To observe the clinical phenomenon of amblyopia vision improvement in patients with monocular amblyopia over 18 years old after non-amblyopia diseases, analyze the conditions and causes of vision improvement, explore the plasticity of the adult optic nerve, and provide a clinical basis for the treatment of adult amblyopia. A total of 74 patients with monocular amblyopia combined with non-amblyopia visual acuity decline from 2018 to 2021 were collected. The patient’s age, initial best-corrected visual acuity (BCVA), pattern visual evoked potential examination results, and visual acuity regression were recorded. The BCVA of amblyopia was recorded every 3 months using an early treatment of diabetic retinopathy study visual acuity chart. In the 3rd month, BCVA increased by 16.2%, reaching 98% in the 9th month and 100% in the 12th months. According to the age of patients, the group aged 18 to 35 years was better than the group aged 35 to 60 years, whereas the group aged 35 to 60 years was better than the group aged over 60 years (P < .05). According to the comparison of initial visual acuity, the BCVA of the < 5 letter group was lower than that of the other 2 groups (P < .05). According to the pattern visual evoked potential results, the peak time of the < 10 ms group was better than that of the 10 to 20 ms group; the 10 to 20 ms group was better than that of the > 20 ms group; the peak decrease of the < 30% group was better than that of the 30% to 50% group; and the 30% to 50% group was better than that of the > 50% group (P < .05). The visual acuity regression of amblyopia in the 0.5 to 1-year group was higher than that in the other 2 groups (P < .05). This study confirms that adult amblyopia can still be cured under certain conditions. This visual plasticity is related to age, initial visual acuity, and excitability of the visual center. This study provides new clinical evidence and diagnostic ideas for the study of the pathogenesis of adult amblyopia.

The present study aimed to observe the progression of diabetic retinopathy (DR) and compare the clinical outcomes of anti‑vascular endothelial growth factor (anti‑VEGF) therapy, laser photocoagulation and vitrectomy in a real‑world setting, to inform treatment strategies. The present prospective, observational study enrolled 371 patients (466 eyes) with DR who were followed for over 3 years at Xi'an Bright Eye Hospital (Xi'an, China). Patients received treatment with anti‑VEGF, laser, combined therapy or vitrectomy based on their clinical condition. Best‑corrected visual acuity (BCVA), central subfield thickness (CST) and incidence of complications were evaluated. The anti‑VEGF group demonstrated a significantly greater improvement in BCVA and a reduction in CST compared with the laser group. Eyes with early‑stage DR required fewer anti‑VEGF injections to achieve stability than those with advanced disease. In eyes with low vision, the anti‑VEGF group had a lower incidence of tractional retinal detachment but a higher rate of persistent macular edema compared with those in the laser group. For stages 4‑5 DR, the rate of vision improvement was similar between anti‑VEGF therapy and vitrectomy. In conclusion, anti‑VEGF therapy is generally superior to laser in improving visual and anatomical outcomes. However, treatment strategies should be individualized based on disease stage and specific complications, with anti‑VEGF favoring traction prevention and laser potentially offering better control for recurrent edema in some cases.

Rationale: Macular damage is a rare yet significant ocular complication of coronavirus disease 2019 (COVID-19) infection. This report highlights the clinical features, diagnosis, treatment, and outcomes in 2 cases of COVID-19-associated macular damage, contributing to the understanding of its pathophysiology and management. Patient concerns: Both patients presented with a sudden onset of visual impairment and black shadows in their central visual fields shortly after contracting COVID-19. Diagnoses: The first patient, a 15-year-old male, was diagnosed with acute macular neuroretinopathy, evidenced by optical coherence tomography (OCT) imaging showing high-density shadows in the macular area. The second patient, a 28-year-old female, presented with more extensive macular lesions, confirmed via fundus photography and OCT imaging. Interventions: Both patients received systemic corticosteroid therapy (oral prednisone acetate, 30 mg daily). The male patient was treated for 5 days, while the female patient underwent a 3-day treatment course. Outcomes: The male patient showed significant improvement in visual acuity, with OCT imaging revealing the resolution of high-density shadows but persistent disruption of the ellipsoid zone. The female patient demonstrated partial improvement in visual symptoms, though residual macular abnormalities remained evident on imaging. Lessons: COVID-19-associated macular damage appears to involve inflammatory and vascular mechanisms. Early systemic corticosteroid therapy may offer symptomatic relief and partially restore visual function. However, long-term monitoring is essential to address potential residual or progressive retinal damage.