with conventional VA, high-pass VA displays slightly higher sensitivity to visual loss in glaucoma and has a stronger correlation with the nasal-side macular GCL+IPL thickness. Translational Relevance The high-pass acuity test has the potential to be used as an ancillary tool to monitor glaucoma over time.

Objective: An algorithm based on real-time accurate target recognition and distance location for VAVs, the existing target location and discrimination methods often fail to meet practical requirements. Method: The image information collected under the common single camera can only obtain two-dimensional information, and the relative distance of the camera based on the target cannot be obtained. However, the commonly used dual camera-based distance acquisition algorithm is too complicated, not stable enough, and requires developers to have higher the level of knowledge, the high threshold for development, and the difficulty of application. Therefore, this paper proposes to train the feature extraction network based on the two-channel Darknet-53 basic structure through the dual camera under the human body posture recognition image dataset, and initialize the YOLOv2 network with its parameters, and to train the human body position in the human body posture image, relative distance, and category. Result: Experimental results verify that the human body position and category recognition of human posture using this method improves the recognition accuracy by 3.83% and 4.81% compared with the single-convolution chain, and the accuracy of the target-based relative distance is achieved 65.21%. Conclusion: The algorithm can be effectively applied to the UAV to quickly recognize the human body posture and obtain a better recognition effect to meet the real-time demand.

Purpose This study identifies and characterizes the nasotemporal hemifield difference of interocular suppression in subjects who have been successfully treated for strabismus. Methods Interocular suppression in the nasal and temporal hemifields were measured using two methods, namely, binocular phase combination and dichoptic motion coherence, both entailed suprathreshold stimuli. We tested 29 clinical subjects, who had strabismus (19 with exotropia and 10 with esotropia) but regained good ocular alignment (within 10 prism diopters) after surgical or refractive correction, and 10 control subjects. Results Both the hemifield binocular phase combination and the hemifield dichoptic motion coherence tests revealed similar nasotemporal asymmetry of interocular suppression. Subjects with previous exotropia showed deeper suppression in the nasal hemifield, and those with previous esotropia showed deeper suppression in the temporal hemifield. This finding was consistent with the hemifield suppression theory. Furthermore, there was deeper suppression but less imbalance of nasotemporal asymmetry in the hemifield dichoptic motion coherence test. Finally, clinical stereopsis and the nasotemporal asymmetry of suppression (P < 0.05 in both tests) were negatively correlated in subjects with previous exotropia and measurable stereopsis. Conclusions Hemifield asymmetry of interocular suppression in corrected strabismus can be measured by using static and dynamic suprathreshold stimuli. Thus, the evaluation of binocular vision in strabismus should focus on both the magnitude and the pattern of interocular suppression.

In this study, we have investigated the electrical properties of the AlGaN/AlN/GaN heterostructure field-effect transistors (HFETs) with floating gate structures using the measured capacitancevoltage (C-V) and current-voltage (I-V) characteristics. It is found that the two-dimensional electron gas (2DEG) density under the central gate cannot be changed by the floating gate structures. However, the floating gate structures can cause the strain variation in the barrier layer, which lead to the non-uniform distribution of the polarization charges, then induce a polarization Coulomb field and scatter the 2DEG. More floating gate structures and closer distance between the floating gates and the central gate will result in stronger scattering effect of the 2DEG.

In patients with anisometropic or strabismic amblyopia, interocular suppression can be minimized by presenting high contrast stimulus elements to the amblyopic eye and lower contrast elements to the fellow eye. This suggests a structurally intact binocular visual system that is functionally suppressed. We investigated whether suppression can also be overcome by contrast balancing in children with deprivation amblyopia due to childhood cataracts. To quantify interocular contrast balance, contrast interference thresholds were measured using an established dichoptic global motion technique for 21 children with deprivation amblyopia, 14 with anisometropic or mixed strabismic/anisometropic amblyopia and 10 visually normal children (mean age mean=9.9years, range 5-16years). We found that interocular suppression could be overcome by contrast balancing in most children with deprivation amblyopia, at least intermittently, and all children with anisometropic or mixed anisometropic/strabismic amblyopia. However, children with deprivation amblyopia due to early unilateral or bilateral cataracts could tolerate only very low contrast levels to the stronger eye indicating strong suppression. Our results suggest that treatment options reliant on contrast balanced dichoptic presentation could be attempted in a subset of children with deprivation amblyopia.

Purpose To evaluate the ability of the new in vivo corneal indentation device (CID) to measure corneal biomechanical properties. Methods and Results In total, 186 eyes from 46 healthy subjects, 107 patients with primary open-angle glaucoma, and 33 patients with ocular hypertension were enrolled in a cross-sectional study. Measurements were performed using corneal visualization Scheimpflug technology (Corvis ST) and the CID. The deformation amplitude (DA), inward applanation time, inward applanation velocity (A1V), outward applanation time (A2T), outward applanation velocity (A2V), highest concavity time, DA ratio, max inverse radius (MIR), integrated radius, and stiffness parameter A1 were included as Corvis ST parameters, and stiffness and modulus were included as CID parameters. Associations between the Corvis ST and CID parameters and correlations between central corneal thickness and corneal biomechanical parameters were analyzed. The stiffness was significantly correlated with all the Corvis ST parameters (P < 0.05). The modulus was significantly correlated with the DA, A1V, A2T, A2V, highest concavity time, and MIR (P < 0.05). The DA, inward applanation time, A1V, A2T, A2V, DA ratio, MIR, integrated radius, and stiffness parameter A1 values and both CID-derived values were significantly correlated with central corneal thickness (P < 0.05). Conclusions Parameters derived from the CID and Corvis ST demonstrated agreement in the measurement of corneal biomechanical properties. The stiffness and modulus can characterize in vivo corneal biomechanical properties. Translational Relevance Agreeing with the Corvis ST regarding the assessment of corneal biomechanical properties, the CID can be a novel clinical tool for biomechanical evaluation of the cornea.

BACKGROUND: To investigate dynamic stereopsis in intermittent exotropia [X(T)] patients using a novel dynamic random-dot stereopsis assessment method. METHODS: A novel dynamic random-dot stereopsis test was performed using novel self-programmed software, which consisted of red and green dots and four blocks on the screen. The test included motion + disparity (MD), motion (M), and disparity (D), where the D cues ranged from 200 to 1,200 arc-seconds. The characteristics of preoperative dynamic stereopsis in 83 X(T) patients and associations with clinical features were analysed, and the prognosis was followed up on the 1(st) day and at the 2(nd), 6(th) and 12(th) months postoperatively. RESULTS: Preoperatively, the mean reciprocal values of near and far stereopsis were 0.013±0.0016 and 0.0011±0.0005 arc-seconds in static stereopsis patients, respectively, and the MD, M, and D values were 0.002±0.0002, 0.0018±0.0001, and 0.0012±0.0002 arc-seconds in dynamic stereopsis, respectively. The MD value was negatively correlated with the Newcastle control score, disease course, and prism deviations (P

AIM: To delineate the characteristics of the dynamic stereopsis test and analyze related parameters in intermittent exotropia [X(T)] patients. METHODS: Fifty-seven X(T) patients and 55 normal subjects were enrolled in this study. The normal and X(T) groups were used to test the reproducibility and reliability of the dynamic stereopsis test, and Bangerter filters with densities of 0.2 were then used to simulate suppression to test for traditional and dynamic stereopsis. In the X(T) group, the measurements included 1) dynamic stereopsis test comprising three parts: motion+disparity, motion only and disparity only; 2) ocular deviation angle; 3) Bagolini striated lens test; 4) disease course; and 5) Titmus stereopsis test. RESULTS: The test-retest reliability of the dynamic stereopsis method was 0.901 in the normal and X(T) groups, and none of the X(T) patients were able to pass the static and dynamic stereopsis tests after using the 0.2 Bangerter filter. The accuracy rate was greater than 80% in the normal group and 31.81%, 36.36%, and 45.45% for the motion+disparity, motion-only and disparity-only components of the traditional test for X(T) patients diagnosed with stereoblindness via traditional tests, respectively. Patients with a long disease course (>1y) had worse dynamic stereopsis than those with a short disease course (0.05, Chi-square test). CONCLUSION: Dynamic stereopsis is preserved in certain X(T) patients diagnosed with stereoblindness via traditional tests. A long disease course was shown to be a negative factor for dynamic stereopsis in X(T) patients which might be associated with worse progression, and provide good references clinically.

Background Children with deprivation amblyopia due to childhood cataract have been excluded from much of the emerging research into amblyopia treatment. An investigation was conducted to determine whether contrast-balanced binocular treatment - a strategy currently being explored for children with anisometropic and strabismic amblyopia - may be effective in children with deprivation amblyopia. Methods An unmasked, case-series design intended to assess proof of principle was employed. Eighteen children with deprivation amblyopia due to childhood cataracts (early bilateral n = 7, early unilateral n = 7, developmental n = 4), as well as 10 children with anisometropic (n = 8) or mixed anisometropic and strabismic amblyopia (n = 2) were prescribed one hour a day of treatment over a six-week period. Supervised treatment was available. Visual acuity, contrast sensitivity, global motion perception and interocular suppression were measured pre- and post-treatment. Results Visual acuity improvements occurred in the anisometropic/strabismic group (0.15 ± 0.05 logMAR, p = 0.014), but contrast sensitivity did not change. As a group, children with deprivation amblyopia had a smaller but statistically significant improvement in weaker eye visual acuity (0.09 ± 0.03 logMAR, p = 0.004), as well a significant improvement in weaker eye contrast sensitivity (p = 0.004). Subgroup analysis suggested that the children with early bilateral deprivation had the largest improvements, while children with early unilateral cataract did not improve. Interestingly, binocular contrast sensitivity also improved in children with early bilateral deprivation. Global motion perception improved for both subgroups with early visual deprivation, as well as children with anisometropic or mixed anisometropic/strabismic amblyopia. Interocular suppression improved for all subgroups except children with early unilateral deprivation. Conclusion These data suggest that supervised contrast-balanced binocular treatment should be further investigated as a treatment option for children with deprivation amblyopia. However, for children with more severe deprivation amblyopia due to early unilateral cataracts, supplementary or alternative options should also be explored.

Purpose Optical treatment can improve visual function in anisometropic amblyopia, but there is no electrophysiological evidence, and the underlying change in visual pathway remains unknown. Our aims were to characterize the functional loss in magnocellular and parvocellular visual pathways in anisometropic amblyopia at baseline and to investigate the effect of optical treatment on the 2 visual pathways. Methods Using isolated-check visual-evoked potential, we measured the magnocellular- and parvocellular-biased contrast response functions in 15 normal controls (20.13 ± 3.93 years; mean ± standard deviation), 16 patients with anisometropic amblyopia (18.00 ± 6.04 years) who were fully refractive corrected before and 29 (19.41 ± 7.41 years) who had never been corrected. Twelve previously uncorrected amblyopes received optical treatment for more than 2 months and finished the follow-up measurement. Results Both the magnocellular- and parvocellular-biased contrast response functions in the amblyopic eye exhibited significantly reduced response and weaker contrast gains. We also found that the uncorrected amblyopes showed a more severe response reduction in magnocellular-biased, but not parvocellular-biased condition when compared with those corrected, with a weaker initial contrast gain and lower maximal response. After optical treatment, 12 uncorrected amblyopes demonstrated improved visual acuity of the amblyopic eye and a significant response gain to magnocellular-biased but not parvocellular-biased stimuli. Conclusions We demonstrated deficits to both magnocellular- and parvocellular-biased stimuli in subjects with anisometropic amblyopia. Optical treatment could produce neurophysiological changes in visual pathways even in older children and adults, which may be mediated through the magnocellular pathway.

Purpose To demonstrate an aniseikonia test for anisometropic amblyopia (ATAA) that uses variable viewing luminance at different interocular contrast levels. Methods The test consists of a direct size comparison task based on a computer. The subject is asked to adjust the size of a dichoptically dissociated paired square target. One square was always presented at 100% contrast to the amblyopic eye/nondominant eye, whereas its counterpart was presented to the fellow eye at six contrast levels. Measurements were performed at two luminance backgrounds: (1) a white square on a black background (WoB) and (2) a black square on a white background (BoW). To test the feasibility of this approach, 16 patients with anisometropic amblyopia and 23 normal controls were recruited. Results The Aniseikonia Index (AI) calculated from the ATAA increased when the difference in the interocular contrast increased in both the patients with anisometropic amblyopia and controls under BoW and WoB conditions. The mean AI differed dramatically between the BoW and WoB conditions in patients with amblyopia but not in normal subjects. Conclusions Our model predicted interocular differences in contrast to the measurement of aniseikonia. Execution of the AI in individuals with amblyopia should consider that their responses to different luminance viewing conditions could be asymmetric. Translational relevance The ATAA has the potential to optimize optical correction for the management of aniseikonia in individuals with anisometropic amblyopia.

Purpose We assessed whether partial occlusion of the nonamblyopic eye with Bangerter filters can immediately reduce suppression and promote binocular summation of contrast in observers with amblyopia. Methods In Experiment 1, suppression was measured for 22 observers (mean age, 20 years; range, 14-32 years; 10 females) with strabismic or anisometropic amblyopia and 10 controls using our previously established "balance point" protocol. Measurements were made at baseline and with 0.6-, 0.4-, and 0.2-strength Bangerter filters placed over the nonamblyopic/dominant eye. In Experiment 2, psychophysical measurements of contrast sensitivity were made under binocular and monocular viewing conditions for 25 observers with anisometropic amblyopia (mean age, 17 years; range, 11-28 years; 14 females) and 22 controls (mean age, 24 years; range, 22-27; 12 female). Measurements were made at baseline, and with 0.4- and 0.2-strength Bangerter filters placed over the nonamblyopic/dominant eye. Binocular summation ratios (BSRs) were calculated at baseline and with Bangerter filters in place. Results Experiment 1: Bangerter filters reduced suppression in observers with amblyopia and induced suppression in controls (P = 0.025). The 0.2-strength filter eliminated suppression in observers with amblyopia and this was not a visual acuity effect. Experiment 2: Bangerter filters were able to induce normal levels of binocular contrast summation in the group of observers with anisometropic amblyopia for a stimulus with a spatial frequency of 3 cycles per degree (cpd, P = 0.006). The filters reduced binocular summation in controls. Conclusions Bangerter filters can immediately reduce suppression and promote binocular summation for mid/low spatial frequencies in observers with amblyopia.

Aim To assess the outcomes of posterior chamber implantable collamer lens (ICL) implantation in Chinese pediatric patients with unilateral high myopic amblyopia. Methods Eleven eyes of 11 amblyopic patients aged 11.02±3.34y underwent ICL (model V4, Staar Surgical Inc.) implantation to treat unilateral anisometropia were studied. Visual acuity, cycloplegic refraction, contrast sensitivity, stereopsis, intraocular pressure (IOP), vaulting, corneal endothelial cell count and complications were evaluated. Patients completed follow-up at 3d, 1, 3mo and the last follow-up time (mean 8.18±2.82mo) after surgery. Results The mean myopic anisometropia was -13.70±3.25 D preoperatively and +0.69±2.63 D at 8mo postoperatively. The logMAR corrected distance visual acuity (CDVA) of the amblyopic eye was 1.51±0.72 preoperatively and 0.75±0.40 at 8mo postoperatively. The logMAR CDVA at 3d, 1, 3 and 8mo postoperatively improved by a mean of 0.64, 1.55, 1.82 and 2.64 lines and gained more than 2 lines accounted for 18%, 45%, 45%, 64%, respectively. The contrast sensitivity of 0.5, 1 and 2 cpd in amblyopic eyes was significantly increased after surgery. No patient had near stereopsis recovery. The vaulting at 3 and 8mo was significantly lower than that at 1mo postoperatively. No other intraoperative or postoperative complications were observed, except an acute pupillary block glaucoma happened in a patient at two weeks postoperatively. Conclusion This short-term results indicate that ICL implantation can be a promising alternative therapy for high myopic anisometropic amblyopia in pediatric patients who have failed with conventional treatments and not suitable to corneal refraction surgery.

Perceptual learning in contrast detection improves monocular visual function in adults with anisometropic amblyopia; however, its effect on binocular combination remains unknown. Given that the amblyopic visual system suffers from pronounced binocular functional loss, it is important to address how the amblyopic visual system responds to such training strategies under binocular viewing conditions. Anisometropic amblyopes (n = 13) were asked to complete two psychophysical supra-threshold binocular summation tasks: (1) binocular phase combination and (2) dichoptic global motion coherence before and after monocular training to investigate this question. We showed that these participants benefited from monocular training in terms of binocular combination. More importantly, the improvements observed with the area under log CSF (AULCSF) were found to be correlated with the improvements in binocular phase combination.