目的:调查角膜塑形镜对近视儿童脉络膜厚度和脉络膜轮廓的长期影响。方法:受试者来自一项2年的随机对照试验。研究对象为年龄8~12岁、等效球镜在-1.00~-6.00 D的儿童(n=80),这些研究对象被随机分配到对照组(n=40)和角膜塑形镜组(n=40)。本研究在基线和1、6、12、18、24个月的随访中收集光学相干断层扫描图像(optical coherence tomography,OCT),然后基于OCT图像计算脉络膜厚度和脉络膜轮廓。在这些随访点也同时测量了眼轴长度(axial length,AL)和其他眼生物学参数。结果:在2年内,对照组的脉络膜厚度随时间变薄,脉络膜轮廓变得更加后凸(均P<0.001)。角膜塑形镜可以改善脉络膜厚度(均P<0.001),并在所有随访中维持脉络膜轮廓不后凸(均P<0.05)。在角膜塑形镜组中,脉络膜轮廓在颞侧的变化小于鼻侧(P=0.008),而脉络膜厚度在颞侧以黄斑中心凹为中心、直径3 mm线性扫描区域的增厚更明显(P<0.001)。2年内脉络膜厚度的变化与对照组中2年内AL变化呈负相关(r=-0.52,P<0.001),然而,这一规律被角膜塑形镜打破(r=-0.05 P=0.342)。在多变量回归模型中校正其他变量后,角膜塑形镜对脉络膜厚度的影响是稳定的。结论:角膜塑形镜可以改善脉络膜厚度并维持脉络膜轮廓,但这种效果在长期内趋于减弱。
Objective: To investigate the long-term effect of orthokeratology on the choroidal thickness and choroidal contour in myopic children. Methods:Subjects were from a conducted 2-year Randomized Clinical Trial. Children (n=80) aged 8-12 years with spherical equivalent refraction of -1.00 to -6.00 D were randomly assigned to the control group (n=40) and ortho-k group (n=40). OCT images were collected at the baseline, 1-, 6-, 12-, 18-, and 24-month visits, then the choroidal thickness and choroid contour were calculated. Axial length (AL) and other ocular biometrics were also measured. Results: During two years, in the control group, the choroidal thickness became thinning and the choroidal contour became prolate with time at all visits (all P<0.001). Ortho-k can improve the choroidal thickness (all P<0.001) and maintain the choroidal contour at all visits (all P<0.05). In the ortho-k group, the choroidal contour was less changed in the temporal than nasal (P=0.008), and the choroidal thickness was more thickening in the temporal 3 mm (P<0.001). Two-year change in choroidal thickness was significantly associated with the two-year AL change in the control group (r=-0.52, P<0.001), however, this trend was broken by ortho-k (r=-0.05, P=0.342). After being adjusted by other variables in the multivariable regression model, the effect of ortho-k on choroidal thickness was stable. Conclusions: In a short term, ortho-k can improve the choroidal thickness and maintain the choroidal contour, but this effect diminished in a long term. Further study with larger sample size and longer follow-up is warranted to refine this issue.
目的:探索一种无创的、智能可穿戴设备监测学龄儿童量化的用眼行为,并定量分析近视发生的相关因素。方法:招募佛山市禅城区石湾第二小学三年级及狮城中学小学部五年级的年龄为7~11岁部分学生共171例。所有受试者均按照非睫状肌麻痹主觉验光结果分为近视组108例和非近视组63例,所有受试者均佩戴智能可穿戴设备“云夹”,进行为期10 d(2022年9月21日—2022年10月2日)的用眼行为数据(近距离用眼距离、近距离用眼时间、近距离环境光照、有效户外时间)采集。采用t检验比较近视组与非近视组儿童在用眼行为数据之间的差异,并应用Logistic回归分析用眼行为与近视发生的相关性。绘制受试者操作特征(receiver operating characteristic curve,ROC)曲线,并计算曲线下面积(area undercurve,AUC)分析用眼行为习惯对近视发生的预测价值。结果:学龄期儿童近视患病率为63.2%。近视组与非近视组在每天用眼时间、单次用眼时间、用眼距离、白天用眼光照、晚上用眼光照、每天户外活动时间及每天有效户外活动暴露次数比较差异均有统计学意义(均P<0.05)。Logistic回归分析显示,单次用眼时间、每天用眼时间是近视发生的危险因素。Spearman相关性分析显示,单次用眼时间及每天用眼时间均与近视发生呈正相关(均P<0.05)。单次用眼时间预测近视发生的ROC曲线下面积为0.939。结论:可穿戴设备“云夹”可量化学龄期儿童用眼行为;学龄期儿童近视发生可能与近距离用眼时间有一定相关性;预测模型可结合儿童屈光发育档案,量化近视发生风险,对儿童实现分类管理,及时采取个性化干预。
Objective: To investigate a non-invasive,smart device capable of monitoring the quantitative visual behavior of school age children, and to analyze quantitatively the relationship between visual behavior and the occurrence of myopia. Methods: This study recruited 171 subjects aged between 7 and 11 years from the third grade of Shiwan SecondPrimary School and the fifth grade of Shicheng Middle School in Chancheng District, Foshan City. Participants werecategorized into a myopia group (108 subjects) and a non-myopia group (63 subjects) based on results from non-ciliary muscle paralysis optometry. All subjects wore "clips" to track their near-work distance, near-work duration, lighting conditions during near-work, and time spent on outdoor activities between September 21, 2020, and October 10, 2020. Differences in these habits between the myopia and non-myopia groups were compared, and logistic regression analysis was conducted to assess the impact of habitual eye use on myopia. Results: The prevalence of myopia was found to be 63.2%. Statistically significant differences (all P<0.05) were observed between the myopic and non-myopic groups regarding average daily near-work time, average single near-work session duration, average near-work distance, average daytime and nighttime near-work lighting conditions, average daily outdoor activity time, and average daily effective outdoor activity exposure. Logistic regression analysis indicated that longer average single near-work sessions and increased average daily near-work time were risk factors for myopia. Spearman correlation analysis further supported these findings, showing a positive correlation between average single near-work session duration and average daily near-work time with the occurrence of myopia (all P<0.05). The predictive accuracy of a model combining average single near-work session duration and average daily near-work time for myopia occurrence was high, with an area under the curve of 0.939. Conclusions: The wearable device "Cloud clip" effectively monitors the visual behavior of school-age children. The occurrence of myopia in this age group may be associated with increased near-work activities. A predictive model incorporating refractive development in myopic children can assess the quantitative risk of myopia, enabling the classification and management of school-age children. Personalized interventions may serve as protective factors against myopia.
朗格汉斯细胞组织细胞增生症 (Langerhans cell histiocytosis,LCH) 是一种由骨髓细胞肿瘤性增殖引起的罕见疾病,多见于儿童。LCH临床表现多样,以骨骼受累最常见。该文报道了一例儿童颅眶沟通LCH,影像学检查结果提示患儿右侧眉弓处类圆形穿凿样骨质破坏,通过手术切除病灶,送组织病理学检查明确诊断,同时选择通过3D打印聚醚醚酮(polyetheretherketone,PEEK)材料修补颅眶缺损部位,PEEK材料匹配度高、安全性好,改善患儿预后,提升患儿生存质量。
Langerhans cell histiocyte (LCH) is a rare disease caused by the tumor-like proliferation of bone marrow cells, which is mostly seen in children. Its clinical manifestations can be diverse, in which the skeletal system is most involved. This paper reports a case of LCH in cranio-orbital communication of a child. The imaging results suggest that there is a round chisel damage at the patient’s right brow ridge. In terms of definitive diagnosis and treatment, this patient underwent surgical resection and histopathological examination. 3D-printed polyether-ether-ketone (PEEK) material was selected to repair the cranio-orbital defect. The material can achieve better biocompatibility, while 3D-printing technique allows higher matching degree, both help to improve the prognosis and quality of life of the patient.
儿童白内障是全球范围内可治疗儿童盲症的主要原因之一。对于这些患儿而言,手术是恢复或保护视力的主要方法。然而,手术后的并发症,特别是青光眼相关不良事件(glaucoma-related adverse events, GRAEs),常常成为导致儿童二次致盲的主要原因,这引起了眼科医疗领域的广泛关注。文章综述了儿童Ⅱ期人工晶状体植入术后GRAEs的影响因素,包括手术设计、眼部解剖特征、其他眼部发育异常和全身疾病等。手术设计中是否植入人工晶状体(intraocular lens,IOL)以及植入的时机和位置都对GRAEs的发生有显著影响。此外,眼部解剖特征如角膜直径、眼轴长度、前房深度、中央角膜厚度和术前晶状体厚度等,也是影响GRAEs发生的重要因素。同时,其他眼部发育异常和全身疾病,如先天性无虹膜、先天性风疹综合征等,也会增加儿童白内障术后青光眼的发生率。文章还总结了预测GRAEs的方法,并推荐使用Cox回归模型建立预测模型。这种模型可以有效地预测儿童Ⅱ期IOL植入术后在特定时间段内发展为GRAEs的概率,从而为早期识别GRAEs高危儿童提供了重要的借鉴。通过对GRAEs影响因素的深入分析和预测模型的建立,文章旨在帮助眼科医生更好地理解GRAEs的发生机制,并在手术前对患儿进行风险评估,从而选择最佳的手术方案和预防措施。这对于改善患儿的术后恢复、减少并发症、保护视功能具有重要的临床意义。
Pediatric cataract is one of the leading causes of treatable childhood blindness worldwide. For these children, surgery is the primary method to restore or preserve vision. However, postoperative complications, particularly glaucoma-related adverse events (GRAEs), often become the main reason for secondary blindness in children, attracting widespread concern in the field of ophthalmology. This study reviews the impact factors of glaucoma-related adverse events after secondary intraocular lens (IOL) implantation in children, including surgical design, ocular anatomical characteristics, other ocular developmental abnormalities, and systemic diseases. Whether to implant an IOL in the surgical design and the timing and positioning of the implantation have a significant impact on the occurrence of GRAEs. In addition, ocular anatomical characteristics, such as corneal diameter, axial length, anterior chamber depth, central corneal thickness, and preoperative lens thickness, are also important factors affecting the occurrence of GRAEs. At the same time, other ocular developmental abnormalities and systemic diseases, such as congenital aniridia and congenital rubella syndrome, also increase the incidence of glaucoma after pediatric cataract surgery. The article also summarizes methods for predicting GRAEs and recommends using the Cox regression model to establish a predictive model. This model can effectively predict the probability of children developing GRAEs after secondary IOL implantation within a specific time period, providing an important reference for the early identification of high-risk children for GRAEs. Through in-depth analysis of the impact factors of GRAEs and the establishment of predictive models, the article aims to help ophthalmologists better understand the mechanisms of GRAEs and assess the risks of children before surgery, thereby selecting the best surgical plan and preventive measures. This is of great clinical significance for improving postoperative recovery in children, reducing complications, and protecting visual function.
目的:评估远视儿童使用1%阿托品凝胶1周后脉络膜厚度(choroidal thickness,CT)的变化。方法:选择42例4~7岁的远视儿童,予每天使用1%阿托品凝胶两次,持续7d。使用光学相干断层成像扫描测量视网膜及CT,并分析使用1%阿托品凝胶前后中心凹以及距中心凹处间隔1.0 mm的上、下、鼻和颞侧(最多3.0mm)CT的变化。结果:在远视儿童中,基线CT随位置而变化(F=27.08, P<0.05),与中心凹相比,鼻侧及距中心凹上方2 mm、3 mm及距中心凹颞侧3 mm处的CT较薄(P<0.05)。使用1%阿托品凝胶后,中央凹及旁中心凹CT改变比较差异无统计学意义(P>0.05)。使用1%阿托品凝胶前后视网膜厚度无明显变化(P>0.05)。结论:短期使用1%阿托品凝胶并没有改变远视儿童的脉络膜和视网膜厚度。
Objective: To assess changes of choroidal thickness (CT) in hyperopia children after 1 week using of 1% atropine.Methods: A total of 42 hyperopia children aged 4–7 years were included into the study.A single drop of 1% atropinegel was used twice a daily for 7 days in the subjects.The thickness of retina and choroid was measured by OCT, and the changes before and after using 1% atropine gel were analyzed at the subfovea and at 1.0 mm intervals (up to3.0 mm) from the fovea at superior, inferior, nasal, and temporal locations. Results: In the hyperopia children, baselineCT parameters were varied with the location(F=27.08,P<0.05).Compared with the fovea, the CT at the nasal side,2 mm and 3 mm above the fovea and 3 mm from the temporal side of the fovea were thinner (P<0.05).After using 1%atropine gel, there was no significant difference in the CT changes of subfoveal choroidal thickness and other sites ofparafovea (P> 0.05). There was no significant change in retinal thickness before and after using 1% atropine gel (P > 0.05).Conclusion: No changes were found in the thickness of choroid and retina in hyperopia children after short-term use of1% atropine gel.
目的:探讨一种改良的简便的儿童晶状体不全脱位摘除技术的手术方法及临床效果。方法:对23例(40眼)晶状体不全脱位儿童采用改良手术方法进行脱位晶状体摘除,术中先做巩膜隧道切口,3个角膜缘穿刺口,经穿刺口放置前房维持器,在维持前房灌注下,截囊针撕囊,水分离后抽吸针头吸净晶状体内容物。撤去前房维持器,用撕囊镊和线镊将囊袋从主切口拖出。若有玻璃体脱出则行前部玻璃体切除术,然后行人工晶状体巩膜缝线固定术。术后中位随访39.0个月,观察其手术效果。结果:术后患儿平均裸眼视力为(0.44±0.22)LogMAR,平均最佳矫正视力为(0.20±0.16)LogMAR,较术前均显著提高(P<0.001)。所有患儿术中眼内压稳定,术中术后没有继发视网膜脱离、脉络膜上腔出血等眼底并发症的发生。结论:改良的儿童晶状体不全脱位摘除技术具有对玻璃体扰动少、手术时间较短、简便易学、对手术设备要求低的优点,值得临床推广。
Objective: To investigate the operation method and clinical effects of a modified-simple technique in children with subluxated lens extraction. Methods: Lens extraction was performed in 40 eyes of 23 children. During operation, the scleral tunnel and 3 lateral corneal incision were made, and anterior chamber maintainer was inserted through one corneal incision. Under stable anterior chamber perfusion, anterior capsulorrhexis was made by needle capsulotome. After hydro-dissection, the content of lens was withdrawn by suction needle completely. Then anterior chamber maintainer was removed, and the capsular bag was dragged out by capsulorhexis forceps and fixation forceps. Anterior vitrectomy was performed if there was prolapse of vitreous. Then scleral intraocular lens fixation was performed. The surgical effects were observed at median 39.0 months postoperative. Results: After surgery, the average uncorrected visual acuity was (0.44±0.22) LogMAR, the average best corrected distant visual acuity was (0.20±0.16) LogMAR. The uncorrected visual acuity and best corrected distant visual acuity were improved postoperative(P<0.001). The intraocular pressure of all patients was stable during operation. During and after operation, there were no fundus complications, such as secondary retinal detachment and suprachoroidal hemorrhage. Conclusion: Modified-simple technique of subluxated lens extraction of children has little disturbance on vitreous and takes shorter time of operation. It is simple, easy to learn and requires simple surgical equipment. This modified technique deserves to be generalized.
目的: 探讨 ETDRS 对数视力表对儿童视力检查的可重复性及其影响的相关因素。方法: 在流行病学调查的过程中, 随机使用 ETDRS 对数视力表, 为 250 位裸眼视力低于 0.5 和 98 位视力正常儿童进行裸眼视力重复检查。
结果: 两次视力测量之间差异的均数为0.004log±0.07; Kappa 分析结果具有很好的一致性(k = 0.71) ; 性别与视力检查一致性无明显相关(P = 0.845) ; 年龄与视力检查一致性有显著相关性(P = 0.019) , 年龄越小视力检查一致性越差; 屈光不正与视力检查一致性也有显著相关性(P = 0.000) , 近视度数在- 1.00D~- 5.00D 之间的儿童视力检查一致性相对差, 而正视眼的视力检查一致性较好。结论: 结果提示 ETDRS 对数视力表适合儿童视力检查, 建议推广使用。
Purpose: To evaluate repeatability of the ETDRS log MAR visual acuity measurementin children and the relative influence factors.Methods: The children (n = 348) with visual acuity less than 0.5 ( equal to 0.3 logunit) in either eye,or one tenth in children with normal visual acuity were chosen todo repeatable uncorrected VA measurement with Bland-Altman analysis and Kappa analysis using ETDRS acuity chart.Results: The mean difference of visual acuity was 0.004log±0.07. There was a significant repeatability (k = 0.71) between two visual acuity examination. There were significant consistent results both on male and female patients (P = 0.845) . A significant relationship was found between age and VA repeatability(P = 0.019) . The VA repeatability could also be influenced by refractive error (P = 0.000) . The acuity measurement in children with emmetropia (k = 0.82) had a higher repeatability than in the children with myopia (k = 0.66) .Conclusions: The ETDRS visual acuity chart can provide a repeatable measure of visual acuity in children. It is recommended for clinic examination of children.
Ⅱ期人工晶状体(intraocular lens,IOL)植入常用于矫正先天性白内障摘除术后无晶状体眼状态。IOL屈光力计算是影响儿童Ⅱ期IOL植入术后视功能发育和改善的关键因素之一。现有IOL屈光力计算公式是基于成人有晶状体眼的数据研发,能准确预测成人眼IOL植入的屈光力,但是对儿童Ⅱ期IOL植入的屈光力预测准确性欠佳,主要原因包括:1)儿童II期植入术前为无晶状体眼,缺乏部分公式定义中的有晶状体眼的前房深度(是指从角膜前表面中央顶点到晶状体前表面的距离)和晶状体厚度。2)公式根据囊袋内植入IOL预测屈光力,但儿童Ⅱ期IOL睫状沟植入术在临床上应用更为广泛。当IOL植入睫状沟时有效晶状体位置发生前移,可能引起屈光预测误差。3)成人眼的发育已完成,目标屈光度多为正视或近视眼(-3.00 ~ +1.00 D),但是儿童眼仍在发育,需针对其特性测算合适的远视目标屈光度(+0.50 ~ +12.00 D)以适应眼球发育引起的屈光变化。为使Ⅱ期IOL植入患儿达到术前预设的目标屈光度,对现有公式进行选择与优化至关重要。
Secondary intraocular lens (IOL) implantation is a common treatment for pediatric aphakia. The accurate prediction of IOL power calculation plays a pivotal role in the postoperative development and improvement of visual function for pediatric secondary IOL implantation. Current IOL power calculation formulas were developed based on data from adult phakic eyes and displayed good performance in adult population. However, the formulas showed poor performance in pediatric aphakic population due to the following reasons: 1) In these pediatric aphakic patients, the unavailability of phakic anterior chamber depth (the distance from corneal epithelium to the anterior surface of the lens) and lens thickness (LT) greatly limits the application of some IOL power calculation formulas. 2) IOL power calculation formulas predict the effective lens position on the basis of in-the-bag IOL implantation, whereas sulcus implantation is more widely used in pediatric secondary implantation. Effective lens position in capsular placement is more posterior to ciliary sulcus IOL placement. When applying the initial IOL power calculated for capsular implantation to sulcus implantation, it can lead to refractive errors. 3) Adult eyes have completed their development, with target refractions often being emmetropic or myopic (-3.00 ~ +1.00 D), while pediatric eyes are still developing, necessitating the calculation of an appropriate hyperopic (+0.50 ~ +12.00 D) target refraction to accommodate refractive changes due to ocular growth.To achieve the predetermined target refractive outcomes, the selection and optimization of IOL power calculation formulas is critically important for pediatric secondary IOL implantation.
目的:建立并评估儿童Ⅱ期人工晶状体(intraocular lens,IOL)植入术后青光眼相关不良事件(glaucoma-related adverse events,GRAEs)的预测模型。方法:选取于中山大学中山眼科中心行Ⅱ期IOL植入术的无晶状体眼患儿205例(356眼),并在术后对其随访3年。采用Cox比例风险模型确定GRAEs的预测因子,并建立列线图预测模型。采用随时间变化的受试者工作特征(receiver operating characteristic,ROC)曲线、决策曲线分析、Kaplan-Meier曲线评估模型性能,并通过Bootstrapping的C指数和校准图进行内部验证。结果:行Ⅱ期IOL植入术时年龄较大(HR=1.50, 95% CI: 1.03 ~2.19)、术后一过性高眼压(HR=9.06, 95% CI: 2.97~27.67)和IOL睫状沟植入术(HR=14.55, 95% CI: 2.11~100.57)是GRAEs的危险因素(均P<0.05),并据此建立了两个列线图预测模型。在术后1、2、3年,模型1的ROC曲线下面积(area under curve,AUC)分别为0.747(95% CI: 0.776 ~0.935)、0.765 (95% CI: 0.804 ~0.936)和0.748 (95% CI: 0.736~0.918),模型2的AUC分别为0.881 (95% CI: 0.836 ~0.926)、0.895 (95% CI: 0.852 ~0.938)和0.848 (95% CI: 0.752~0.945)。在内部验证和评价中,两种模型均表现出良好的性能和临床净效益。Kaplan-Meier曲线显示两个不同的风险组在两个模型中都能被显著且稳健地区分。此外,本研究也构建了在线风险计算器。结论:两种列线图均能灵敏、准确地识别Ⅱ期IOL植入术后GRAEs的高危患儿,有助对其进行早期识别和及时干预。
Aims: To establish and evaluate predictive models for glaucoma-related adverse events (GRAEs) following secondary intraocular lens (IOL) implantation in paediatric eyes. Methods: 205 children (356 aphakic eyes) receiving secondary IOL implantation at Zhongshan Ophthalmic Center with a 3-year follow-up were enrolled. Cox proportional hazard model was used to identify predictors of GRAEs and developed nomograms. Model performance was evaluated with time-dependent receiver operating characteristic (ROC) curves, decision curve analysis, Kaplan-Meier curves and validated internally through C-statistics and calibration plot of the bootstrap samples. Results: Older age at secondary IOL implantation (HR=1.5, 95% CI: 1.03 to 2.19), transient intraocular hypertension (HR=9.06, 95% CI: 2.97 to 27.67) and ciliary sulcus implantation (HR=14.55, 95% CI: 2.11 to 100.57) were identified as risk factors for GRAEs (all p<0.05). Two nomograms were established. At postoperatively 1, 2 and 3 years, model 1 achieved area under the ROC curves (AUCs) of 0.747 (95% CI: 0.776 to 0.935), 0.765 (95% CI: 0.804 to 0.936) and 0.748 (95% CI: 0.736 to 0.918), and the AUCs of model 2 were 0.881 (95% CI: 0.836 to 0.926), 0.895 (95% CI: 0.852 to 0.938) and 0.848 (95% CI: 0.752 to 0.945). Both models demonstrated fine clinical net benefit and performance in the interval validation. The Kaplan-Meier curves showing two distinct risk groups were well discriminated and robust in both models. An online risk calculator was constructed. Conclusions: Two nomograms could sensitively and accurately identify children at high risk of GRAEs after secondary IOL implantation to help early identification and timely intervention.
目的:比较轻、中、重度近视患儿之间的视觉功能的差异,探索虚拟现实下的短期可塑训练对近视视觉功能的改善效果。方法:选择2022年6月—2022年9月就诊于苏州大学附属儿童医院的6~16岁儿童102例,按照屈光度分为正常对照组、轻度近视组和中重度近视组,进行眼科常规检查和视知觉功能检查,并进行视觉短期可塑训练。结果:近视患儿存在立体视功能缺损,近视程度与精细立体视功能损害呈正相关,各组之间比较差异具有统计学意义(P<0.05),部分患儿存在中心凹抑制。训练后,轻度近视组的中距离精细立体视功能得到改善,比较差异具有统计学意义(P<0.05)。结论:近视患儿存在立体视功能异常和中心凹抑制,且立体视功能的损害随着近视程度的增加而加重。轻度近视患儿部分精细立体视功能经过虚拟现实短期可塑训练可得到改善,而中重度近视患儿精细立体视功能改善不明显。
Objective: To compare the difference of visual function among children with myopia in different diopter, and explore the effect of short-term plastic training of virtual reality on visual function improvement. Methods: The 102 children aged 6-16 years who admitted to Children's Hospital of SoochowUniversity from June 2022 to September 2022 were recruited and divided into control group, mild myopia group and middle and high myopia group according to diopter. Routine ophthalmologic examination and visual perception function examination were carried out, and short-term plastic training was implemented. After the training, visual perception function examination was completed again. Results: There were significant differences in stereoscopic function defect at different distances among myopic children, a negative correlation between myopia and stereoscopic function was found. while there were several cases have foveal suppression. After training, the fine stereopsis at medium distance of the mild myopia group was significantly improved with significance statistical difference. Conclusions: Myopia can lead to the abnormality of stereopsis and foveal suppression in children. The defect of binocular visual function increases with the increase of myopia. Short term plastic training of virtual reality can partially improve the fine stereoscopic function of mild myopia children whileshowsnosigni ficanceimprovementof the fine stereoscopic function in middle and high myopia group.