| Children's visual development is a process of maturation from embryonic stage to early birth,especially in infancy.Normal development of visual system involves the integrity of peripheral organ(eye)structure,the normal progress of "emmetropization" of refractive state,the perfection of the retina to visual center(brain)and the normal function of the eye movement.Any part of the affected visual system may lead to abnormal visual development of infants.In this period,visual development is high plasticity and has a time limit for treatment,therefore early intervention is very important to help and promote visual development if abnormal.In this paper,comprehensive treatment of visual abnormalities in infants and study of zebrafish retinal development-related polypeptides are discussed in three parts from clinical experience and basic experiment.1.Early refractive correction of infants with visual abnormalities: All infants tested were set up visual development records and accepted post-mydriasis refractive correction.Firstly,A cross-sectional analysis of 795 children aged 0-3 years old with visual dysplasia showed that the top three causes were high and moderate hyperopia(51.45%),significant astigmatism(33.71%)and strabismus(22.77%),among which severe visual impairment accounted for 9.06%.The prevalence of amblyopia in 3-year-old children with ametropia was 43.94%,and visual impairment after refractive correction was reduced from 36.74% to 8.71%.The visual acuity of infants in ametropia group,ophthalmopathy group and cerebral visual impairment(CVI)group can be effectively improved by simple refractive correction,with the effective rates being 72.11%,44.55% and 14.70%.Secondly,115 children aged 1-3 years with ametropia were accepted refractive corrected and followed up for 3 years.It was found that the equivalent spherical(SE)values of myopia,emmetropia and hyperopia children declined with age,but astigmatism did not change.The SE difference between the eyes of hyperopic anisometropia children decreased year by year.The younger the age and the heavier the degree,the greater the average annual declined.Thirdly,the prevalence of amblyopia was found to be significantly different between groups of children who started wearing glasses at 1-year-old(38 cases),2-year-old(65 cases)and 3-year-old(96 cases),(?2=31.65,P<0.01)with moderate and high hyperopia.We found that the detection rate of amblyopia in 3-year-old group was the highest(71.33%).Therefore,it is suggested that infants with visual abnormalities should be closely followed up and accepted carefully optical rectification according to age,diopter and visual development level.2.Early visual rehabilitation training for infants with CVI:29 infants with CVI initially diagnosed in our hospital from January 2017 to December 2018 were assessed with the CVI assessment scale introduced from the Hong Kong Center of Cardiology and given targeted visual rehabilitation training.Premature accounted for 51.72% of these children.All CVI children were with poor clinical visual function,and the top three visual impairment characteristics of CVI assessment scale were visual field impairment(68.97%),eye movement abnormality(65.52%)and poor visual search ability(62.07%).But only 10 CVI children were followed up and treated,6 of them improved in the tracking,visual distance and visual field.It is suggested that children with CVI should be screened earlier and more effectively,the evaluation and training methods should be standardized.Ultimately,we are to improve the functional vision and achieve comprehensive rehabilitation of CVI children.3.Study on the polypeptide rerelated to retinal development of Juvenile Zebrafish.Our team identified differentially expressed polypeptides in zebrafish retina which may related to retinal development in early stage.In this study,we chosed ?YGLPVVKLLHPPSHWPLIKATVGLIRNLALCP?,a polypeptide whose function has not been reported yet.Bioinformatics analysis showed that this polypeptide was located in ARM,the functional domain of the precursor protein beta-catenin,highly conserved among species(99.1% homology in human,mouse and zebrafish),stable and lipophilic,easy to enter cells,and highly expressed in the cerebral cortex and eye structure related to visual development.Whether this polypeptide can affect retinal development through some signaling mechanisms will provide us new clinical thinking in the treatment of infantile retinopathy. |
PDF Full Text Request