Key Points Question Can deep learning algorithms achieve a performance comparable with that of ophthalmologists on multidimensional identification of retinopathy of prematurity (ROP) using wide-field retinal images? Findings In this diagnostic study of 14 108 eyes of 8652 preterm infants, a deep learning–based ROP screening platform could identify retinal images using 5 classifiers, including image quality, stages of ROP, intraocular hemorrhage, preplus/plus disease, and posterior retina. The platform achieved an area under the curve of 0.983 to 0.998, and the referral system achieved an area under the curve of 0.9901 to 0.9956; the platform achieved a Cohen κ of 0.86 to 0.98 compared with 0.93 to 0.98 by the ROP experts. Meaning Results suggest that a deep learning platform could identify and classify multidimensional ROP pathological lesions in retinal images with high accuracy and could be suitable for routine ROP screening in general and children’s hospitals.

CH measurement is practical in young children because this is when myopia undergoes its most rapid progression. Prospective follow-up of this cohort at high risk for myopia is under way to determine whether low CH is predictive, or a consequence, of long AL.

Purpose: To evaluate the efficacy of Highly Aspherical Lenslets (HAL) in slowing myopia progression among school children and compare it to Orthokeratology. Methods: This retrospective cohort study included 186 cases of myopic individuals aged between 7 to 15 years, with myopia ranging from -0.75 to -8.00D and astigmatism of ≤ 4.0D. Each group consisted of 62 subjects, and only the right eye was included in the analysis. The study involved six-monthly measurements of both cycloplegic refraction and axial length to track changes over time. Results: The baseline average age, gender, Spherical equivalent refraction (SER), and axial length (AL) in the SV group, HAL group, and Ortho-K group were no statistically significant differences (P>0.05). At six months, average (SER) myopia progression was -0.44±0.34 D in the single vision (SV) lenses group and -0.16±0.32 D in the HAL group. Average axial elongation was 0.22±0.13mm in the SV group, 0.08±0.14mm in the HAL group and 0.04±0.11mm in the orthokeratology group. As compared to the SV group, the HAL group reduced myopia progression (SER) to 65.9% (mean difference 0.29±0.46D, P＜0.001). Compared with the SV group, the HAL group axial elongation more slowly(63.6%, mean difference 0.14±0.19mm, P＜0.001). Likewise, axial elongation more slowly at 81.8% for orthokeratology group subjects than the SV group (mean difference 0.18±0.20mm， P＜0.001). In terms of individual issues, 35 of 62 children wearing HAL had no myopia progression after 6 months, higher than the SV group (15 of 62, 24.2%, P＜0 .001). In addition, 30.6% of children with HAL revealed no axial elongation, compared with 3.2% of those with SV lenses (2 of 62, P＜0 .001). The axial elongation of HAL and Ortho-K lenses (28 of 62, 45.2%) was similar (P> 0.05). Conclusions: Wearing the HAL daily slows myopia progression in myopic children and significantly reduces axial elongation. Additionally, both the daily employment of HAL and overnight Orthokeratology demonstrate comparable efficacy in slowing axial elongation in myopic children.

PurposeTo compare the biometric characteristics between concomitant exotropia (XT) and orthotropia (OT) with OA2000.MethodThis cross-sectional study collected 4–18 years old children. All subjects underwent a comprehensive ophthalmic examination and prism alternate cover test for ocular alignment measurement. Included subjects had no any eye surgery, structural ocular anomalies, amblyopia of either eyes, ptosis, cataract and nystagmus. OA-2000 was used for the measurement of ocular biological parameters. Spherical equivalent (SE, spherical power + (cylindrical power)/2), keratometry, central corneal thickness (CCT), white to white distance (WTW), pupil diameter (PD), anterior chamber depth (ACD), lens thickness (LT), axial lengths (AL) and intereye differences in SE, keratometry, CCT, WTW, PD, ACD, LT and AL were analyzed by independent sample t-tests. Pearson correlation was used for correlations assessment. Partial correlation was used to control for intereye differences in SE.ResultsA total of 156 subjects (79 XT and 77 OT) were collected. Intereye differences in spherical equivalent (SE) (t 2.369, P 0.019), AL (t 3.423, P 0.001), ACD (t 3.782, P < 0.001), LT (t 3.136, P 0.002) and PD (t 3.229, P 0.002) were significantly larger in XT patients than OT patients. The correlation coefficient of XT with SE asymmetry was 0.187 (P 0.020), 0.265 with AL asymmetry (P 0.001), 0.289 with ACD asymmetry (P < 0.001), 0.251 with PD asymmetry (P 0.002) and 0.243 with LT asymmetry (P 0.002). Strong correlation (r 0.875) was found between anisometropia and AL asymmetry. After controlling the effect of anisometropia, the correlation coefficients slightly reduced between XT patients and intereye differences in AL (reduced to 0.213), ACD (reduced to 0.266), PD (reduced to 0.230) and LT (reduced to 0.230). Strong correlation (r 0.855) was found between intereye differences in ACD and LT.ConclusionCompared with OT subjects, intereye differences in SE, AL, ACD, LT and PD were significantly larger in XT patients and had positive correlation with XT and may be associated with the pathogenesis of XT.

Background: This study aimed to evaluate the asymmetry of optic nerve head parameters measured by confocal scanning laser ophthalmoscopy (CSLO) in myopic anisometropic eyes. Methods: A total of 36 eyes of 18 healthy myopic anisometropic subjects, defined as cases in which the difference in spherical equivalent (SE) between both eyes is ≥1.5D, were recruited. The optic nerve heads were measured using the Heidelberg retina tomograph II (Heidelberg Engineering, GmBH, Heidelberg, Germany). Differences in optic nerve head parameters between more myopic eyes and fellow eyes were evaluated using the paired-sample t-test. Pearson correlation and multiple linear regression analysis were used to evaluate factors associated with cup/disc ratio (CDR). Results: The cup/disc area ratio (mean difference 0.07 ± 0.11, P = 0.027), horizontal (mean difference 0.10 ± 0.17, P = 0.033), and vertical CDR (mean difference 0.13 ± 0.18, P = 0.008) were significantly smaller in more myopic eye. Larger disc area was independently and significantly associated with larger cup/disc area ratio (β = 0.561, P = 0.001) and vertical CDR (β = 0.499, P = 0.03). Conclusion: The CDR, horizontal, and vertical CDR were significantly smaller in the more myopic eyes in myopic anisometropic subjects. Further studies with larger samples are needed to confirm the asymmetry of the optic nerve head in myopic anisometropic eyes.

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Purpose: To evaluate the ocular biometric parameters in patients with constant and intermittent exotropia by the measurement of swept-source optical coherence tomography (SS-OCT) optical biometer OA-2000 and comparing it with the normal control subjects.Design: Cross-sectional case-control study.Participants: Fifty-five constant and 24 intermittent patients with exotropia with central fixation and 77 orthotropic normal control participants aged 4–18 years old.Methods: Non-contact and high-resolution optical biometric OA-2000 measurements were conducted under uniform ambient light conditions. The statistical analysis included intraclass correlation coefficient (ICC), Bland-Altman plot, and independent t-tests.Main Outcome Measures: Spherical equivalent (SE), ocular biological parameters such as pupil diameter (PD), anterior chamber depth (ACD), lens thickness (LT), and axial lengths (AL). The absolute values of inter-eye differences for SE, PD, ACD, LT, and AL were recorded as AnisoSE, AnisoPD, AnisoACD, AnisoLT, and AnisoAL, respectively.Results: AnisoSE (0.878 vs. 0.577, P = 0.019), AnisoAL (0.395 vs. 0.208, P = 0.001), AnisoACD (0.060 vs. 0.032, P &lt; 0.001), AnisoLT (0.060 vs. 0.031, P = 0.002), and AnisoPD (0.557 vs. 0.340, P = 0.002) were significantly larger in concomitant patients with exotropia. The SE, AL, ACD, LT, and PD showed excellent binocular correlation with ICC values that ranged from 0.943 to 0.987 in control participants and from 0.767 to 0.955 in concomitant exotropia patients. Bland-Altman plots showed the wider range of agreement in patients with concomitant exotropia than the control participants (SE: 5.0288 vs. 3.3258; AL: 2.2146 vs. 1.3172; ACD:0.3243 vs. 0.1682; PD: 2.4691 vs. 1.9241; and LT:0.3723 vs 0.1858).Conclusion: Patients with concomitant exotropia showed larger inter-eye differences in SE, ACD, LT, PD, and AL. Advice should be given to suspicious children to avoid or delay the development of concomitant exotropia.