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To investigate the factors for treatment success in anisometropic amblyopia according to the spherical equivalent (SE) type of amblyopic eyes. Medical records of 397 children with anisometropic amblyopia aged 3 to 12 years who presented in a secondary referral eye hospital during 2010 ~ 2016 were retrospectively reviewed. Anisometropia was defined as ≥ 1 diopter (D) difference in SE, or ≥ 1.5 D difference of cylindrical error between the eyes. According to the SE of amblyopic eyes, patients were categorized into hyperopia (SE ≥ 1D), emmetropia (− 1 < SE <  + 1) and myopia (SE ≤ − 1D) groups. Treatment success was defined as achieving interocular logMAR visual acuity difference < 0.2. Multivariate logistic regression was used to analyze the factors for treatment success. Significant factors for the amblyopia treatment success in hyperopia group (n = 270) were younger age [adjusted odds ratio (aOR) (95% confidence interval, CI) = 0.529 (0.353, 0.792)], better BCVA in amblyopic eyes at presentation [aOR (95% CI) 0.004 (0, 0.096)], longer follow-up period [aOR (95%CI) = 1.098 (1.036, 1.162)], and no previous amblyopia treatment history [aOR (95% CI) 0.059 (0.010, 0.364)]. In myopia group (n = 68), younger age [aOR (95% CI) 0.440 (0.208, 0.928)] and better BCVA in amblyopic eyes [aOR (95% CI) 0.034 (0.003, 0.469)] were associated with higher odds of treatment success. There was no significant factor for treatment success in emmetropia group (n = 59) in this population. The refractive error type of amblyopic eyes at presentation affects the factors for treatment success in anisometropic amblyopia.

To build a deep learning model to diagnose glaucoma using fundus photography. Cross sectional case study Subjects, Participants and Controls: A total of 1,542 photos (786 normal controls, 467 advanced glaucoma and 289 early glaucoma patients) were obtained by fundus photography. The whole dataset of 1,542 images were split into 754 training, 324 validation and 464 test datasets. These datasets were used to construct simple logistic classification and convolutional neural network using Tensorflow. The same datasets were used to fine tune pre-trained GoogleNet Inception v3 model. The simple logistic classification model showed a training accuracy of 82.9%, validation accuracy of 79.9% and test accuracy of 77.2%. Convolutional neural network achieved accuracy and area under the receiver operating characteristic curve (AUROC) of 92.2% and 0.98 on the training data, 88.6% and 0.95 on the validation data, and 87.9% and 0.94 on the test data. Transfer-learned GoogleNet Inception v3 model achieved accuracy and AUROC of 99.7% and 0.99 on training data, 87.7% and 0.95 on validation data, and 84.5% and 0.93 on test data. Both advanced and early glaucoma could be correctly detected via machine learning, using only fundus photographs. Our new model that is trained using convolutional neural network is more efficient for the diagnosis of early glaucoma than previously published models.

To compare a biometer using swept-source optical coherence tomography (SS-OCT) with a partial coherence interferometry (PCI)-based biometer in measurements of two ocular biometry parameters, i.e., the axial length and anterior cornea curvature. We compared the two biometers SS-OCT (ANTERION, Heidelberg Engineering Inc., Heidelberg, Germany) and PCI (IOL Master, Carl Zeiss Meditec, Jena, Germany) in terms of the axial length (AL) and corneal curvature (K) measurements of 175 eyes. Paired t-tests were used to compare the two biometers. Agreement between the biometers was evaluated using the Bland-Altman method. The mean age was 36.0 ± 25.6 years (range: 5 to 85 years). The mean axial length was 24.42 ± 0.13 mm for SS-OCT and 24.45 ± 0.14 mm for PCI. The mean corneal curvature was significantly different between the two biometry in flat K (K1) but not in steep K (K2). The limit of agreement was -0.15 to 0.21 in the axial length, -1.18 to 0.83 in K1, and -1.06 to 0.95 in K2. All above ocular biometric measurements between SS-OCT and PCI correlated significantly (Pearson's correlation, p<0.001). The axial length measured using SS-OCT is useful in clinical practice. It shows a good correlation and agreement with that measured using PCI. However, the axial length and corneal curvature measured using SS-OCT cannot be used interchangeably with that measured using PCI in clinical practice.

To investigate differences in clinical features based on magnetic resonance imaging (MRI) in idiopathic isolated optic neuritis patients. We retrospectively analyzed 68 eyes of 59 patients diagnosed with optic neuritis and showed inflammatory findings indicative of optic neuritis on MRI. We investigated clinical features, such as the presence of accompanying pain, visual acuity, and optic disc swelling. Optic disc swelling was classified as normal, mild, or severe. The MRI results were divided into intraorbital, intracanalicular, and whole optic nerve according to the lesion, and these were compared and analyzed with clinical features. The study included 29 men and 30 women, with a mean age of 42.6 ± 16.6 years. Among 59 patients, 48 (81.4%) complained of pain. Optic disc swelling was not observed in 48.5% of patients (33 eyes). Inflammatory changes were the most common in the intraorbital region (33 eyes), intracanalicular region (20 eyes), and the entire optic nerve (15 eyes). There was no statistical difference in the pain pattern according to the location of the lesion ( p  = .677), but when inflammation was present in the entire optic nerve, optic disc swelling was severe ( p  = .023). The initial and final visual acuity did not significantly correlate with the MRI pattern, presence of pain, or optic disc swelling ( p  = .156, p  = .714, and p  = .436). The MRI contrast enhancement pattern was associated with optic disc swelling but was not associated with pain or initial visual acuity. It should be noted that it is insufficient to judge the clinical features of optic neuritis based on MRI findings.

To investigate the efficacy of the Korean version of the Minnesota low vision reading chart. A Korean version consisting of 38 items was prepared based on the MNREAD acuity chart developed by the University of Minnesota. A linguist composed the representative sentences, each containing nine words from second and third grade levels of elementary school. Reading ability was measured for 20–35-year-old subjects with normal visual acuity (corrected visual acuity of logMAR 0.0 or better). The maximum reading speed (words per minute [wpm]) for healthy participants, reading acuity (smallest detectable font size), and critical print size (smallest font size without reduction of reading speed) were analyzed. The average age of the subjects was 28.3 ± 2.6 years (male:female ratio, 4:16). The average reading time for 38 sentences was 3.66 ± 0.69 s, with no differences in the average maximum reading speed between sentences (p = 0.836). The maximum reading speed was 174.2 ± 29.3 and 175.4 ± 27.8 in the right and left eye, respectively. Reading acuity was measured as logMAR 0.0 or better in 80% of the cases. All subjects showed a critical print size of 0.2 logMAR or better. The overall reading ability can be measured using the Korean version of the MNREAD acuity chart, thereby making it useful in measuring the reading ability of those with Korean as their native language.

Purpose. To investigate the psychophysiologic aspects of refractive accommodative esotropia (RAE). Methods. I prospectively recruited patients aged 3–6 years with more than 3.0 diopters of hyperopia who presented at Kim’s Eye Hospital from January 2011 to March 2013. I compared Korean Child Behavior Checklist (K-CBCL) which consists of internalizing factors (social withdrawal, somatic complaints, anxiety, and depression) and externalizing factors (social problems, thought problems, attention problems, delinquent behavior, and aggressive behavior) between RAE group and control group. Results. Two out of three internalizing indexes were significantly different between groups (somatic complaints: RAE children 50.1 ± 4.6 and controls 46.6 ± 5.8 , P = 0.026 ; depression/anxiety: RAE children 48.8 ± 7.9 and controls 43.9 ± 6.8 , P = 0.024 ) . Although there was no significant difference, RAE children scored slightly higher on the externalizing behavior index. In the RAE group, the far angle of esodeviation showed a moderate correlation with withdrawn behaviors. Conclusion. Hypermetropic children with high scores on the somatic complaint and depression/anxiety subscales of the CBCL could be at high risk for developing RAE. Psychosocial problems might be related to the pathogenesis of refractive accommodative esotropia.

Purpose: To investigate the surgical results of the non-adjustable suture technique under general anesthesia for the correction of acute acquired comitant esotropia. Study design: Retrospective case study. Methods: Patients with acute acquired comitant esotropia who underwent corrective surgery from September 2008 to June 2018 were included. Surgical treatment was conducted based on the measured maximum angle after occlusion for at least 1 h; all surgeries were performed using the non-adjustable suture technique under general anesthesia. Motor success was categorized into three groups: good, ortho; fair, 2 to 8 prism diopters (PD); and poor, over 8 PD. Sensory success was divided into two groups: good (no diplopia with binocular vision) and poor (no stereopsis with diplopia). Results: 40 patients (21 male and 19 female, 28.78 ± 15.32 years old) were included. Preoperative esodeviation was 28.0 ± 12.8 PD. Mean refractive error was − 2.5 ± 2.5 D (spherical equivalent). After the occlusion of one eye, 14 patients (35%) showed an esodeviation increase of more than 5 PD. There were 70% good, 25% fair, and 5% poor outcomes regarding motor success. 96% of the patients demonstrated good sensory success. Conclusion: The non-adjustable correction based on the maximum angle after 1 h had a relatively excellent motor and sensory success rate.

Background Full-thickness macular hole (FTMH) associated with Valsalva retinopathy has been rarely reported. In this report, we describe a case of surgically treated FTMH secondary to Valsalva retinopathy. Case presentation A 59-year-old male complained of a sudden decrease in visual acuity of the left eye after straining on the toilet for 2 weeks. Best-corrected visual acuity (BCVA) of the left eye was counting fingers at 30 cm. Dilated fundus imaging revealed multiple preretinal hemorrhages involving the fovea. Optical coherence tomography (OCT) revealed a dome-shaped elevated lesion with a hyperreflective surface and hyporeflective area underneath. After 6 weeks of observation, the preretinal hemorrhages were almost completely absorbed, and visual acuity of the left eye improved to 0.06. However, OCT revealed an FTMH. After 12 weeks, no improvement in visual acuity was observed, and the macular hole did not close spontaneously. The patient underwent vitrectomy with indocyanine green-assisted internal limiting membrane peeling and gas tamponade. One month postoperatively, closed macular hole was confirmed using OCT, and the BCVA improved to 0.4. Conclusions FTMH associated with Valsalva retinopathy is rare, and its underlying mechanism requires further investigation. Surgical intervention can achieve closure of the FTMH and lead to improvement in visual acuity.

[This corrects the article DOI: 10.1371/journal.pone.0207982.].

Background Myopia is a prevailing refractive disorder and rapidly increases the risk of vision-threatening conditions. Earlier intervention is crucial to suppress myopia progression; however, the pharmacological and non-pharmacological therapies currently available have limitations. SAT-001 is a novel digital therapeutic software developed for myopia control and is designed to overcome the limitations of existing therapies. The present study aims to evaluate the efficacy and safety of the software as a medical device, SAT-001, for the inhibition of myopia progression and treatment in pediatric patients with myopia. Methods This clinical trial is a two-arm, prospective, randomized, open-label study with a duration of approximately 25 months, comprising a maximum of 52 weeks of participant participation. We will enroll 110 pediatric patients with myopia aged 5 to < 9 years, each with a spherical equivalent of − 0.75 D to − 5.75 D in each eye. Eligible participants will be randomly assigned in a 1:1 ratio to either the study group using SAT-001 with single-vision spectacles or the control group using single-vision spectacles alone. The change in the spherical equivalent refractive error (SER) at 48 weeks from baseline serves as the primary endpoint. The change in SER at 24 weeks and axial length at every 12 weeks from baseline will be the secondary endpoints. Each change will be assessed depending on the myopic severity. Treatment emergent adverse events will be evaluated for the safety analysis. Discussion This randomized controlled trial aims to confirm the efficacy and safety of SAT-001 in slowing pediatric myopia progression. The findings of this study could establish SAT-001 as an easily accessible, convenient, and non-invasive treatment option with minimal side effects, offering long-term myopia control from an early stage. Further research is needed to validate the effectiveness of SAT-001 for moderate to high myopia and concurrent conditions like astigmatism and to improve user engagement, diversify the program, and integrate with hospital-based treatments. Trial registration ClinicalTrials.gov: NCT06344572 ; date of registration: April 12, 2024 (retrospectively registered).