To establish percentile curves of refractive development for children and adolescents aged 5–18y in Hubei Province.

A cross-sectional study was conducted in 103 county-level administrative districts of Hubei Province via a multistage stratified cluster sampling strategy. Participants underwent non-cycloplegic autorefraction, and spherical equivalent refraction (SER) of the right eye was calculated. Generalized additive models for location, scale, and shape (GAMLSS) were applied to construct age-specific standard SER percentile curves stratified by gender and region. Moreover, age-related curves of annual refractive progression rate at each percentile were plotted.

A total of 1255454 participants (673341 boys and 582113 girls) aged 5–18y (mean age: 11.13±3.59y) were enrolled. An overall myopic shift trend was observed with advancing age. The median SER was +0.25 diopters (D) at 5 years of age and decreased to -0.50 D at 9 years of age. From 5 to 18 years of age, the refractive progression was -6.63 D at the 3rd percentile, while the values were -3.25 D and -1.00 D at the 50^th and 97^th percentiles, respectively. Girls and rural children presented higher myopic degrees. The annual age-dependent refractive progression rate curve showed a U-shaped pattern, with greater annual refractive changes in lower percentiles and peak refractive progression occurring at younger ages.

Children in lower SER percentiles suffer from more severe myopia and faster refractive progression. Therefore, earlier and targeted intensive myopia interventions are warranted for children with SER below the 50^th percentile.

To evaluate clinical characteristics, treatment patterns and long-term quality of life (QoL) among children with retinoblastoma (RB) managed at a single tertiary center in China.

Totally 62 consecutive patients (71 eyes) diagnosed with RB were retrospectively reviewed. The mean age at first visit was 22.13±17.87mo; 35 (56.45%) were male. Unilateral disease occurred in 53 patients (85.48%) and bilateral disease in 9 (14.52%). According to the international intraocular retinoblastoma classification (IIRC), eyes were staged as A (n=6), B (n=9), C (n=9), D (n=21), E (n=19), and extraocular (n=7). Treatments followed stage-based indications. QoL at follow-up was assessed using validated pediatric ophthalmic instruments completed by patients and/or parents.

The mean follow-up duration was 42.9±6.49mo. Overall survival was 90.32% (56/62), mortality was 9.68% (6/62). The overall globe-preservation rate was 64.79% (46/71), and 71.88% (46/64) for intraocular RB. Eye salvage by IIRC stage was 100% for A–C, 71.43% (15/21) for D, and 36.84% (7/19) for E; no eyes were preserved in extraocular disease. Compared with the globe-preservation group, enucleated children had significantly lower scores in appearance, social functioning, and role domains on QoL measures (P<0.05). Across all PedEyeQ domains, children with preserved globes scored higher than those who underwent enucleation (P<0.05).

Most children in this cohort present with intermediate-to-advanced disease, which limit eye-preservation opportunities. While survival approached contemporary benchmarks, QoL deficits are most pronounced in appearance, social participation, and role functioning after enucleation. Additionally, parents of children who underwent enucleation often experience heightened anxiety about their child’s vision and social integration. These findings underscore the need for earlier detection and integrated psychosocial support alongside stage-appropriate therapy.

To observe the surgical effects of slanted bilateral lateral recession (S-BLR) versus conventional bilateral lateral recession (C-BLR) in convergence insufficiency intermittent exotropia (CI-IXT).

Using a randomized, double-blind, prospective design, 22 patients with CI-IXT who were admitted to Renmin Hospital of Wuhan University from July 2019 to December 2020 were included. Patients were randomly divided into either S-BLR or C-BLR group for their subsequent strabismus surgery. All patients were followed up for 12mo. Near deviation, distant deviation, and near-distance difference (NDD) were measured in all patients.

Twelve months after surgery, NDD improvement was 10 (8, 13) prismatic degrees (PD) in S-BLR group and 3 (1, 6) PD in C-BLR group (P=0.011). The near deviation of S-BLR group was 0 (-2, 2) PD, while that of C-BLR group was -4 (-6, -3) PD (P=0.005). Before and after surgery, the difference in the distant deviation between the two groups was not statistically significant. There was no statistically significant difference in near stereopsis between the two groups (P=0.380) at 12mo. The success rate at 12mo after operation was 90.91% and 72.73% in the two groups (P=0.280).

CI-IXT patients treated with S-BLR have better surgical outcomes than those treated with C-BLR, which indicates S-BLR is a safe and effective operation pattern.

To study the causal relationship between obesity-related anthropometric traits and myopia and the mediating role of educational attainment (EA).

Univariable Mendelian randomization (UVMR) was performed to evaluate the causal association between body mass index (BMI), height, waist-hip ratio (WHR, adjusted for BMI), and mean spherical equivalent (MSE). BMI was divided into fat and fat-free mass and included in multivariable Mendelian randomization (MVMR) to explore the roles of different BMI components in the causal relationship between BMI and MSE. A mediation analysis based on two-step Mendelian randomization (MR) was carried out. Specifically, UVMR was conducted to estimate the causal effect of BMI on EA. The direct effect of EA on MSE was estimated from MVMR. The mediation effect of EA in the BMI-EA-MSE model was calculated by the product of coefficients method. Expression quantitative trait loci (eQTL)-MR, reverse MR, and Linkage Disequilibrium Score Regression (LDSC) were performed to assess the robustness.

Genetically predicted higher BMI had a positive total effect on MSE (βIVW=0.26 D, 95%CI=0.14 to 0.37 D, P<0.001), whereas there was no significant association between height, WHR, and MSE. Fat mass was found to play a significant role in the effect of body mass on MSE (βIVW=0.50 D, 95%CI=0.21 to 0.78 D, P=0.001), but there was no significant association between fat-free mass and MSE. The causal effect of BMI on EA was -0.14 (95%CI=-0.16 to -0.11, P<0.001), and the direct effect of EA on MSE was -0.63 D (95%CI=-0.81 to -0.44 D, P<0.001). The mediating effect of EA in the BMI-EA-MSE model was 0.09 D (95%CI=0.06 to 0.12 D), with a mediation proportion of 33% (95%CI=22.1% to 44.6%). No reverse causal associations were detected except for BMI on EA. The results of eQTL-MR and LDSC were consistent with each MR analysis.

Genetically predicted higher BMI decreases the degree of myopia with a 33% mediation proportion by EA, and fat mass provides a dominant protective role in body mass-myopia. As a supplement to previous observational studies, it provides strong evidence for the relationship between anthropometric traits and refractive errors and offers a theoretical basis for future measures to prevent and control myopia.