Longitudinal Visual Recovery and Exploratory Neuroimaging Findings in Pediatric Deprivation Amblyopia Following Unilateral Congenital Cataract Extraction: A Prospective Cohort Study
4 affiliations
- 1Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Ophthalmology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China
- 2Department of Pulmonary and Critical Care Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing 102218, China
- 3Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743 Jena, Germany
- 4Department of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing 102218, China
Abstract
Objectives: Visual outcomes after unilateral congenital cataract (UCC) extraction remain variable, and the neuroanatomical changes accompanying subsequent visual improvement are poorly understood. This study characterized longitudinal changes in visual function and explored hemispheric asymmetry, longitudinal neuroimaging changes, and their associations with visual recovery in children after UCC extraction. Methods: This prospective observational cohort study enrolled 55 children aged 5 to <9 years with unilateral deprivation amblyopia receiving optical correction, passive occlusion, and dichoptic training. We analyzed 6-month changes in central visual field (CVF; mean sensitivity [MS], mean defect [MD]) and corrected distance visual acuity (CDVA). To assess structural alterations along the posterior visual pathways, a strictly controlled, exploratory subgroup of 18 right-handed patients (aged 5 to <8 years) with left-eye amblyopia underwent 3-Tesla (3T) MRI. Multiple comparisons in the neuroimaging and structure–function analyses were controlled using the Benjamini–Hochberg false discovery rate (FDR) procedure. Results: At 6 months, CDVA and CVF improved significantly from baseline across all amblyopia severity groups (all p < 0.05). Greater CDVA improvement was associated with larger increases in MS (β = 3.36, 95% CI, 1.37 to 5.35; p = 0.001) and greater reductions in MD (β = −2.80, 95% CI, −4.82 to −0.79; p = 0.007). Exploratory longitudinal neuroimaging analyses showed decreases in ipsilateral secondary visual cortex (V2) volume (Cohen’s d = −0.75, PFDR = 0.042) and cortical thickness (Cohen’s d = −0.77, PFDR = 0.042). Interhemispheric differences in V2 and middle temporal visual area (MT) cortical thickness were also observed at the 6-month follow-up (all |Cohen’s d| > 0.75, PFDR < 0.05). Nominal structure–function associations were observed for CVF and CDVA changes (all |r| > 0.54, all p < 0.05). No serious adverse events were observed. Conclusions: Children with unilateral deprivation amblyopia following UCC extraction showed improvements in CDVA and CVF over 6 months of routine care. CVF perimetry may provide complementary functional information during longitudinal assessment. Exploratory neuroimaging findings suggested potentially distinct structural correlates of CDVA and CVF recovery, requiring validation in larger controlled longitudinal studies to clarify the clinical significance of CVF and its associated neuroimaging changes.
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BibTeX
@article{ni2026longitudinal,
title = {{Longitudinal Visual Recovery and Exploratory Neuroimaging Findings in Pediatric Deprivation Amblyopia Following Unilateral Congenital Cataract Extraction: A Prospective Cohort Study}},
author = {Shuhua Ni and Xiaoli Tang and Meng Li and Jing Li and Fei Leng and Panpan Zheng and Wei Shi and Li Li},
journal = {Journal of clinical medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15197696},
url = {https://europepmc.org/article/PMC/PMC13666433},
note = {CC BY},
}
RIS
TY - JOUR
TI - Longitudinal Visual Recovery and Exploratory Neuroimaging Findings in Pediatric Deprivation Amblyopia Following Unilateral Congenital Cataract Extraction: A Prospective Cohort Study
AU - Shuhua Ni
AU - Xiaoli Tang
AU - Meng Li
AU - Jing Li
AU - Fei Leng
AU - Panpan Zheng
AU - Wei Shi
AU - Li Li
PY - 2026
DA - 2026/10/01
JO - Journal of clinical medicine
DO - 10.3390/jcm15197696
UR - https://europepmc.org/article/PMC/PMC13666433
AB - Objectives: Visual outcomes after unilateral congenital cataract (UCC) extraction remain variable, and the neuroanatomical changes accompanying subsequent visual improvement are poorly understood. This study characterized longitudinal changes in visual function and explored hemispheric asymmetry, longitudinal neuroimaging changes, and their associations with visual recovery in children after UCC extraction. Methods: This prospective observational cohort study enrolled 55 children aged 5 to <9 years with unilateral deprivation amblyopia receiving optical correction, passive occlusion, and dichoptic training. We analyzed 6-month changes in central visual field (CVF; mean sensitivity [MS], mean defect [MD]) and corrected distance visual acuity (CDVA). To assess structural alterations along the posterior visual pathways, a strictly controlled, exploratory subgroup of 18 right-handed patients (aged 5 to <8 years) with left-eye amblyopia underwent 3-Tesla (3T) MRI. Multiple comparisons in the neuroimaging and structure–function analyses were controlled using the Benjamini–Hochberg false discovery rate (FDR) procedure. Results: At 6 months, CDVA and CVF improved significantly from baseline across all amblyopia severity groups (all p < 0.05). Greater CDVA improvement was associated with larger increases in MS (β = 3.36, 95% CI, 1.37 to 5.35; p = 0.001) and greater reductions in MD (β = −2.80, 95% CI, −4.82 to −0.79; p = 0.007). Exploratory longitudinal neuroimaging analyses showed decreases in ipsilateral secondary visual cortex (V2) volume (Cohen’s d = −0.75, PFDR = 0.042) and cortical thickness (Cohen’s d = −0.77, PFDR = 0.042). Interhemispheric differences in V2 and middle temporal visual area (MT) cortical thickness were also observed at the 6-month follow-up (all |Cohen’s d| > 0.75, PFDR < 0.05). Nominal structure–function associations were observed for CVF and CDVA changes (all |r| > 0.54, all p < 0.05). No serious adverse events were observed. Conclusions: Children with unilateral deprivation amblyopia following UCC extraction showed improvements in CDVA and CVF over 6 months of routine care. CVF perimetry may provide complementary functional information during longitudinal assessment. Exploratory neuroimaging findings suggested potentially distinct structural correlates of CDVA and CVF recovery, requiring validation in larger controlled longitudinal studies to clarify the clinical significance of CVF and its associated neuroimaging changes.
SN - 2077-0383
ER -